Fluids Flashcards
reason for fluids
-dehydration (n.v.d)
-ileus, GI tract
-unconscious
isotonic fluids have ______ concentration
equal, same (salt and water in ICF/ECF is same)
hypotonic fluids have a ________ concentration than serum
_______ moves _______ cell
lower
water
into
hypertonic have _______ concentration than plasma
______ moves _______ cell
higher
water
out of
normal osmolality range
280-300
_____ is directly related to serum osmolality
Na+
serum osmolality directly reflects the concentration of :
-sodium
-Blood urea nitrogen
-glucose
factors increasing osmolality (7)
-dehydration
-free water loss
-DI
-hypernatremia
-hyperglycemia
-stroke or head injury
-renal tubular necrosis
factors decreasing osmolality (5)
-fluid volume excess
-SIADH
-renal failure
-hyponatremia
-overdehydration
isotonic fluids _____ where they are being infused
stay
when infusing isotonic solution, what happens to RBCs
stay the same size
isotonic solutions
-D5W
-normal saline
-LR
what is special about D5W? what pts do we use with caution?
isotonic outside body, hypotonic inside body
cells swell
diabetes (increase BG), head trauma (altered LOC)
what pts do we use NS with caution
renal or heart failure - fluid overload
what pts do we use LR with caution
-CHF
-renal insufficiency
hypotonic solutions cause cells to what? because?
swell, water floods into cell
hypotonic solutions
-0.45% NS
-0.33% NS
-0.225% NS
-2.5% dextrose in water
when would we give a hypotonic solution
hypernatremia
caution with which pts for hypotonic solutions
head trauma
diabetes (D5W)
burns
what happens to the cells with hypertonic solution? because?
cells shrink
water leaves the cells to ECF
hypertonic solutions are normally given through what?
central line, less likely to infiltrate
hypertonic solutions _____ risk of _____, stabilize _____, and regulates ________
decrease risk of edema
stabilize BP
regulate urine output
use caution in hypertonic fluids in what pts
diabetes
impaired heart or kidney function
hypertonic fluids
-D5NS
-D51/2NS
-D51/4NS
-D5LR
-D10W
colloids are used for what?
volume expansion
what to watch for with colloids
-fluid overload - neck vein distention, increased BP, resp, distress
-monitor fluid balance (I&O, VS, HR, RR)
-monitor electrolytes
signs of fluid overload
SOB, dyspnea, crackles
causes of fluid volume deficit (hypovolemia)
-vomiting
-severe dehydration
-trauma
-burns
-meds (diuretics)
s/s of hypovolemia
-DRY mucous membranes
-low BP
-high HR
-postural hypotension (fall risk)
-dark urine
nursing interventions for hypovolemia
-oral rehydration
-increase fluid intake
-IV hydration
what to do first when a pt. comes in with fluid loss
weight (baseline)
fluid volume overload - hypervolemia causes
-rapid infusion rate
-cardiac, hepatic, or renal dz
-elderly
s/s of hypervolemia
-edema
-weight gain (2lbs / day, 5lbs/week)
-crackles in lungs
-JVD
-crackles
-dyspnea , shallow resp.
-high BP
-decreased lab values
