Fluids

Question 1

reason for fluids

Answer 1

-dehydration (n.v.d)
-ileus, GI tract
-unconscious

Question 2

isotonic fluids have ______ concentration

Answer 2

equal, same (salt and water in ICF/ECF is same)

Question 3

hypotonic fluids have a ________ concentration than serum
_______ moves _______ cell

Answer 3

lower
water
into

Question 4

hypertonic have _______ concentration than plasma
______ moves _______ cell

Answer 4

higher
water
out of

Question 5

normal osmolality range

Answer 5

280-300

Question 6

_____ is directly related to serum osmolality

Answer 6

Na+

Question 7

serum osmolality directly reflects the concentration of :

Answer 7

-sodium
-Blood urea nitrogen
-glucose

Question 8

factors increasing osmolality (7)

Answer 8

-dehydration
-free water loss
-DI
-hypernatremia
-hyperglycemia
-stroke or head injury
-renal tubular necrosis

Question 9

factors decreasing osmolality (5)

Answer 9

-fluid volume excess
-SIADH
-renal failure
-hyponatremia
-overdehydration

Question 10

isotonic fluids _____ where they are being infused

Answer 10

stay

Question 11

when infusing isotonic solution, what happens to RBCs

Answer 11

stay the same size

Question 12

isotonic solutions

Answer 12

-D5W
-normal saline
-LR

Question 13

what is special about D5W? what pts do we use with caution?

Answer 13

isotonic outside body, hypotonic inside body
cells swell
diabetes (increase BG), head trauma (altered LOC)

Question 14

what pts do we use NS with caution

Answer 14

renal or heart failure - fluid overload

Question 15

what pts do we use LR with caution

Answer 15

-CHF
-renal insufficiency

Question 16

hypotonic solutions cause cells to what? because?

Answer 16

swell, water floods into cell

Question 17

hypotonic solutions

Answer 17

-0.45% NS
-0.33% NS
-0.225% NS
-2.5% dextrose in water

Question 18

when would we give a hypotonic solution

Answer 18

hypernatremia

Question 19

caution with which pts for hypotonic solutions

Answer 19

head trauma
diabetes (D5W)
burns

Question 20

what happens to the cells with hypertonic solution? because?

Answer 20

cells shrink
water leaves the cells to ECF

Question 21

hypertonic solutions are normally given through what?

Answer 21

central line, less likely to infiltrate

Question 22

hypertonic solutions _____ risk of _____, stabilize _____, and regulates ________

Answer 22

decrease risk of edema
stabilize BP
regulate urine output

Question 23

use caution in hypertonic fluids in what pts

Answer 23

diabetes
impaired heart or kidney function

Question 24

hypertonic fluids

Answer 24

-D5NS
-D51/2NS
-D51/4NS
-D5LR
-D10W

Question 25

colloids are used for what?

Answer 25

volume expansion

Question 26

what to watch for with colloids

Answer 26

-fluid overload - neck vein distention, increased BP, resp, distress -monitor fluid balance (I&O, VS, HR, RR) -monitor electrolytes

Question 27

signs of fluid overload

Answer 27

SOB, dyspnea, crackles

Question 28

causes of fluid volume deficit (hypovolemia)

Answer 28

-vomiting -severe dehydration -trauma -burns -meds (diuretics)

Question 29

s/s of hypovolemia

Answer 29

-DRY mucous membranes -low BP -high HR -postural hypotension (fall risk) -dark urine

Question 30

nursing interventions for hypovolemia

Answer 30

-oral rehydration -increase fluid intake -IV hydration

Question 31

what to do first when a pt. comes in with fluid loss

Answer 31

weight (baseline)

Question 32

fluid volume overload - hypervolemia causes

Answer 32

-rapid infusion rate -cardiac, hepatic, or renal dz -elderly

Question 33

s/s of hypervolemia

Answer 33

-edema -weight gain (2lbs / day, 5lbs/week) -crackles in lungs -JVD -crackles -dyspnea , shallow resp. -high BP -decreased lab values