Fluids Flashcards by Bethany Au

What are some output methods of body fluids?

Kidneys
Lungs
Feces
Sweat Skin

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Define filtration

Movement of water and solutes together between vascular and interstitial compartments because of hydrostatic and osmotic pressure

water/solutes move from higher net pressure to lower net pressure

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Define osmosis

Passive transport of water between fluid compartments moving from an area of lower solute concentration to an area of higher solute concentration until equilibrium is achieved

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Define osmolality

The concentration of solutes in body fluids

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What are the 3 factors affecting fluid balance?

Fluid intake
Fluid distribution
Fluid output

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Explain hypovolemia

ECF Volume DEFICIT

body fluids have decreased volume but have normal osmolarity

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What can hypovolemia be caused by?

diarrhea, vomiting, sweating, kidney problems, decreased fluid intake

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What are some physical assessment signs of hypovolemia?

Tented skin
Dry lips/skin
low BP
tachycardia
lightheaded/dizzy upon standing
dark, concentrated urine

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What are some risk factors for hypovolemia?

Very young/old

those working in the heat

GI bugs

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Explain hypervolemia

ECF Volume EXCESS

body fluids have increased volume but have normal osmolarity

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What can hypervolemia be caused by?

Eating lots of salty foods (draws water out of cells)

pregnancy

heart failure

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What are some physical assessment signs of hypervolemia?

swollen tissue
leg edema
high BP
pulse force 3+/4+

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What kind of medications may cause hypovolemia?

Diuretics- increase urination

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How does a recent surgery affect ECF volume?

Being NPO before surgery

Blood loss

Appetite decreased during recovery

physiological stress causes the body to retain fluids

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How can the following affect ECF volume?

Fever
Burns

Fever: losing fluids-hypovolemia

Burns: cells explode, fluid loss-hypovolemia

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How is perfusion affected and assessed in a hypovolemic patient?

Capillary refill above 3 seconds suggests poor perfusion

What are some ways that fluid volume is assessed?

Calculating Intake and Output (I&O)

Daily weights (same time, clothes)

Tenting for skin turgor

Capillary refil

Urine output

When assessing I&O, when is someone at hypervolemic risk?

When there is a Net+ of 2000mL

(2000mL intaken MORE than output)

What kind of fluid output is insensible (nonmeasurable)?

Skin and lungs

Define:
VAD

Vascular access devices
(IV access)

Explain peripheral IVs

VAD
-usually in the hand/arm
-short catheter
-lasts a couple of days

Explain Central Venous Catheters (CVC)
What are the 2 types?

VAD in which the catheter tip lies close to the heart in the central circulatory system, such as in the superior vena cava

PICC: Peripheral Inserted Central Catheter
-Upper inserted in upper arm
-Catheter reaches heart

“Port”: IVAD: Implanted Vascular Access Device
-surgically placed in chest
-Line goes into vein and then to heart (superior vena cava)
-chemotherapy/long term use

List the IV catheter sizes

14G
16G
18G
20G
22G
24G (smallest/shortest)

Where do you find the infusion rate?

How do you set the infusion rate?

How should you manage tubing and dressing?

In the medication order

Pump

Change tubing and soiled dressing regularly to prevent infection

Explain phlebitis Symptoms? How do you handle it?

Inflammation/irritation of the inner layer of a vein -heat, erythema, tenderness Stop infusion, assess, start a new line, warm moist compress, elevate extremity

Explain the difference between discontinuing an IV and stopping infusion

Discontinuing an IV: taking entire IV out Stopping infusion: turning off whatever is going through the IV

Explain Infiltration symptoms? How do you handle it?

IV fluid has entered subcutaneous tissue around venipuncture site coolness, paleness, swelling Stop infusion, assess, discontinue, elevate extremity, warm moist or cool compress

Can an IV presenting phlebitis be saved? Can an IV presenting Infiltration be saved?

Unsure NO

Explain Extravasation How should it be prevented?

A vesicant drug (tissue-damaging) drug has infiltrated the IV site and entered the surrounding tissues Not good Assess IV more often if the patient is receiving an IV vesicant drug

List the 3 methods of intravenous med. administration

1. Infusion of large volume of IV fluid 2. Injection of a bolus/small volume of med. through an existing IV infusion line (IV Push) 3. "Piggyback" Infusion of a solution containing the prescribed medication and a small volume of IV fluid through an existing IV line

Explain the difference between Continuous IV fluids and saline locks

Continuous IV fluids: actively attached and pumping Saline locked: short tube, nothing attached, last thing pushed through was saline

How should an incompatible drug be given?

Must flush the line with 10mL saline before and after medication administration

When is incompatibility not a problem?

If the IV is saline locked

What is "piggyback" also known as? Explain it

Secondary Infusion A small IV bag/bottle is connected to a short tubing line that links up with the upper Y-port of a primary infusion line or to an intermittent venous access

What are the steps if there are continuous fluids present and you need to give an incompatible drug?

10 mL flush Medication 10 mL flush -flush the same volume of saline as the medication at the same rate, then slow and steady until remaining saline is done

What are the steps if there are continuous fluids running and you need to give a compatible drug?

Give medication- no flush needed!

What are the steps if there is no continuous fluids running and you need to give a medication?

Give via Saline Lock 2-3 mL flush Medication 2-3 mL flush -flush the same volume as the med at the same rate, then slow and steady until remaining saline is done- ensure at least 2 mL of saline are given total regardless of med. dose

What safety measure should be done EVERY time you access the line with a syringe?

Clean the hub with an alcohol swab for at least 15 seconds every time