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IM2 > Fluids And Iv Therapy > Flashcards

Fluids And Iv Therapy Flashcards

1
Q

How much of your fluid in the body is water

A

60%

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2
Q

What affects the fluids

A

Age
Gender
Body fat

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3
Q

Where do solutes move for diffusion

A

Move from area of higher concentration to area with lower concentration
This results in equal distribution

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4
Q

Where do fluids move for osmosis

A

Moves from areas with lower solute concentration to areas with higher concentration

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5
Q

What does hydrostatic push out of the capillaries

A

Pushes fluid out

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6
Q

What organ produces hydrostatics

A

The heart

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7
Q

What does oncotic movement mean

A

Means fluid is being pulled out of the capillaries

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8
Q

What exerts oncotic pressure

A

Exerted by non-diffusible plasma proteins such as albumin

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9
Q

What is third spacing

A

Condition where fluid accumulates in a pocket that is not serving a purpose

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10
Q

What is anasarca

A

Severe, generalized edema marked by profound swelling of sub-q tissues and accumulation of fluid in body cavities

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11
Q

Where is icf

A

Fluid in cells

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12
Q

Where is the ECF

A

Fluid outside the cell’s:
Intravascular
Interstitial
Transcellular

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13
Q

What is the name for the isotonic fluid concentration

A

Normal saline(0.9%NaCl)

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14
Q

Normal saline= isotonic due to?

A

The same concentration of sodium in the blood

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15
Q

What is the hypotonic fluid concentration

A

1/2 normal saline

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16
Q

What happens to the cells when we give 1/2 n.s.

A

The cells swell

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17
Q

What is the fluid concentration for a hypertonic solution

A

D5 n.s.

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18
Q

What happens to the cells when hypertonic solution is introduced

A

Fluid is pulled from the cells so they shrink

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19
Q

What helps maintain fluid balance

A

Kidneys
ADH
Renin-Angiotensin-Aldosterone System (RAAS)
Aldosterone
Atrial natriuretic peptide
Thirst

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20
Q

What are the 7 functions of the kidneys

A

A-controlling ACID-base balance
W-controlling WATER balance
E- maintaining ELECTROLYTE balance
T-removing TOXINS and waste products from the body
B- controlling BLOOD PRESSURE
E- producing the hormone ERYTHROPOIETIN
D- activating vitamin D

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21
Q

How does ADH restore blood volume

A

Reducing diuresis
Increasing water retention
Vasoconstricts

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22
Q

What happens as the ECF decreases

A

Renin acts to produce angiotensin

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23
Q

What happens after renin produces angiotensin

A

Angiotensin 1 is produced which converts into angiotensin 2 which equals massive vasoconstriction

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24
Q

What does A2 stimulate the release of

A

Release of aldosterone

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25
Q

What is retained after this release of aldosterone

A

Retention of sodium and water

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26
Q

Aldosterone does what to water

A

Regulates water

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27
Q

What does aldosterone cause the kidneys to retain

A

Na and water

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28
Q

What causes aldosterone to be released

A

If Na is too low and k+ is high

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29
Q

Where is atrial natriuertic peptide produced and stored

A

In the atria

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30
Q

What does ANP stop

A

Stops action of RAAS

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31
Q

How does ANP decrease bp

A

By vasodilation

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32
Q

How does ANP reduce fluid volume

A

By increasing the secretion of Na+ and water

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33
Q

Thirst is regulated by

A

Hypothalamus

34
Q

Thirst is stimulated by

A

Increase in ECF and drying of mucous membranes

35
Q

What depletes electrolytes (VPPS)

A

Vomiting
Peeing
Pooping
Sweating

36
Q

What causes hypovolemia

A

Deficit of isotonic fluid in ECF
Diuretics
Third spacing
Chronic diseases

37
Q

What causes fluid deficit of isotonic fluid in ECF

A

Abnormal:
Fluidloss
Fever
Hemorrhage
Vomiting
Diarrhea
GI suction
Decreased fluid intake

38
Q

What causes an excess of isotonic fluid in the ECF

A

Abnormal retention of water and sodium in about same proportions which they normally exist in ECF

39
Q

Hypervolemia can cause

A

Isotonic fluid overload
Excess sodium intake
Heart failure, renal failure, liver cirrhosis

40
Q

What are some signs of fluid deficit

A

Restlessness
Cold clammy skin
Decreased skin turgor
Weave, rapid heart rate
Rapid respirations
Orthostatic hypotension
Decreased urine output

41
Q

What are some signs of fluid excess

A

Headache
Confusion
Peripheral edema
Jugular vein distention
S3 heart sound
Bounding pulse, increased bp
Dyspnea, tachycardia, crackles, pulmonary edema
Weight gain

42
Q

How can we manage hypervolemia

A

Asses for s/s of fluid imbalance
Give iv fluids and meds as orders
O2 as ordered
Fall precautions
Daily wts
Accurate I&o
Eval edematous extremities
Encourage oral fluids when appropriate

43
Q

What are the advantages of iv therapy

A

Replace fluid
Transfuse blood
Deliver meds
Correct electrolyte imbalances

44
Q

What are the disadvantages of iv therapy

A

Adverse reactions
Incompatibilities
Infections
Damage
Fluid overload
Overdose
Hindrance
Potential electrolyte imbalances

45
Q

Isotonic iv solutions

A

D5W - 5% Dextrose in water
NS - 0.9% Sodium Chloride
LR -Lactated Ringers

46
Q

Hypotonic iv solutions

A

1/2 NS-0.45% Sodium chloride
1/3 NS-0.33% Sodium chloride
1/4 NS-0.25% Sodium chloride
D2.5W-2.5% Dextrose in Water

47
Q

Hypertonic solutions

A

D5 1/2 NS - 5% Dextrose 0.45% Sodium chloride
D5NS - 5% Dextrose 0.9% sodium chloride
D5LR - 5% Dextrose Lactated Ringers
D10W -10% Dextrose in Water

48
Q

Where do we start looking for an iv site

A

Start lower (around hand) then work up if unable to stick hand

49
Q

When starting a non-trauma iv what vein is our last option

A

The AC

50
Q

Where are iv sites to avoid

A

Legs, ankles, and feet
Sclerosed or thromboses veins
Veins that are knotted or tortuous
Veins below an infiltrated site ov areas of phlebitis
Areas of inflammation, disease, bruising, or breakdown
Veins of surgically compromised or injured extremities
Dominant hands (if possible) and extremities with AV shunts

51
Q

What considerations should we use when selecting a vein

A

Condition of vein
Reason for iv
What solutions/ meds will be used

52
Q

What should we do before sticking

A

Palpate the vein

53
Q

Suitable veins should be

A

Round
Firm
Elastic

54
Q

What are 14g or 16 g good for

A

Trauma
Surgery
Needing rapid infusion

55
Q

What is an 18g good for

A

Surgery
Receiving blood or caustic meds

56
Q

What is the most common needle size for adults

A

20g or 22g

57
Q

What is the most common needle for peds or adults with small and fragile veins

A

24g

58
Q

What are complications of iv therapy

A

Fluid overload
Infection
Phlebitis
Infiltration
Extraversation

59
Q

What are the methods of iv admin

A

Intermittent
Continuous
Bolus
Push

60
Q

What are intermittent iv meds

A

Meds on scheduled dose daily or several times per day

61
Q

What are continuous iv meds

A

iv solutions continuously

62
Q

What are bolus iv meds

A

Specified amount of solution to be admin in a specific time frame

63
Q

What are push iv meds

A

Specified amount of med to be admin in a specific time frame

64
Q

What are the nurses responsibilities with iv sites

A

Assess site
Know the meds
Assess for adverse affects
Teach pt

65
Q

What causes an air embolism

A

Solutions run dry
Air in line
Loose connections
Improper removal of CVAD
Poor technique with dressing or tubing changes

66
Q

What are s/s of an air embolism

A

Dyspnea
Tachypnea
Lightheadedness
Palpations
Drop in bp
Weakness
Cyanosis
Expiratory wheezes

67
Q

What are the nurses interventions when they know there is an air embolism

A

Call for help
Position pt in trendelenburg on their left side
Admin o2
Monitor vitals
Have crash cart

68
Q

What are s/s of extravasation

A

Pain or burning @ iv site
Skin lightness @sight
Blanching and coolness of skin
Dependent edema

69
Q

How can we prevent extravasation

A

Dilute meds as recommended
Avoid use of high pressure pumps
Assess and monitor iv site
Reach pt what to report

70
Q

What causes a venous spasm

A

Viscous solutions
Too rapid admin
Cold or irritating solutions

71
Q

What are symps of a venous spasm

A

Sharp pain@ iv sight
Pain radiating up the arm with the iv site

72
Q

How can we prevent venous spasm

A

Dilute meds as recommended
Admin solutions and meds @room temp
Admin @recommended rate
Restart questionable ivs
Consider a warm compress during infusion

73
Q

How do access med vials

A

Nurse uses syringe and blunt fill needle

74
Q

How long do we clean the lumen after removing the cap and before administering the med

A

15 secs

75
Q

What do we do after cleaning the lumen

A

Purge air from flush
Attach syringe

76
Q

How many mLs do we flush line

A

9mL

77
Q

What do we do after flushing line

A

Clean access
Then do med admin

78
Q

After giving iv push med, how are we supposed to flush the line

A

Flush slowly for 2-3mL then vigorously for the rest of the flush

79
Q

After removing post flesh for iv push med do we do

A

Clamp lumen
Attach new green cap

80
Q

What is our drops per min for gravity infusion formula

A

Total volume x drop factor/ time in mins =gtts/min
mL x gtts/min = gtts/min

IM2 (17 decks)

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