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MS_Primers for Exam 3 Content > Fluids Primer > Flashcards

Fluids Primer Flashcards

1
Q

True or False

Water follows the solutes in a solution.

A

True

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2
Q

Solutes in a fluid =

A

• Osmolarity of the fluid

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3
Q

High osmolarity is…

A
  • Large solute % in fluid

* AKA: hypertonic

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4
Q

Low osmolarity is…

A
  • Small solute % in fluid

* AKA: Hypotonic

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5
Q

A hypertonic solution draws water out of ______ and into _____.

A
  • The cells

* Extracellular space

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6
Q

A hypotonic solution draws water out of _____ and into _____.

A
  • Extracellular space

* Into the cell

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7
Q

Define an isotonic solution.

A

• Both extracellular and intracellular fluids have the same osmolarity so there is no water movement between them

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8
Q

Crystalloid solutions are generally used for…

A

• Fluid resuscitation

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9
Q

Colloid solutions are generally used for…

A

• Volume expansion in the intravascular space

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10
Q

What some conditions where an isotonic 0.9% Normal Saline solution may be given?

A
  • Dehydration
  • Hypovolemia (absolute)
  • Hemorrhage
  • Sepsis
  • Shock
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11
Q

What some conditions where an isotonic Lacted Ringers solution may be given?

A
  • Burns and trauma
  • Acute blood loss
  • Hypovolemia (relative)
  • Electrolyte imbalance
  • Metabolic acidosis
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12
Q

Why is 0.9%NS used with caution or sometimes avoided for pts with cardiac or renal comprise?

A

• Because the sodium in the solution may cause fluid retention or volume overload

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13
Q

What is the only fluid used in conjunction with blood product administration?

A

• 0.9%NS

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14
Q

Dextrose (D5W) is an intravenous _____ solution.

A

• Sugar

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15
Q

Explain the tonicity of D5W.

A
  • It is both an isotonic and hypotonic solution
  • Initially hypotonic, D5 dilutes the osmolarity of the extracellular fluid.
  • Once the cells have absorbed the dextrose, the remaining water and electrolytes become an isotonic solution
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16
Q

Why should D5 not be used as the sole treatment of fluid volume deficit?

A

• Because it dilutes plasma electrolyte concentrations

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17
Q

D5W is contraindicated for what scenarios?

A
  • Resuscitation
  • Early post-op recovery
  • Cardiac and renal conditions
  • Any case of suspected increased ICP
18
Q

True or False

D5W can be administered for hypernatremia

A

• True

19
Q

0.45% NS may be used to treat _____ and _____.

A
  • Hypernatremia

* Diabetic ketoacidosis

20
Q

For what conditions is 0.45% NS contraindicated? Why?

A
  • Burns
  • Trauma
  • Liver disease
  • Why: Because it depletes intravascular fluid volumes.
21
Q

Infusing 0.45% NS too quickly can cause…

A

• Hemolysis of RBCs

22
Q

Before administering fluids, what should be documented?

A
  • Vital signs
  • Edema status
  • Lung and heart sounds
23
Q

Hypotonic solutions may exacerbate existing _____ and ______ causing _____.

A
  • Hypovolemia
  • Hypotension
  • Cardiovascular collapse
24
Q

Why are hypotonic solutions contraindicated for conditions with ICP?

A

• The fluid shift makes the cells bigger and increases ICP

25
Q

What is the tonicity of D10W, D20W and D50W?

A

• They are all hypertonic

26
Q

When administering hypertonic solutions, we need to watch for signs of _____.

A

• Hypervolemia

27
Q

Hypertonic solutions should be administered only in high acuity areas with…

A

• Constant nursing surveillance for potential complications

28
Q

True or False

Patients with or heart disease and those who are dehydrated should not receive hypertonic IV fluids.

A

• True

29
Q

True or False

Hypertonic dextrose solutions should not be administered peripherally

A

• True, they can cause irritation and damage to the blood vessel and should be administered through a central vascular access device inserted into a central vein.

30
Q

Hypertonic dextrose solutions will have to be used with caution for patients with…

A
  • Diabetes Mellitus

* Monitor blood glucose closely

31
Q

3% and 5% NaCl are used for…

A
  • The acute treatment of sodium deficiency

* When serum osmolality has decreased to critically low levels

32
Q

True or False

3% and 5% NaCl can be used in pts with cerebral edema.

A

• True

33
Q

What are colloid fluids?

A
  • Fluids with large molecules that are unable to pass through semipermeable membranes and remain in the blood vessels.
  • They also draw fluid from the interstitial space and increase intravascular volume
34
Q

Why may a colloid solution be used as opposed to a crystalloid?

A
  • Colloids don’t require as much volume to increase intravascular pressure as crystalloids
  • As such, a colloid solution would be indicated for a pt that cannot tolerate large fluid volumes
35
Q

Two common colloids are…

A
  • Albumin

* Hespan

36
Q

5% Albumin is commonly used to…

A

• increase the circulating volume and restore protein levels in conditions such as burns and pancreatitis and plasma loss through trauma.

37
Q

25% Albumin is used together with sodium and water restriction to reduce…

A

• excessive edema

38
Q

The use of albumin is contraindicated in patients with the following conditions:

A
  • Severe anemia
  • Heart failure
  • Known sensitivity to albumin.
39
Q

Angiotensin-converting enzyme (ACE) inhibitors should be withheld for at least 24 hours before administering _____ because of the risk of atypical reactions, such as _____ and _____.

A
  • Albumin

* Hypotension and flushing

40
Q

True or False

A small bore needle is needed when administering colloid solutions.

A

• False, a large 18 gauge needle should be used

41
Q

What adverse reactions need to be monitored for when administering colloids?

A
  • Hypervolemia
  • Hypertension
  • Dyspnea
  • Crackles in the lungs
  • Edema.

MS_Primers for Exam 3 Content (13 decks)

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