Fluids pt. 2 Flashcards
Define Isotonic
Same osmolality as body fluids
What kind of fluids are often indicated for ECV replacement to prevent/treat ECV deficit?
Sodium-containing isotonic solutions such as Normal Saline
Define Hypotonic
Lower Osmolality than body fluids
-Less concentrated
-Dilutes body fluids
-Moves water into cells
-Makes cells swell
Define Hypertonic
Higher Osmolality than body fluids
-More concentrated
-Increases osmolality rapidly and pulls water out of cells
-Makes cells shrivel
Explain if the following are isotonic, hypertonic, or hypotonic
DEXTROSE (Glucose) in water:
Dextrose 5% in water (D5W)
Dextrose 10% in water (D10W)
Isotonic
Hypertonic
Explain if the following are isotonic, hypertonic, or hypotonic:
SALINES (NaCl in water):
0.225% NaCl (1/4 NS)
0.45% NaCl (1/2 NS)
0.9% NaCl (NS)
3% or 5% NaCl
Hypotonic
Hypotonic
Isotonic
Hypertonic
Explain if the following are isotonic, hypertonic, or hypotonic:
DEXTROSE in salines:
Dextrose 5% in 0.45% NaCl
Dextrose 5% in 0.9% NaCl
Hypertonic
Hypertonic
When should isotonic Iv fluids be used?
When should hypertonic IV fluids be used?
ECV deficit
Brain swelling (hypertonic fluid will cause cells to shrink)
When should hypotonic IV fluids be used?
Hypernatremia: causes dehydrated, shrunken cells
Hypotonic IV fluids dilutes the ECF and rehydrates cells
Who can O+ receive blood from?
Who can A+ receive blood from?
Who can B+ receive blood from?
Who can AB+ receive blood from?
O+, O-
A+, A-, O+, O-
B+, B-, O+, O-
Universal recipient
Who can O- receive blood from?
Who can A- receive blood from?
Who can B- receive blood from?
Who can AB- receive blood from?
O-
A-, O-
B-, O-
AB-, O-, A-, B-
What must be acquired before a patient can receive a blood transfusion?
Informed consent
What must be done before a patient receives a blood transfusion?
Pretransfusion Assessments
Establish vitals vaseline, assess any condition that may increase risk of reaction/fluid overload
What are the appropriate gauges for blood transfusions in different ages/situations?
Adults: 20-24 gauge
Rapid Infusion: 18-20
Children: 22-24
How do you find out the transfusion rate for a blood transfusion?
What is the max length of a blood transfusion?
Provider order/facility policy
4 hours
What kind of tubing does a blood transfusion require?
Filter
What other fluid is the only thing you can use to flush the IV line after a blood transfusion?
Normal Saline
How many RNs need to check the blood infusion?
2
What should you do after beginning a blood transfusion?
Stay with the patient for 15 mins to assess, then increase the rate after 15 minutes
What are some important lab values regarding blood and transfusion?
Hemoglobin and Hematocrit
(Hbg and Hct)
What are the steps you take after noticing a blood transfusion reaction?
Stop transfusion
Administer 0.9% NaCl to maintain IV
Notify provider
Treat symptoms
Keep blood so that the blood bank can conduct testing
