Iv And Fluid Administration

Question 1

What is the measurement for electrolytes?

Answer 1

Millimole (mmol)

1 mmol of any cation is able to react completely with 1 mmol of any anion

Question 2

Dehydration

Answer 2

Inadequate total systemic fluid volume

Dehydration happens over a period of time, so must be corrected slowly (Ie., don’t use too much fluid)

Question 3

Overhydration

Answer 3

Total systemic fluid volume increases

Question 4

Colloids

Answer 4

Expands plasma volume by drawing fluid from interstitial space into vascular compartments (eg., Albumin, pentaspan)
Used for hypovolemic states
Forms a suspension (does not dissolve)
Water crosses the membrane through osmosis to equalize concentrations
* use of colloids drastically reducing because of unexplained renal failure/mortality

Question 5

Crystalloid

Answer 5

A solution that dissolves. Molecules or atoms separate and disperse completely and equally through the solvent
- dissolved molecules cross the membrane through osmosis to equalize unequal concentrations

Question 6

What are crystalloid solutions used for?

Answer 6

• Isotonic, hypotonic, and hypertonic
• Electrolyte replacement
• As a route for medication
• Short-term intravascular volume expansion

Question 7

What does an isotonic solution do?

Answer 7

Increases volume in the intravascular compartment without moving fluid to or from other compartments (eg., normal saline 0.9%, Ringer’s Lactate)

• fluids that have equal osmotic pressure with the body under normal conditions
• same concentration of sodium concentration as body water

Do not overload fluids; causes heart failure, renal impairment, hypertension

Question 8

What is the 3 to 1 rule for isotonic solutions?

Answer 8

3 mL of isotonic crystalloid solution is needed to replace 1 mL of a patient’s blood

Question 9

How much IV fluid is lost in one hour?

Answer 9

2/3 of infused IV fluid will leave the vascular space in 1 hour

Question 10

How does a crystalloid replace patient’s blood?

Answer 10

Crystalloid solution cannot carry oxygen, but works by diluting remaining blood volume and proportional hemoglobin

Question 11

Electrolytes

Answer 11

Salts dissolved in water with the potential to conduct electricity

• sodium most prominent in blood and interstitial fluid
• potassium is most prominent in body cells

Question 12

How much of a crystalloid is required to compensate for loss of blood?

Answer 12

At least three times the amount of blood lost

- because of large volume of IV fluid distribution, fluids shift or leak out of the vascular space

Question 13

Autoresuscitate

Answer 13

Body responds to blood loss by shifting fluid from the intracelluar and interstitial space into the vascular system
- Cells can become dehydrated, causing malfunction and organ failure

Question 14

Hypotonic

Answer 14

Fluids have LESS osmotic pressure than the body

Question 15

Hypertonic

Answer 15

Fluids have GREATER than normal osmotic pressure than the body

Question 16

How much fluid is in a typical fluid bolus for adults?

Answer 16

Typical fluid bolus is 1000 mL (1 L)

- usually given through a 14 or 16 gauge IV

Question 17

Hyperkalemia

Answer 17

Elevated levels of potassium that can be life-threatening. Patient presents with:
- renal failure
- nausea
- abdo pain
- diarrhea
- leads to cardiac arrest if not treated
Caused by burns, crush injuries, diabetic ketoacidosis, severe infection

Question 18

Hypokalemia

Answer 18

Low serum concentrations of potassium (rarely diagnosable without lab tests)
Patient presents with:
- muscle weakness
- abdo distension
- constipation
Caused by low dietary intake of K+, diuretic therapy, diarrhea, vomiting, burns

Question 19

Hypocalcemia

Answer 19

Low levels of calcium in the blood

Signs and symptoms: irritability, twitching and tetany, convulsions, parenthesis, abdo and muscle cramps, neural excitability

Causes: sepsis, inadequate vitamin D, pancreatitis, parathyroid disease

Question 20

Hypercalemia

Answer 20

High levels of calcium in the blood

Signs/symptoms: weakness, irritability, dehydration, headache, hypertension, renal stones

Causes: cancer, parathyroid disease, overactivity

Question 21

Drop factor

Answer 21

The number of drops in the chamber required to administer 1 mL of fluid

• microdrip = 60 gtt/mL
• macrodrip = 10, 12, 15, 20 gtt/mL

Question 22

To keep vein open (TKO)

Answer 22

IV to keep vein open, usually run with a microdrip set at 30-50 gtt/mL

Question 23

IV piggyback

Answer 23

Infusions that are secondary infusions attached the primary infusion line

Rather than directly injecting the medication into the line as an IV push, the medication is added to a smaller bag of IV fluid and slowly infused through the medication port of the main IV line

Question 24

Infiltration (complication of IV)

Answer 24

When the tip of the catheter dislodges from the lumen of the vein. Fluid or medication goes into soft tissues surrounding vein and can cause tissue destruction/necrosis

Question 25

Catheter shear (IV complication)

Answer 25

When a segment of the catheter breaks off and is regained in the vein or embolizes through the venous system

Question 26

Phlebitis (IV complication)

Answer 26

Inflammation of the vein

- pain, redness, edema

Question 27

Thrombophlebitis (IV complication)

Answer 27

Inflammation of vein causes blood inside the lumen to clot

Suppurative thrombophlebitis occurs when clot becomes infected. Can be fatal