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Clinical Skills > IV Fluid/ Drug Administration > Flashcards

IV Fluid/ Drug Administration Flashcards

1
Q

What is the normal range of sodium ions?

A

135-145mmol/L

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2
Q

What are some common causes of hyponatraemia?

A 
Hypovolaemic causes (loss of fluid and sodium together): 
-	Extra-renal loss= diarrhoea, vomiting, burns. 
-	Renal loss = thiazide diuretics 
Euvolaemic causes:
-	SIADH
-	Severe polydipsia 
Hypervolaemic causes:
-	Heart failure 
-	Renal failure
-	Liver failure
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3
Q

What are some common causes of hypernatraemia?

A
  • Poor fluid intake
  • Excessive fluid output – dehydration, diarrhoea, vomiting, DI
  • Excessive salt administration
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4
Q

What is the normal range for potassium ions?

A

3.5-5.3 mmol/L

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5
Q

What are some common causes of hypokalaemia?

A
  • Diuretics – non potassium-sparing
  • Poor dietary intake
  • Diarrhoea and vomiting
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6
Q

What are some common causes of hyperkalaemia?

A
  • Potassium-sparing diuretics
  • CKD
  • Trauma and burns
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7
Q

What is the normal range for calcium ions?

A

2.2-2.6 mmol/L

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8
Q

What are some common causes of hypocalcaemia?

A
  • Vit D deficiency

- PTH deficiency

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9
Q

What are some common causes of hypercalcaemia?

A
  • Hyperparathyroidism
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10
Q

What is the normal range for phosphate ions?

A

0.8-1.5 mmol/L

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11
Q

What are some common causes of hypophospataemia?

A
  • DKA
  • CKD
  • Malnutrition
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12
Q

What are some common causes of hyperphospataemia?

A
  • Burns

- Trauma

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13
Q

What is the normal range for magnesium ions?

A

0.7-1.0 mmol/L

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14
Q

What are some common causes of hypomagnesaemia?

A
  • Malnutrition

- Alcoholism

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15
Q

What are some common causes of hypermagnesaemia?

A
  • Renal failure

- Hypothyroidism

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16
Q

What is the normal range for chloride ions?

A

95-108 mmol/L

17
Q

What are some common causes of hypochloraemia?

A
  • Sweating

- Renal disease

18
Q

What are some common causes of hyperchloraemia?

A
  • Diarrhoea

- Hypernatraemia

19
Q

What is the difference between sensible and insensible fluid losses?

A

Sensible fluid losses can be measured e.g. urine output, diarrhoea
Insensible fluid losses cannot be measured - estimated between 5-800ml/day depending on resp rate and temp.

20
Q

What are the different compartments of water in the body?

A 
Intracellular fluid = 2/3 (28L) 
Extracellular fluid =1/3 (14L):
-	Interstitial fluid = ¾ (10.5L)
-	Intravascular fluid = ¼ (3L)
-	Transcellular fluid (CSF, lymph, synovial fluid) = 0.5L
21
Q

How does fluid move with regards to hypotonic solutions?

A

Fluid will move out of the hypotonic solution, across the semi-permeable membrane to the other solution to maintain equilibrium.

22
Q

How does fluid move with regards to hypertonic solutions?

A

Fluid will move into the hypertonic solution across the semi-permeable membrane from the other solution to maintain equilibrium.

23
Q

Name some different types of crystalloid?

A
  • Isotonic (same tonicity as ICF) = 0.9% Saline, Harttmans, 5% dextrose – no movement of water across compartments
  • Hypotonic (less tonicity than ICF) = NaCL 0.45%, Dextrose 2.5% - draws water into the cells
  • Hypertonic (more tonicity than ICF) = 10% Dextrose, 4.5% NaCl – draws water out of the cells
24
Q

How do colloids work?

A

Colloids contain large molecules that do not cross the semi-permeable membrane and so remain in the intravascular space, allowing them to draw water into the bloodstream– plasma expanders.

25
Q

When are colloids used? Give some examples…

A

Colloids are used to increase patient’s circulating blood volume, when crystalloids have not worked.

  • Albumin 20%
  • Volulyte
  • Dextran
  • Blood products e.g. FFP, platelets, packed red cells
26
Q

What are three indicative signs of anaphylaxis?

A
  1. Acute onset of illness
  2. Life threatening A,B,C problems
  3. Skin changes e.g. urticaria
27
Q

What are two things you can do before medical management for anaphylaxis?

A
  • Lie patient flat

- Raise patient legs

28
Q

When equipment is available, what is the treatment protocol for anaphylaxis?

A
  • High flow O2
  • IV fluid challenge – 0.5-1.0L 0.9% NaCl
  • Adrenaline (1 in 1000) 0.5ml IM
  • Chlorphenamine 10mg
  • Hydrocortisone 200mg
29
Q

What are the pre procedure checks before administering IV drugs?

A
  • Check formulation, dose and diluent
  • Rate of administration
  • Patient allergies
  • Check venous access site is appropriate
  • Packaging intact and within expiry date
  • Calculate volume of medicine solution needed
  • Check blood test results to maintain therapeutic levels
  • Any special requirements
30
Q

When is the patient most likely to have an adverse reaction from IV drug?

A

First 20-30 mins

Clinical Skills (5 decks)

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