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IM 2 Exam 2 > IV/ Fluids > Flashcards

IV/ Fluids Flashcards

1
Q

3 factors affecting body fluid levels

A

Age
Gender
Body Fat

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2
Q

What are the 3 Homeostatic mechanisms?

A

Filtration
Diffusion
Osmosis

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3
Q

What is filtration

A

The movement of fluid across the cell membrane due to hydrostatic pressure

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4
Q

What is diffusion?

A

The movement of solutes (substances) from higher to lower concentration

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5
Q

What is Osmosis

A

The movement of fluid from areas of more fluid to areas to less fluid

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6
Q

When hydrostatic pressure is high, what happens?

A

It pushes fluid out of the capillaries into the tissue

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7
Q

What happens when the oncotic pressure is high?

A

The fluids are pulled from the tissue into the capillaries

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8
Q

What is third spacing

A

A condition where fluid is accumulated in a pocket that isn’t serving a purpose.

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9
Q

What is Anasarca

A

A severe, generalized edema with profound swelling and accumulation of fluid in the body cavities

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10
Q

The is Edema?

A

An accumulation of interstitial fluid within the tissues

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11
Q

Where is the majority of the body’s water

A

Inside the cells

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12
Q

What are the 3 divisions of extracellular fluid

A

intravascular
Intersititial
TransCellular

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13
Q

What are some examples of transcellular fluid

A

cerebral spinal fluid, synovial fluid, pleural fluid

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14
Q

What does Osmolality and Osmolarity measure in

A

Osmolality- Kg
Osmolarity- L

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15
Q

What does a high osmolarity of urine mean

A

More concentrated urine

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16
Q

What is the effects of
Isotonic solutions
Hypotonic Solutions
Hypertonic Solutions

A

No Fluid shift
Fluid will flow into the cells
Fluid will flow out of the cells

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17
Q

What are the 7 functions of the kidneys (a Wetbed)

A

Acid/base control
Water balance control
Electrolyte control
Toxin/waste removal
Blood pressure control
Erythropoietin
D (vitamin D synthesis

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18
Q

ADH restores blood volume by

A

Reducing diuresis
Increasing water retention
Vasoconstriction

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19
Q

What is the medication form of ADH

A

Vasopressin

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20
Q

What does Angiotension2 do? (2)

A

Vasoconstriction
Stimulates Aldosterone Release

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21
Q

what does Aldosterone do

A

Increase water and sodium retention

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22
Q

What does ANP do?

A

Ultimately lowers BP
-Stops action of RAAS
-Vasodilation
-Increases secretion of Na and water

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23
Q

How do they measure ANP

A

BNP

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24
Q

What lvl of BNP is abnormal

A

> 100

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25
Q

What simulates thirst?

A

An increase of extracellular fluid?

26
Q

Where do fluids go? VPPS

A

Vomiting
Peeing
Pooping
Sweating

27
Q

What can cause Hypovolemia

A

Abnormal fluid loss
Hemorrhage
Vomitting
Diaherra
GI Suction
Deceased fluid intake
Fever
Sweating
Diuretic
Third spacing
Chronic Diesease

28
Q

What can cause Hypervolemia

A

Abnormal retention of sodium/water
Isotonic fluid overload
Heart failure
Renal failure
Liver cirrhosis

29
Q

What are S/S of Hypovolemia

A

Restlessness/confusion
Cold, clammy skin
Decreased skin turgor
Weak, rapid HR
Rapid respirations
Orthostatic hypotension
Decreased urine output

30
Q

What are S/S of Hypervolemia

A

Headache, confusion
Peripheral edema
Jugular vein distenion
Bounding pulse, Increased BP
Dyspnea, Tachypnea, crackles, pulmonary edema
Weight gain, 2 lbs over night or 5lbs during a week

31
Q

Nursing Inventions of fluid imbalances (8)

A

Assess for S/S of fluid imbalances
Give IV fluids
O2 therapy
Fall precautions
Daily weights
I&Os
Elevate swelling extremites
Encourage oral fluids when appropiate

32
Q

Treatment for Hypovolemic Shock

A

Monitor lung sounds
Monitor Vs and mental status
O2 therapy
Fluid replacement (Blood transfusion, Vasopressors)
Insertion of indwelling urinary catheters if needed

33
Q

Difference between Hypovolemia and dehydration

A

Salt and water loss Vs just water loss ( Hypernatremia)

34
Q

What are some advantages of IV therapy

A

The fastest delivery method
Correct electrolytes imbalance
Replace fluids
Transfuse blood

35
Q

What are some disadvantages of IV therapy

A

Adverse reactions
Incompatibilities
Infections
Damage
Fluid overload
Overdose
Hinderance
Potentiate electrolyte imbalances

36
Q

3 types of isotonic IV fluids

A

D5W
NS
LR

37
Q

What happens of D5W when it enters the body

A

It becomes Hypotonic

38
Q

What is the only solution that can be given with blood

A

NS

39
Q

What electrolytes are in LR

A

Potassium, sodium, chloride, calcium,

40
Q

What type of patient shouldn’t receive LR

A

anyone with renal disease

41
Q

What are some hypotonic solutions

A

1/2NS
1/3 NS
1/4 NS
D2.5w

42
Q

What are some Hypertonic solutions

A

D5 1/2 NS
D5NS
D5LR
D10W

43
Q

Sites to avoid with starting IVs (8)

A
  • Legs, ankles, and feet
  • Sclerosed or thrombosed veins
  • veins that are knotted
  • Veins below an infiltrated site or phlebitis
  • Areas of inflammation, disease, bruising , or breakdown
  • Veins of surgically compromised or injured extremities
    -Dominant hands
  • Extremities with AV shunts
44
Q

Why use a 24 g to start an IV

A

Pediatric patients
Elderly patients with fragile veins

45
Q

why use a a 20-22 g to start an IV

A

It is the most common size for adult patients

46
Q

why would you use a 18 g to start an IV (3)

A
  • Going to surgery
  • Receiving blood
    -caustic meds
47
Q

Why would you start an IV with a 14-16 g

A

Trauma or surgery

48
Q

5 Complications of IV therapy

A

-Fluid overload
- Infections
-Phlebitis
-Infiltration
-Extravasation

49
Q

What is Extravasation

A

When caustic medication infiltrate into the surrounding tissues, resulting in damaged tissues

50
Q

What four types of IV med administration

A

-Intermittent
- Continuous
- Bolus
-Push

51
Q

6 advantages of IV medications

A
  • Direct access to circulatory system
  • Instant drug action
    -Instant drug termination
    -Better control
    -Great for those with GI Tract limitation
  • Great for med that cause GI irritation
52
Q

8 Disadvantages and Complications of IV meds

A
  • Reconstitution errors
    -Venous spasm
    -Drug incompatibilities
    -Impaired drug absorption
  • Speed Shock
    -Chemical phlebitis
    -Extravasation
    -Air Embolisms
53
Q

What is speed shock

A

A systemic reaction when too much medication is administrated in too short of a period

54
Q

S/S of an air embolism

A

-dyspnea
-Tachypnea
-Lightheadedness
-palpitation
-drop in BP
-Cyanosis
-wheezes
-weakness

55
Q

Nursing intervention for air embolisms

A

Call for help
Position patient in left side trendelenburg
Administer o2
Monitor vital signs
-have emergency equipment ready

56
Q

S/S for extravasation (4)

A

-Pain or burning at IV site
- Skin tightness at site
- Blanching and coolness of skin
-Dependent edema

57
Q

Prevention of Extravasation

A
  • Dilute meds as recommended
    -avoid use of high pressure pumps
    -Assess & monitor IV sites
  • Teach patient what to report
58
Q

Causes of venous spasm

A

-viscous solution
-Too rapid administration
-Cold or irritating solutions

59
Q

Symptoms of venous spasm

A

-sharp pain at the IV site
-Pain radiating up the arm with the IV site

60
Q

Ways to prevent venous spasm

A

-properly dilute med
-Admin meds at room temp
-Restart IV
Consider a warm compress during an infusion

61
Q

Causes of phlebitis

A

-too rapid infusion
-presence of particulates matter in solution
-improper dilution or reconstitutaion
-administration of irritating meds

62
Q

Ways to prevent phlebitis

A

-use an in-line filter for meds that do not reconstitute
- increase volume of diluation
-use a CVAD or a larger vein
-Slow the rate of the infusion down
-restart any questionable IVs

IM 2 Exam 2 (2 decks)

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