IV fluids Flashcards
what are the names of normal saline?
0.9% Normal saline
0.9% NS
0.9% NaCl
ns
What does D5W start as and then turn into
starts as isotonic and then changes to hypotonic when dextrose is metabolized
3 types of isotonic fluids
- normal saline
- Lactated ringer’s solution
- 5% dextrose in Water
what does lactated ringer’s solution contain?
LR
- water
- sodium
- potassium
- calcium
- chloride
- lactate
what are the two types of hypotonic fluids
- 0.45% normal saline
- D5W after its metabolized
what are the three names of hypotonic normal saline
- 0.45% ns
- 0.45% NaCl
- 1/2 NS
what are the 4 types of hypertonic fluids
- 3% normal saline
- 5% Dextrose + 0.45% NS
- 5% dextrose and lactated ringer
- 10% dextrose in water
names for 5% dextrose + 0.45% normal saline
- D5 0.45% NS
- D5 0.45% NaCl
- D5 1/2 NS
D5LR
5% dextrose and lactated ringer
D10W
10% dextrose with water
How is a bolus IV given
rapidly
wide open line
over 15 minutes or less
when is a bolus IV indicated
- dehydration
- hypotension
- shock
- active bleeding + unstable vitals
for what comorbidities should be caution be taken when giving bolus IV
- heart failure
- chronic renal failure
standard adult dosing IVF bolus
500-1000 ml NS
how to dose IV bolus in pedatric patients
weight based dosing
20ml/kg
what is the dosage for typical maintenance dosage of IVF
30ml/kg/24 hrs
for what pts is maintenance IVF administered?
NPO, restricted oral intake, vomiting, hypotension requiring fluid resus.
what is the maintenance dosage for obese patients
24ml/kg/24 hours
when should a maintenance dose of 20-25ml/kg/24hrs be considered
- elderly
- renal impairment
- cardiac fialure
- malnourished pts
IV NS at KVO
IV normal saline keep vein open
* IVF given at minimal drip rate to maintain access.
IV SL
IV saline lock
IV catheter in place in pt but not hooked up
what type and solution of IVF should be used for a hemorrhage?
isotonic 0.9% NS
what type and solution of IVF should be used for severe vomiting/diarrhea?
isotonic 0.9% NS
what type and solution of IVF should be used for GI suctioning losses ?
isotonic 0.9% NS
what type and solution of IVF should be used for wound drainage?
isotonic 0.9% NS
what type and solution of IVF should be used for MILD hyponatremia?
isotonic 0.9% NS
what type and solution of IVF should be used for blood transfusions?
isotonic 0.9% NS
what should be monitored when given isotonic 0.9% NS
hypervolemia and fluid overload
when should isotonic 0.9% NS be avoided
in pts with pulmonary edema
what type and solution of IVF should be used for basic fluid resuscitation?
Lactated ringer’s solution
isotonic
what type and solution of IVF should be used for GI tract fluid losses?
lactated ringer’s solution
isotonic
what type and solution of IVF should be used for burns/trauma?
lactated ringer’s solution
isotonic
what type and solution of IVF should be used for metabolic acidosis?
Lactated Ringer’s solution
isotonic
what solution is often used during surgery
lactated ringer’s solution
(isotonic)
at what pH should LR not be used?
pH >7.5 bc it worsens alkalosois
what can happen if LR is used during renal failure
may elevate potassium levels
what solution provides free water to help renal excretion of solutes
D5W (isotonic) then (hypotonic)
0.45% NaCl (hypotonic)
what solution is used for hypernatremia
D5W
0.45% NaCl (hypotonic)
when should D5W not be used?
- fluid resuscitation (causes brain swelling after metabolized)
- can cause hyperglycemia
what solution and type of IVF is used for intracellular dehydration
hypotonic
0.45% NaCl
what should you monitor closely in the 0.45% NaCl and D5W
- hypovalemia
- hypotension
- confusion
- cerebral edema
due to shifting intracellular fluids
when should 0.45% NaCl and D5W be avoided?
in pts with
* liver disease
* trauma
* burns
what solution and type of IVF treats severe hyponatremia?
3% NaCl
hypertonic
what solution and type of IVF treats severe cerebral edema?
3% NaCl
hypertonic
what should be monitored closely when administering hypertonic solution?
- hypervolemia
- hypernatremia
- respiratory distress
what pts should NOT be given 3% NaCl
heart failure/renal failure conditions
