IV Fluids Flashcards
What are the two types of IV fluids?
Crystalloids
Colloids
CRYSTALLOIDS
-3 examples
-use examples?
-distribution speed compared to colloids?
NaCl, D5W, Lactated Ringers
Dehydration, fluid maintenance, electrolyte imbalances
Faster than colloids
ISOTONIC FLUIDS
-location?
-examples?
-uses?
Stays put in bloodstream
Lactated ringers, 0.9% NaCl, D5W
Bolus-for low BP, waiting for blood, maintenance/rehydration
HYPOTONIC FLUIDS
-shift to where?
-Examples?
-Uses?
Shift fluid to a more concentrated solution- into the cells
-0.45 NaCl, 0.225 NaCl, 2.5 Dextrose in water
-Hypernatremia
-Severe dehydration
HYPERTONIC FLUIDS
-shifts what?
-examples?
-uses?
-risk of?
Pull less concentrated fluid into itself-fluids leave cells
anything > 0.9% NaCl
D5 1/2 NS
D10W
Severe hyponatremia
Demyelenation Syndrome
What are some contraindications/cautions for Hypotonic fluids?
What is the big system to monitor?
-How do you prevent cerebral edema?
NOT WITH: cerebral edema, head injury, Increased ICP
-MUST MONITOR NEURO STATUS
-correct sodium imbalances slowly
What must be monitored when giving hypertonic fluids? How do you prevent demyelination syndrome?
NEURO STATUS, BP, LUNGS
Correct sodium imbalances slowly
0.9% NaCl
-tonicity?
-components?
-Uses?
-contraindications?
Isotonic
Sodium, chloride
Hypotension, hypovolemia, maintenance fluid
Blood transfusions
Incompatibility
Lactated Ringers
-tonicity?
-components?
-uses?
-contraindications?
Isotonic
Sodium, chloride, potassium, calcium, lactate
maintenance fluid, dehydration w/ electrolyte imbalance
Hyperkalemia, hypercalcemia, lactic acidosis, incompatibility
D5W
-tonicity?
-components?
-1 L= ?
-uses?
-contraindications?
Isotonic
Free water, dextrose
1 L= 170 calories
NPO-calories needed
Hypoglycemia risk
Incompatibility
0.45% NaCl
-tonicity?
-components?
-uses?
-contraindications?
Hypotonic- half-NS
Sodium, chloride
Dehydration
Cerebral edema, increased ICP, head injury
0.225% NaCl
-components?
-tonicity?
-uses?
-contraindications?
Hypotonic- quarter NS
-Sodium, chloride
severe dehydration, severe hypernatremia
Cerebral edema, increase ICP, head injury
2.5 Dextrose in water
-tonicity?
-components?
-1 L= ?
-uses?
-contraindications?
Hypotonic
Dextrose, free water
1L=85 Calories
Dehydration, NPO calories
Cerebral edema, head injury, increase ICP
3% NaCl
-tonicity?
-components?
-uses?
-contraindications?
Hypertonic
Sodium, chloride
Severe hyponatremia
uncontrolled BP
D5 1/2 NS
-tonicity?
-uses?
Hypertonic
severe hyponatremia
D10W
-tonicity?
-components?
-1 L= ?
-uses?
Hypertonic
Dextrose, free water
1L=340 calories
Severe hyponatremia
Due to a ___ body water %, preterm/neonates are at a higher risk of fluid _____
Due to a ____ body water %, older adults are at a higher risk of fluid _____
higher- excess risk
Lower- deficit risk
COLLOIDS
-3 examples
-synthetic example
-Stay _____ and cause ____
-used for ____, _____
-less likely to cause ____ and have a ____ duration of action
Plasma, blood, albumin
-Dextran
Stay in vascular space and increase osmotic pressure
Used for shock, burns
Less likely to cause edema and have a longer duration of action
Normal plasma osmolality: ________
Too high= water concentration is ____
Too low= water concentration is ____
Normal urine osmolality is _________
280-295 mOsm/kg
Too high= water deficit
Too low= water excess
100-1300 mOsm/kg
explain the difference between hydrostatic and oncotic pressure
Hydrostatic pushes fluids into the tissues
Oncotic pressure pulls fluids into the vessel via albumin
Explain fluid shifts into:
-first space
-second space
-third space
First: fluid where expected
Second: edema- shifts from capillary to interstitial space
Third: Ascites- shifts into nonfunctional space between cells
Explain ADH
Pituitary hormone
Secreation causes water reabsorption in kidneys, raising BP
How does the hypothalamus-pituitary system respond to:
FVD
FVE
How does the hypothalamus know when to respond?
FVD: hypothalamus makes pituitary release ADH, raising BP
FVE: hypothalamus makes pituitary suppress ADH, increase diuresis
Osmoreceptors in hypothalamus detect FVD or FVE through increased or decreased plasma osmolality
How does the adrenal cortex contribute to water/electrolyte regulation? (2 secretions)
Cortisol: raised BG, antiinflammatory, raises BP
Aldosterone: increase sodium and water reabsorption in kidneys, raising BP
