IV Fluids 2 SG Flashcards
What is the treatment for pts w/ thrombocytopenia or impaired platelet function to prevent or treat bleeding?
Platelets
Which treatment?
- Contains all factors of the soluble coagulation system
- Used to correct major bleeding complications in patients on warfarin and/or with a Vitamin K deficiency
Fresh Frozen Plasma (FFP)
What tx is given if pt has:
- Increased INR
- Bleeding
Prothrombin Complex Concentrates (PCC)
–As a last resort..
Which Treatment?
- Prepared by thawing fresh frozen plasma & collecting the precipitate
- Contains high concentrations of factor VIII & fibrinogen (also factor XIII & vonWillebrand factor
- ***Used in pts w/ low fibrinogen, typically in the setting of massive hemorrhage or consumptive coagulopathy (esp. liver dz pts)***
Cryoprecipitate
What are the 3 boluses of IVF (isotonic crystalloids) which can be given depending on the clinical situation such as:
- Hypovolemia (dehydration & acute blood loss)
- Give PRBCs
- How much can be given at a time?
- Use caution in patients with which condition?
- Normal Saline (NS)
- Lactated Ringers (LR)
- Plasma-Lyte
- 250 - 1L
- Heart Failure
What treatment?
- Maintains/Accounts for ongoing losses of water & electrolytes under normal physiologic conditions via urine, sweat, respirations, and stool
- Used when pts are not eating or drinking normally
- Goal is to provide water and electrolyte balance
- Rate calculated, but is always dependent on clinical scenaria
Maintenance IVF
What are the 3 common fluids used for Maintenance IVF?
- NS
- Plasma-Lyte
- LR
When giving Maintenance IVF, what ist he method for peds and adult pts?
The kg Method: body weight is used to determine water needs
Who requires more sodium in IVF?
Children (as compared to adults)
What are the 3 most common rates for maintenance fluids in adults?
- 75 ml/hr
- 100 ml/hr
- 125 ml/hr
When determining the rate for IV fluids in adults, what can the numbers be rounded to?
Closest 5 or 10 number
Maintenance IVF & Potassium
- Is K or Na more osmotically active?
- Additional K can be added to IVF to treat _____ or for maintenance fluids if the patient is NPO
- Never _____ potassium containing IVF!!
- It’s okay to ____ LR & Plasma-Lyte, but not NS!
- Use caution when replacing potassium in patients with what condition?
- K is as osmotically active as Na
- hypokalemia
- bolus
- Kidney Disease
What treatment?
- Corrects any existing water & electrolyte deficits caused by GI, urinary, skin, or blood losses, or “third spacing”
- Type of IVF used depends upon what 2 things?
- Monitor what 3 things to determine effectiveness?
Replacement IVF
- Underlying electrolyte disturbances & Type of fluid lost
- Vital signs, urine output, clinical picture
Replacement IVF
- If a pt is significantly ____ or _____, caution must be exercised to avoid _______ which could lead to ____.
- hyponatremic / hypernatremic
- overly rapid correction
- osmotic demyelination/central pontine myelinosis (CPM)
Replacement in Surgical Patients
- In addition to maintenance fluids, surgical pts need replacement of fluids lost in which 3 ways?
- Which surgery has the most fluid loss?
- What are 2 things to monitor as guides to the amount of additional fluid needed?
- What is normal UOP in post-op pts?
- Urine output, blood loss, “third spacing” due to surgical intervention at the operative site w/ resultant leakage of fluids
- Abdominal surgery
- UOP / VS
- 0.5 ml/kg/hr
