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NCLEX > IV Fluids > Flashcards

IV Fluids Flashcards

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1
Q

Describe isotonic solutions

A

Same osmolality as body fluids
Increase ECF volume
Do not enter cells because no osmotic force exists to shift the fluids

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2
Q

Describe hypotonic solutions

A

More dilute solutions and have a lower osmolality than body fluids

Cause movement of water into the cells by osmosis

Administer slowly to prevent cerebral edema

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3
Q

Describe colloids

A

Also called plasma expanders

Pull fluid from the interstitial compartment into the vascular compartment

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4
Q

What are names of isotonic fluids

A

Normal saline 0.9%
5% dextrose in water D5W
5% dextrose in 0.225% saline
Lactated ringers

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5
Q

Name hypotonic solutions

A
  1. 45% sodium chloride NS
  2. 25% NS
  3. 33% NS
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6
Q

Name hypertonic solutions

A 
5% NS 
3% NS 
D10W 
5% dextrose in 0.9% NS 
5% dextrose in 0.45% NS 
5% lactated ringers
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7
Q

Name colloid solutions and why are they used

A

Dextran
Albumin

-hypoproteinemia and malnourished states for those who cannot tolerate large volumes of fluids

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8
Q

Who would you give a isotonic solution

A

Hemorrhage
Diarrhea / vomiting

When they are losing fluids

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9
Q

Who would you give a hypertonic solution

A

Cerebral edema

Severe hyponatremia
usually only used for highly acute patients

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10
Q

Who would you give a hypotonic solution ?

A

Intracellular dehydration.

Diabetic ketoacidosis

Hyperosmolar hyperglycaemic state

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11
Q

Signs and symptoms of air embolism

A 
Tachycardia 
Chest pain and dyspnea 
Hypotension 
Cyanosis 
Decreased LOC
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12
Q

Signs and symptoms of catheter embolism

A 
Decrease in BP 
Pain along the vein 
Weak and rapid pulse 
Cyanosis of the nail beds 
LOC
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13
Q

Signs and symptoms of circulatory overload

A 
Increased BP 
distended jugular veins 
Rapid breathing 
Dyspnea 
Moist cough and crackles
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14
Q

Signs and symptoms of electrolyte overload

A

Signs depend on the specific electrolyte overload

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15
Q

Signs and symptoms of a hematoma

A

Ecchymosis
Immediate swelling and leakage of blood at the site
Hard and painful lump at the site

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16
Q

Signs and symptoms of an infection.

A

Local - redness swelling drainage at the site

Systemic - chills, fever, malaise, headache, nausea, vomiting, backache, tachycardia

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17
Q

Signs and symptoms of infiltration.

A

Edema
Pain
Coolness at the site
May or may not have blood return.

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18
Q

Signs and symptoms of phlebitis

A 
Heat 
Redness 
Tenderness at the site 
Not swollen or hard 
IV infusion sluggish
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19
Q

Signs and symptoms of tissue damage

A

Skin colour changes
Sloughing of the skin
Discomfort at the site

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20
Q

Who are at risk for circulatory overload?

A

Respiratory clients
Cardiac client
Renal or liver dysfunction
Older and very young persons

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21
Q

Hyponatremia - CV SIGNS

A

Normovolemic - rapid pulse rate, normal BP
Hypovolemic - thready weak rapid pulse rate, hypotension flat neck veins; normal or low CVP
hypervolemic - rapid bounding pulse BP normal or elevated; normal or elevated CVP

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22
Q

Hyponatremia - RESP SIGNS

A

Shallow

Ineffective respiratory movement is a late manifestation related to skeletal muscle weakness

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23
Q

Hyponatremia - NEUROMUSCULAR SIGNS

A

Generalized skeletal muscle weakness that is worse in the extremities
Diminished deep tendon reflexes

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24
Q

Hyponatremia - CNS SIGNS

A 
Headache 
Personality changes 
Confusion
Seizures 
Coma
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25
Q

HYPONATREMIA - GI SIGNS

A

Increased motility and hyperactive bowel sounds
Nausea
Abdominal cramping and diarrhea

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26
Q

HYPONATREMIA - RENAL SIGNS

A

Increased urinary output

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27
Q

HYPONATREMIA- integumentary signs

A

Dry mucus membranes

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28
Q

Labs findings - HYPONATREMIA

A

Serum less than 135

Decreased urine gravity

29
Q

HYPERNATREMIA - cv signs

A

Heart rate and blood pressure respond to vascular volume status

30
Q

HYPERNATREMIA - RESP SIGNS

A

Pulmonary edema if hypervolemia is present

31
Q

HYPERNATREMIA- neuromuscular signs

A

Early; spontaneous muscle twitches, irregular muscle contractions
Late ; skeletal muscle weakness; deep tendon reflexes diminished or absent

32
Q

HYPERNATREMIA- CNS SIGNS

A

Altered cerebral function is the most common
Normovolemia or hypovolemia - agitation, confusion, seizures
Hypervolemia ; lethargy, stupor , coma

33
Q

HYPERNATREMIA- GI SIGNS

A

Extreme thirst

34
Q

HYPERNATREMIA- RENAL SIGNS

A

Decreased urinary output

35
Q

HYPERNATREMIA– integumentary signs

A

Dry and flushed skin
Dry and sticky tongue and mucus membranes
Presence or absence of edema depending on fluid volume changes

36
Q

HYPERNATREMIA - labs

A

Serum sodium above 145

Increased urine gravity

37
Q

HYPOKALEMIA - CV

A

Thready weak irregular pulse
Weak peripheral pulses
Orthostatic hypotension

38
Q

HYPOKALEMIA- RESP

A

Shallow ineffective respirations - weakness of the skeletal muscles of RESP
Diminished breath sounds

39
Q

HYPOKALEMIA - neuromuscular

A 
Anxiety lethargy confusion coma 
Skeletal muscle weakness leg cramps 
Loss of tactile discrimination 
Parastesias 
Deep tendon hyporeflexia
40
Q

HYPOKALEMIA- GI

A

Decreased motility hypo active to absent sounds
Nausea vomiting constipation abdominal distension
Paralytic Ileus

41
Q

HYPOKALEMIA LABS

A

ST depression
Shallow flat or inverted t wave
Prominent u wave

42
Q

HYPERKALEMIA - CV

A

Slow weak irregular heart rate

Decreased blood pressure

43
Q

HYPERKALEMIA - RESP

A

Profound weakness of the skeletal muscles leading to respiratory failure

44
Q

HYPERKALEMIA - neuromuscular

A

Early; muscle twitches, cramps, parasthesias, tingling and burning followed by numbness in the heads and feet and around the mouth
Late ; profound weakness, ascending flaccid paralysis in the arms and legs
Lethal level- trunk head and respiratory muscles become affected

45
Q

HYPERKALEMIA - labs

A

Tall peaked T waves
Flat p wave
Widened QRS
Prolonged PR

46
Q

HYPOCALEMIA - CV

A

Decreased heart rate
Hypotension
Diminished peripheral pulses

47
Q

HYOCALCEMIA - RESP

A

Not directly affected

H/E RESP failure or arrest can result from decreased respiratory movement because of muscle tetany or seizures

48
Q

HYPOCALEMIA- neuromuscular

A

Irritable skeletal muscles - twitches cramps tetany seizures
Painful muscle spasms in the calf or foot during periods of inactivity
Parasthesias followed by numbness that may affect the lips nose and ears in addition to the limbs
Positive trousseaus and chvosteks signs
Hyperactive deep tendon reflex
Anxiety irritability

49
Q

HYPOCALEMIA- GI

A

Increased gastric motility
Hyperactive bowel sounds
Cramping diarrhea

50
Q

HYPOCALCEMIA - renal

A

Urinaryoutput depends on the cause

51
Q

HYPOCALEMIA labs

A

Prolonged ST LEVEL

prolonged QT

52
Q

HYPERCALCEMIA - CV

A

Increased HR in the early phase ; Bradycardia that can lead to arrest in the late phases
Increased BP
Bouncing full peripheral pulses

53
Q

HYPERCALCEMIA - RESP

A

Ineffective respiratory movement as a result of profound skeletal muscle weakness

54
Q

HYPERCALCEMIA - Neuromuscular

A

Profound muscle weakness
Diminished or absent deep tendon reflexes
Disorientation lethargy coma

55
Q

Hypercalcemia - renal

A

Varies on cause

Formation of renal calculi flank pain

56
Q

Hypercalcemia - GI

A

Decreased motility and hypo active sounds

Anorexia nausea abdominal distension constipation

57
Q

HYPERCALCEMIA - labs

A

Shortened ST SEGMENT

widened T WAVE

58
Q

Hypomagnesemia - cv

A

Tachycardia

Hypertension

59
Q

Hypomagnesemia - RESP

A

Shallow RESP

60
Q

Hypomagnesemia - neuromuscular

A

Twitches parasthesias
Positives trousseaus sign and chvosteks sign
Hyperreflexia
Tetany seizures

61
Q

Hypomagnesemia- CNS

A

Irritability

Confusion

62
Q

Hypomagnesemia - labs

A

Tall t waves

Depressed st segment

63
Q

Hypermagnesemia - cv

A

Bradycardia dysrhythmias

Hypotension

64
Q

Hypermagesemia - RESP

A

Insufficiency when the skeletal muscles of respiration are involved

65
Q

Hypermagnesemia - Neuro

A

Diminished or absent DTR

skeletal muscle weakness

66
Q

Hypermagnesemia - CNS

A

Drowsiness and lethargy progresses to coma

67
Q

Hypermagnesemia - labs

A

Prolonged Pr interval

Widened QRS COMPLEXES

68
Q

Antidote for magnesium overdose

A

Calcium gluconate

69
Q

Describe hypertonic solutions

A

More concentrated solutions have a higher osmolality than body fluids
Cause movement of water from cells into the ECF by osmosis

NCLEX (10 decks)

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