IV Fluids-Electrolytes

Question 1

What is the unit of measurement for electrolytes?

Answer 1

Millimole (mmol)

Question 2

What are the electrolytes in your body?

Answer 2

Sodium (Na+), potassium (K+), calcium (Ca++), magnesium (Mg++), chloride (Cl-)

Question 3

Types of IV solutions

Answer 3

Colloids, crystalloids

Question 4

What are crystalloid solutions used for?

Answer 4

Isotonic, hypotonic, hypertonic
Electrolyte replacement
Route for medication
Short term intravascular volume expansion

Question 5

Colloids

Answer 5

Do not dissolve but form a suspension
Do not pass through semi-permeable membranes but will cause H2O to cross the membrane through osmosis to equalize concentrations

Question 6

Crystalloid

Answer 6

Solutions truly dissolve, molecules or atoms separate and disperse completely and equally throughout solvent
Dissolved molecules cross the membrane through osmosis to equalize concentrations

Question 7

Dehydration

Answer 7

Inadequately total systemic fluid volume
Chronic condition of elderly or very young

Question 8

Signs of dehydration/hypovolemia

Answer 8

Decreased urine output, hypotension, weak pulse, tachycardia, dry mucous membranes, skin turgor

Question 9

What can cause dehydration/hypovolemia

Answer 9

Vomiting, diarrhea, blood loss

Question 10

Fluid overload

Answer 10

Total systemic fluid volume increases

Question 11

Fluid overload signs

Answer 11

Hypertension, pulmonary crackles, SOB, peripheral edema, JVD, bounding pulse

Question 12

What can cause fluid overload

Answer 12

Cardiac failure, IV fluid mistakes, renal failure, HTN

Question 13

Isotonic solutions

Answer 13

Expand the contents of the intravascular compartment without shifting fluid to or from other compartments

Question 14

Types of isotonic solutions

Answer 14

Normal saline 0.9%
Ringer’s lactate

Question 15

Isotonic solution 3 to 1 rule

Answer 15

3mL of isotonic crystalloid solution is needed to replace 1mL of patients blood

Question 16

How long does it take for approximately 2/3 of infused IV fluid to leave the vascular space

Answer 16

1 hour

Question 17

0.9% normal saline mechanism of action

Answer 17

Replaces fluid and electrolytes, isotonic solution

Question 18

0.9% normal saline indications

Answer 18

Heat-related problems, shock, hypovolemia, hyperglycaemia, sepsis

Question 19

0.9% normal saline contraindications

Answer 19

None

Question 20

0.9% normal saline adverse reactions

Answer 20

Rare in therapeutic dosages

Question 21

0.9% normal saline considerations

Answer 21

Care should be used in patients with congestive heart failure, renal compromise, hypertension

Question 22

Lactated ringers mechanism of action

Answer 22

Replaces water and electrolytes (NA+, K+, Ca2+, Cl-), isotonic solution

Question 23

Lactated ringers indications

Answer 23

Hypovolemic shock; acute blood loss, burns

Question 24

Lactated ringers contraindications

Answer 24

Liver failure patients (cannot metabolize lactate)

Question 25

Lactated ringers adverse reactions

Answer 25

Rare in therapeutic dosages

Question 26

Lactated ringers considerations

Answer 26

Blood work prior for levels, care should not be used in patients with CHF, renal failure, electrolyte imbalances or edema.

Question 27

Lactated ringers consideration levels

Answer 27

Sodium - 130 mEq/L
Potassium - 4 mEq/L
Calcium - 30 mEq/L
Chloride - 109 mEq/L
Lactate - 28 mEq/L

Question 28

5% dextrose in water mechanism of action

Answer 28

Provides nutrients in the form of dextrose as well as free water, isotonic solution but changes to hypotonic when dextrose is metabolized

Question 29

5% dextrose in water indications

Answer 29

For dilution of concentrated drugs for intravenous infusion, compatibility with IV infusion medications

Question 30

5% dextrose in water contraindications

Answer 30

Should not be used as a fluid replacement for hypovolemic states

Question 31

5% dextrose in water adverse reactions

Answer 31

Rare in therapeutic dosages

Question 32

5% dextrose in water considerations

Answer 32

Hyperglycemia

Question 33

Dextrose in water D10W/D25W mechanism of action

Answer 33

Provides nutrients in the form of dextrose as well as free water, hypertonic solution

Question 34

Dextrose in water D10W/D25W indications

Answer 34

Neonatal resuscitation, hypoglycemia in children

Question 35

Dextrose in water D10W/D25W contraindications

Answer 35

Should not be used as a fluid replacement for hypovolemic states

Question 36

Dextrose in water D10W/D25W adverse reactions

Answer 36

Rare in therapeutic dosages

Question 37

Dextrose in water D10W/D25W considerations

Answer 37

None

Question 38

Normal saline 2/3, dextrose respectively 1/3 mechanism of action

Answer 38

Replaces free water and electrolytes and provides nutrients in the form of dextrose, hypertonic solution

Question 39

Normal saline 2/3, dextrose respectively 1/3 indications

Answer 39

Impaired cardiovascular, heat-related disorders

Question 40

Normal saline 2/3, dextrose respectively 1/3 contraindications

Answer 40

Should not be given to patients with impaired renal function

Question 41

Normal saline 2/3, dextrose respectively 1/3 adverse reactions

Answer 41

Rare in therapeutic dosages

Question 42

Normal saline 2/3, dextrose respectively 1/3 considerations

Answer 42

None

Question 43

Why are colloids rarely used in prehospital setting?

Answer 43

If not in a controlled setting it can be dangerous because of the dramatic fluid shift

Question 44

Colloids

Answer 44

Contain proteins to large to pass out of vascular compartments.
Expand plasma volume.
Draws fluid from interstitial space/intracellular into vascular compartments