IV Therapy

Question 1

Body Fluid Compartments

Answer 1

Intracellular fluid and extracellular fluid

Question 2

intracellular fluid

Answer 2

fluid inside the cell

Question 3

extracellular fluid

Answer 3

fluid outside the cell: consists of interstitial fluid and intravascular fluid

Question 4

Interstitial fluid

Answer 4

fluid that surrounds the cells in the tissues

Question 5

intravascular fluid

Answer 5

plasma/fluid in the blood vessels

Question 6

Sodium and Water

Answer 6

where sodium goes, water flows

Question 7

Hypertonic Solutions

Answer 7

MORE salt in the solution and LESS water in the solution

vessel becomes MORE concentrated than the cell. water then LEAVES the cell (the cell will shrink)

Question 8

Hypertonic solution Examples

Answer 8

10% dextrose in water (D1OW)

5% dextrose in LR (D5LR)

5% dextrose in 0.9% saline (D5NS)

Question 9

Hypertonic Solution Uses

Answer 9

• cerebral edema,
  -hyponatremia (decreases levels of sodium)
  -metabolic alkalosis
  -maintenance fluid
  -hypovolemia

Question 10

What to monitor for in hypotonic solutions

Answer 10

fluid volume overload

Question 11

Isotonic Solutions

Answer 11

same osmolality as body fluids (equal water & particle ratio)

the cells will stay the same

Question 12

Isotonic Solution Examples

Answer 12

0.9% sodium chloride = normal saline (NS)

5% dextrose in water (D5W)

Lactated Ringers (LR)

Question 13

Isotonic Solution Uses

Answer 13

-blood loss (hemorrhage, burns, surgery)

-dehydration (vomiting, diarrhea)

-Fluid maintenance

-diabetic ketoacidosis (DKA - there is so much glucose in the cells, they need water!)

Question 14

Hypotonic Solutions

Answer 14

Less salt in the solution & more water in the solution

-the vessel becomes LESS concentrated than the cell. water then enters the cell.

-therefore the cells will swell.

Question 15

Hypotonic Solution Examples

Answer 15

-0.45% saline (1/2 NS)
-0.33% (1/3 NS)

Question 16

Hypotonic Solution Uses

Answer 16

-helping kidneys excrete fluids

-hypernatremia (increase levels of sodium)

Question 17

IV Therapy Complications

Answer 17

air embolism, infiltration, infection, circulatory overload, phlebitis, hematoma

Question 18

Air Embolism Pathology

Answer 18

entry of air into the vein through the IV tubing

Question 19

Air Embolism Symptoms

Answer 19

• tachycardia, chest pain, hypotension, decrease in LOC, cyanosis, dyspnea or cough

Question 20

Air Embolism Treatment

Answer 20

• clamp the tubing
  -turn the pt onto their left side and place in Trendeleburg position
  -notify the HCP

Question 21

Infiltration pathology

Answer 21

leaking of IV fluid into surrounding tissue

Question 22

Infiltration Symptoms

Answer 22

-pain
-swelling
-coolness
-numbness
-no blood return

Question 23

Infiltration Treatment

Answer 23

remove the IV

elevate the extremity

apply a warm or cool compress

avoid rubbing the area

Question 24

Infection Pathology

Answer 24

entry of microorganism into the body via IV

Question 25

Infection Symptoms

Answer 25

-tachycardia -redness -swelling -chills and fever -malaise -nausea and vomiting

Question 26

Infection Treatment

Answer 26

-remove the IV -obtain cultures -possibly administer antibiotics

Question 27

Circulatory overload

Answer 27

administration of fluids too rapidly (fluid volume overload)

Question 28

Circulatory Overload Symptoms

Answer 28

- increase in blood pressure -distended neck veins -dyspnea -wet cough and crackles

Question 29

Circulatory Overload Treatment

Answer 29

-decrease in flow rate (keep -vein-open rate) - elevate HOB -keep pt warm -notify the HCP

Question 30

Phlebitis

Answer 30

inflammation of the vein can lead to a clot (thrombophlebitis)

Question 30

Phlebitis Symptoms

Answer 30

-heat -redness -tenderness -decrease flow of IV

Question 30

Phlebitis Treatment

Answer 30

-remove the IV -notify the HCP -restart the IV on the opposite side

Question 31

Hematoma

Answer 31

collection of blood in the tissues

Question 32

Hematoma Symptoms

Answer 32

-blood -hard and painful lump -ecchymosis

Question 33

Hematoma Treatment

Answer 33

-elevate extremity -apply pressure and ice

Question 34

Hypovolemia

Answer 34

low fluid volume in the blood aka: dehydration, fluid volume deficit

Question 35

Hypovolemia Causes

Answer 35

- loss of fluid from anywhere : thoracentesis, paracentesis, hemorrhage, NG tube, trauma, GI losses (vomiting, diarrhea) -Third spacing: burns, ascites -polyuria (peeing a lot): diabetes, diuretics, diabetes insipidus

Question 36

Hypovolemia S/Sx

Answer 36

-flat neck veins -increase HR -increased respirations -increased urine specific gravity -decreased BP (less volume = less pressure) -decreased CVP -decreased weight -decreased skin turgor -decreased urine output -dry mucous membranes -thirst

Question 37

Hypovolemia Labs

Answer 37

Concentrated (Dehydrated) makes the #s Curve up -increased urine specific gravity -increased hematocrit -increased serum sodium -increased BUN

Question 38

Hypovolemia Treatment / Considerations

Answer 38

-fluid replacement (administer via PO or IV) -safety precautions (risk for falls due to orthostatic hypotension) -daily weight & I/Os

Question 39

Hypervolemia

Answer 39

high volume in the blood aka; over hydrated, fluid volume excess

Question 40

Hypervolemia Causes

Answer 40

-heart failure -kidney dysfunction (can't filter the blood = backup of fluids) -cirrhosis -increased sodium intake

Question 41

Hypervolemia S/Sx

Answer 41

-Jugular vein dysfunction -increased HR (bounding) -increased BP (more volume = more pressure) -increased weight -increased CVP -wet lung sounds: crackles/dyspnea -due to backflow of fluid from the heart -increased edema -increased polyuria -kidneys are trying to get rid of excess fluid

Question 42

Hypervolemia Labs

Answer 42

Diluted (overhydrated) makes the #s curve go Down -decreased urine specific gravity -decreased hematocrit -decreased serum sodium -decreased BUN

Question 43

Hypervolemia Treatment / Considerations

Answer 43

-low sodium diet -daily weight and I&Os -diuretics -high fowler's or semi-fowler's position (easier to breathe)