IV therapy - fluid vol and effects

Question 1

intravenous therapy:

Answer 1

within the vein - peripherally or centrally; short-term or long-term, fastest delivery method

Question 2

advantages of IV therapy:

Answer 2

replace fluid, transfuse blood, deliver medication, and correct electrolyte imbalances

Question 3

disadvantages of IV therapy:

Answer 3

adverse reactions, incompatibilities, infections, damage, fluid overload, overdose, hindrance, and potentiate electrolyte imbalances

Question 4

intravenous solutions: isotonic

Answer 4

D5W - 5% Dextrose in water
NS - 0.9% Sodium Chloride
LR - Lactated Ringers

Question 5

isotonic solutions remain in the _____ compartment and do not pull fluid from other compartments - replace volume

Answer 5

intravascular

Question 6

intravenous solutions: hypotonic

Answer 6

1/2 NS - 0.45% Sodium Chloride
1/3 NS - 0.33% sodium chloride
1/4 NS - 0.25% sodium chloride
2.5 DW - 2.5% dextrose in water

Question 7

a ____ solution has an osmolarity lower than serum osmolarity - these agents should be used cautiously especially in persons at risk for increased _______

Answer 7

hypotonic; intracranial pressure

Question 8

when a patient receives a hypotonic solution the fluid shifts:

Answer 8

out of the blood vessels and into the cells and the interstitial spaces where osmolarity is higher

Question 9

intravenous solutions: hypertonic

Answer 9

D5 1/2 NS - 5% dextrose 0.45% sodium chloride

D5NS - 5% dextrose 0.9% sodium chloride

D5LR - 5% dextrose lactated ringers

D10W - 10% dextrose in Water

Question 10

hypertonic solutions draw fluid from the ____ space which causes cells to ____ and expansion of the ____ space. supply no calories

Answer 10

intracellular; shrink; extracellular

Question 11

hypertonic solutions may be ordered for patients postoperatively because they reduce the risk of:

Answer 11

edema, stabilize BP, and regulate urine output.

Question 12

fluid volume deficit (hypovolemia):

Answer 12

fluid deficit of isotonic fluid in extracellular space caused by abnormal fluid loss, fevering, hemorrhage, diarrhea, decreased fluid intake, excess perspiration, GI suction, vomiting

Question 13

other causes of hypovolemia:

Answer 13

diuretics, third spacing, and chronic diseases

Question 14

fluid volume excess (hypervolemia):

Answer 14

fluid excess of isotonic fluid (sodium & water) in the ECF space caused by abnormal retention of water and sodium in about the same proportions which they normally exist in the ECF

Question 15

other causes of hypervolemia:

Answer 15

isotonic fluid overload, excess sodium intake, heart failure, renal failure, and liver cirrhosis

Question 16

danger signs for fluid imbalances: fluid deficit

Answer 16

restlessness, confusion, seizures, coma, cold/clammy skin, decreased skin turgor, weak/rapid HR, rapid respirations, orthostatic hypotension, decreased urine output, and weight loss

Question 17

danger signs for fluid imbalances: fluid excess

Answer 17

headache, confusion, peripheral edema, jugular vein distention, S3 heart sound, bounding pulse, increased BP, dyspnea, tachypnea, crackles, pulmonary edema, and weight gain

Question 18

nursing management:

Answer 18

assess for S/S of fluid imbalances, give IV fluids/meds as ordered, oxygen therapy as ordered, implement fall precautions, daily weights, accurate I&O, elevate edematous extremities, and encourage oral fluids when appropriate

Question 19

hypovolemic shock is ___

Answer 19

40% or more of intravascular volume loss

Question 20

how is hypovolemic shock treated?

Answer 20

fluid replacement NS, LR; blood transfusion; vasopressor, oxygen therapy, monitor VS and mental status, insertion of indwelling urinary catheter may be necessary, and monitor lung sounds

Question 21

hypovolemic shock can come from:

Answer 21

plasma loss through burns, hemorrhage, decreased body fluids, GI loss, diabetes insipidus, diuresis

Question 22

hypovolemia vs dehydration: hypovolemia

Answer 22

ECF fluid volume is reduced, results in tissue perfusion, it can be produced by salt and water loss, and salt/water loss comes from ECF

Question 23

hypovolemia vs dehydration: dehydration

Answer 23

water loss alone is termed as dehydration, pure water loss comes from total body water (only 1/3 is of ECF), ALWAYS HYPERNATREMIC. treatment: free water administration

Question 24

isotonic solution is there to help:

Answer 24

replace volume - push & pull movement

Question 25

what solution becomes metabolized quickly once it is in bloodstream and after it is burned down, it becomes ____

Answer 25

D5W; hypotonic

Question 26

normal saline is used a lot when you have a patient with _____ or _____, _____

Answer 26

hypovolemia; in shock; burn injuries

Question 27

lactated ringers have sodium, potassium, and calcium in it, so good for what patients?

Answer 27

acute blood loss, surgical patients, mom & baby world

Question 28

normal saline is good for patients with

Answer 28

kidney failure or kidney disease