IV therapy - fluid vol and effects Flashcards
intravenous therapy:
within the vein - peripherally or centrally; short-term or long-term, fastest delivery method
advantages of IV therapy:
replace fluid, transfuse blood, deliver medication, and correct electrolyte imbalances
disadvantages of IV therapy:
adverse reactions, incompatibilities, infections, damage, fluid overload, overdose, hindrance, and potentiate electrolyte imbalances
intravenous solutions: isotonic
D5W - 5% Dextrose in water
NS - 0.9% Sodium Chloride
LR - Lactated Ringers
isotonic solutions remain in the _____ compartment and do not pull fluid from other compartments - replace volume
intravascular
intravenous solutions: hypotonic
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
a ____ solution has an osmolarity lower than serum osmolarity - these agents should be used cautiously especially in persons at risk for increased _______
hypotonic; intracranial pressure
when a patient receives a hypotonic solution the fluid shifts:
out of the blood vessels and into the cells and the interstitial spaces where osmolarity is higher
intravenous solutions: hypertonic
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
hypertonic solutions draw fluid from the ____ space which causes cells to ____ and expansion of the ____ space. supply no calories
intracellular; shrink; extracellular
hypertonic solutions may be ordered for patients postoperatively because they reduce the risk of:
edema, stabilize BP, and regulate urine output.
fluid volume deficit (hypovolemia):
fluid deficit of isotonic fluid in extracellular space caused by abnormal fluid loss, fevering, hemorrhage, diarrhea, decreased fluid intake, excess perspiration, GI suction, vomiting
other causes of hypovolemia:
diuretics, third spacing, and chronic diseases
fluid volume excess (hypervolemia):
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
other causes of hypervolemia:
isotonic fluid overload, excess sodium intake, heart failure, renal failure, and liver cirrhosis
danger signs for fluid imbalances: fluid deficit
restlessness, confusion, seizures, coma, cold/clammy skin, decreased skin turgor, weak/rapid HR, rapid respirations, orthostatic hypotension, decreased urine output, and weight loss
danger signs for fluid imbalances: fluid excess
headache, confusion, peripheral edema, jugular vein distention, S3 heart sound, bounding pulse, increased BP, dyspnea, tachypnea, crackles, pulmonary edema, and weight gain
nursing management:
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
hypovolemic shock is ___
40% or more of intravascular volume loss
how is hypovolemic shock treated?
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
hypovolemic shock can come from:
plasma loss through burns, hemorrhage, decreased body fluids, GI loss, diabetes insipidus, diuresis
hypovolemia vs dehydration: hypovolemia
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
hypovolemia vs dehydration: dehydration
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
isotonic solution is there to help:
replace volume - push & pull movement
what solution becomes metabolized quickly once it is in bloodstream and after it is burned down, it becomes ____
D5W; hypotonic
normal saline is used a lot when you have a patient with _____ or _____, _____
hypovolemia; in shock; burn injuries
lactated ringers have sodium, potassium, and calcium in it, so good for what patients?
acute blood loss, surgical patients, mom & baby world
normal saline is good for patients with
kidney failure or kidney disease
