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IV therapy solutions Flashcards

1
Q

why is IV therapy used?

A
  • to provide water, electrolytes and nutrients needed to reach the daily required amount.
  • replaces and correct defeciencies
  • beneficial to administer medications and blood products
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2
Q

what do IV solutions contain?

A
  • dextrose or electrolytes mixed in varous proportions with water
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3
Q

can electrolyte free water be administered by IV?

A

NO.
it rapidly enters the cells and causes them to rupture.

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4
Q

IV solution additives:

Potassium

Potassium Chloride (KCL)

A

potassium can be administered:
- orally
- slow IV infusion

NEVER IVP, IM, or SC potassium

  • COMMON ADDITIVE TO IV FLUIDS
  • POTASSIUM CHLORIDE- MEASURED IN
    MILLIEQUIVALENTS (MEQ)
  • ORDER USUALLY WRITTEN TO INDICATE THE
    AMOUNT OF MILLIEQUIVALENTS PER LITER
  • IV SOLUTIONS ARE OFTEN AVAILABLE WITH
    POTASSIUM PREMIXED IN THEM
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5
Q

remember the following when adding potassium to an IV:

A
  • Check compatibility with the solution and make sure it is well-diluted.
  • Monitor client during infusion; rapid infusion of potassium can cause death due to cardiac depression, arrhythmias, and arrest.
  • Check IV site frequently; medication is extremely
    irritating.
  • Administer IV using an infusion control device.
  • Never administer potassium concentrate IV push.
  • DO NOT add potassium to an IV bag that is already infusing.
    • this would cause the medication to concentrate
      in the lower portion of IV bag.
    • results in client receiving a concentrated
      medication solution can be harmful.
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6
Q

IV Fluid Types

A
  • isotonic
  • hypotonic
  • hypertonic
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7
Q

isotonic

A

same number of solutes outside the cell as there is on the inside

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8
Q

hypotonic

A

less solutes on the outside and more solutes on the inside

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9
Q

hypertonic

A

more solutes on the inside and less solutes on the inside

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10
Q

isotonic solutions

A
  • 0.9% Sodium Chloride
  • Lactated Ringer’s (LR)
  • D5W

= number of solutes

  • 0.9% Sodium Chloride = Normal Saline
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11
Q

Hypotonic solutions

A
  • 0.45% NaCl
  • 0.33% NaCl
  • D5W
  • D5/0.45 %NS

-

  • D5W- Glucose rapidly metabolized = hypotonic
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12
Q

Hypertonic

A
  • 3% NS
  • D5/LR
  • D5/0.9%NS -> (D5/NS)
  • D5/0.45%NS -> (D5 ½ NS)
  • TPN
  • Solutions containing meds
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13
Q

why dextrose?

A

it is given to patients who need extra sugar as glucose is rapidly metabolized in the body and leaves the extra fluids to help with volume.

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14
Q

.

A
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15
Q

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A
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16
Q

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A
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17
Q

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18
Q

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A
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19
Q

dextrose in water

A
  • 5% dextrose in water (D5W)
  • 10% dextrose in water (D10W)
  • 20% dextrose in water (D20W)
  • 50% dextrose in water (D50W)

  • do not use these alone to treat fluid volume deficency because it will dilute the plasma and the electrolytes
  • cautionin patients with ELEVATED ICP and diabetics(unless they are severly hypoglycemic)
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20
Q

dextrose in water

5% dextrose in water (D5W)

isotonic solution

A
  • replaces water loss
  • provides free water necessary for cellular rehydration
  • lowers serum sodium in hypernatremia

- isotonic in the bag, hypotonic in the body
- good for diluting

21
Q

dextrose in water

10% dextrose in water (D10W)

Hypertonic solution

A
  • provides free water
  • provides nutrition

  • given with TPN; just incase the TPN runs dry we do not want the pt to become hypoglycemic
22
Q

dextrose in water

20% dextrose in water (D20W)

Hypertonic solution

A
  • provides nutrition
  • may cause diuresis
23
Q

dextrose in water

50% dextrose in water (D50W)

Hypertonic solution

A
  • used to correct hypoglycemia
24
Q

.

A
25
Q

saline solutions

0.45% sodium chloride

Hypotonic solution

A
  • provides free water to replace hypotonic fluid losses
  • maintains levels of plasma sodium and chloride
  • enters cells
26
Q

saline solutions

0.9% sodium chloride

Isotonic solution

A
  • replaces water lost from extracellular fluid
  • used with blood transfusions
  • replaces large sodium losses (burns)
  • does not enter cells

  • equally gives back sodium and fluid and does not distrupt the homeostasis of the vasculature
  • great resuscitative fluid
27
Q

saline solutions

3% sodium chloride

hypertonic solution

A
  • corrects serious sodium depletion
  • draws water from cells into ECF
28
Q

saline solutions

D5 ½ NS

Hypertonic solution

A
  • tx hypovolemia

Hypertonic in sln, Hypotonic in body

29
Q

saline solutions

D% NS

A
  • provides calories, water and electrolytes

Hypertonic in solutionn, Isotonic in body

30
Q

saline solutions

Multiple electrolyte solutions

A
  • Lactated Ringer’s solution (LR)
  • D5 LR
31
Q

multiple electrolyte solution

Lactated Ringer’s solution (LR)

isotonic solution

A
  • replaces losses from burns and the lower GI tract
  • fluid of choice for acute blood loss, contains Na, K, Ca, Cl, and lactate
  • does not enter cells

  • contraindicated with liver disease bc the liver is not able to metabolize the lactate
  • liver labs; get AST/ALP…
  • caution in renal failure pts because they may not be able to excrete the potassium and cause a build up
32
Q

multiple electrolyte solution

D5 LR

hypertonic solution

A
  • provides calories, water, electrolytes
  • tx metabolic acidosis

Hypertonic in solution, Isotonic in body

33
Q

isotonic solutions

A
  • are close to the same osmolarity as serum
  • Isotonic fluids expand the ECF volume
  • expand the intravascular space
34
Q

What implications does this have for a patient with Hypertension or Heart failure if they receive isotonic IV’s?

A

Risk of fluid overload

35
Q

Isotonic Solutions

PURPOSE

A
  • hydration
  • maintain electrolytes
  • used during and after surgery
36
Q

D5/W

A
  • Provides free water necessary for renal excretion of solutes
  • Used to replace water losses and treat hypernatremia
  • Provides 170 calories/L
37
Q

The nurse recognizes requires fluid replacement with isotonic solution. One of the isotonic solutions that may be ordered by the health care provider is:

a. 0.45% saline
b. Lactated Ringer’s
c. 5% dextrose in normal saline
d. 5% dextrose in lactated Ringer’s

A

b. Lactated Ringer’s

38
Q

Hypotonic solution

PURPOSE

A

- Replace cellular fluid
- Provides free water for excretion of wastes
- Often use 0.45% NS – Rx hypernatremia or other hyperosmolar conditions
- Less osmolarity than serum
- Dilutes the serum

- good for intracellular dehydration: DKA, HHS patients
- caution in hypovelimia (monitor bp for hypotension) –> can lead to cardiovascular collapse, so monitor for: s/s of fluid volume deficency (confusion, decrease urinary output, dizzyness, confusion, tachycardia.

39
Q

Excessive Use of hypotonic Solutions

A
  • Leads to intravascular fluid depletion
  • Decreased blood pressure
  • Cellular edema
40
Q

0.45% NS - Hypotonic

A
  • Provides free water in addition to Na+ and Cl–
  • Used to replace hypotonic fluid losses
  • Used as maintenance solution
    * does not replace daily losses of other electrolytes
  • Provides no calories
  • A hypotonic solution that provides Na+, Cl−, & free water
    * Used as a basic fluid for maintenance needs
41
Q

Hypotonic helpful for:

A

Cellular dehydration:
- Fluid shifts out of blood vessel (less concentrated) to the tissue cells (more concentrated)
- Ex: dry mucous membranes

Hyperglycemic conditions:
- Diabetic ketoacidosis

42
Q

Hypotonic harmful for:

A
  • sudden shift of fluid from blood vessel to the cells - cardiovascular collapse
  • potential to cause cellular swelling
    - monitor for changes in mentation –> indicate cerebral edema
43
Q

A client experiences a loss of intracellular fluid. The nurse anticipates that the intravenous (IV) therapy that will be used to replace this type of loss is:

a. 0.45% normal saline (NS)
b. 10% dextrose
c. 5% dextrose in lactated Ringer’s
d. Dextrose 5% in NS

A

a. 0.45% normal saline (NS)

44
Q

Hypertonic (hyper-osmolar)

PURPOSE

A
  • Higher osmolarity than serum
  • Pulls fluids and electrolytes from the intracellular & interstitial compartments into the intravascular compartment

Examples
- 3% NS
D5/0.9NS and D5/0.45NS
Use Postop when some sodium is needed
- D5LR

45
Q

Hypertonic helpful for:

A
  • ↓ edema
  • increase urine output
  • Stabilize BP
  • Used to maintain fluid intake
  • Can temporarily be used to treat hypovolemia if plasma expander is not available
  • Solutions with concentrations greater than 10% must be administered through a central line
    - Allows adequate dilution to prevent shrinkage of RBCs
46
Q

A client is prescribed 0.9% sodium chloride (normal saline), which is an isotonic solution. The nurse recognizes the primary goal of such intravenous therapy is to:
a. Expand the volume of fluid in the vascular system
b. Pull fluid from the cells
c. Keep protein levels normal
d. Move fluid into the cells

A

a. Expand the volume of fluid in the vascular system

47
Q

A client is prescribed 3% sodium chloride, which is a hypertonic solution. The nurse recognizes the primary goal of such intravenous therapy is to:

a. Expand the volume of fluid in the vascular system
b. Pull fluid from the cells
c. Keep protein levels normal
d. Move fluid into the cells

A

b. Pull fluid from the cells

48
Q

A client is prescribed 0.45% sodium chloride, which is a hypotonic solution. The nurse recognizes the primary goal of such intravenous therapy is to:

a. Expand the volume of fluid in the vascular system
b. Pull fluid from the cells
c. Keep protein levels normal
d. Move fluid into the cells

A

d. Move fluid into the cells

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