IVF Flashcards
3 types of IVF…
crystalloids, colloids, blood and blood products
What type of IVF?
contain sodium as main osmotically active particle
crystalloids
What type of IVF?
contain high-molecular weight substances that don’t migrate easily across capillaries
more likely to stay in vascular compartment
colloids
What type of IVF?
similar to colloids because they stay in the vascular space
blood/blood products
3 types of isotonic crystalloids…
0.9 NS, LR, plasmalyte
These crystalloids have same salt concentration as normal cells of body and blood…
isotonic crystalloids
These crystalloids have higher salt concentration than normal cells…
hypertonic crystalloid
What IVF is a hypertonic crystalloid?
3% NS
This type of crystalloid has a lower salt concentration than normal cells
hypotonic crystalloids
What are two types of hypotonic crystalloids?
0.5 NS, 0.25 NS
D5W is what type of IVF?
crystalloid
Which isotonic crystalloid?
contains lactate, potassium, calcium and NaCl
lactated ringers
isotonic crystalloids distribute in a _____ pattern throughout ECF space
uniform
This type of IVF is used for tx of dehydration, hypovolemia. They can be used for IV bolus
isotonic crystalloids
This type of IVF should be used cautiously
can be used with life-threatening hyponatremia with significant water excess
replacement rate must be calculated.
hypertonic crystalloids (3% NS)
what could occur with overly rapid correction of hyponatremia?
CPM
This type of IVF is used for maintenance fluids, and is distributed throughout the TBW.
It isn’t adequate for replacing intravascular volume deficit (hypovolemia/dehydration)
hypotonic crystalloids
This IVF has similar TBW distribution to hypotonic crystalloids
can be used to treat hypoglycemia
D5W
This type of IVF can be considered when crystalloids fail to sustain plasma volume due to low osmotic pressure
colloids
burn patients or peritonitis patients with considerable protein loss can be repleted with…
colloids
Colloids are more likely to expand which compartment?
vascular
is there evidence to support use of colloids in severe hypovolemia?
no
What are the 3 main categories of colloids?
albumin, dextran, hetastarch
Albumin comes in what preparations?
5%, 25%
Dextran comes in what two preparations?
40, 70
what colloid is used in edematous patients to mobilize interstitial fluid to vascular space?
albumin
This colloid can be helpful patients experiencing third spacing…
albumin
This is a synthetic glucose polymer that is a colloid IVF
dextran
What is dextran’s intravascular expansion equal to?
amount infused
This is a glyocogen like molecule that is less expansive than albumin, and therefore can be used as an alternative
hetastarch
hetastarch is more frequently used in what setting?
intra-operatively
hetastarch increases vascular volume to an amount _____ than the volume infused
greater or equal to
Three types of blood products are…
PRBCs, platelets, fresh frozen plasma
PRBCs can be used with crystalloids for what reason?
expand intravascular volume
Before transfusion with PRBCs, what must be done?
blood type screen/cross
When can platelets be considered?
thrombocytopenia or impaired function
This is used to correct major bleeding complications in patients on wararin or with a vitamin K deficiency
FFP
Which 4 IVF can be given as bolus?
NS, LR, plasmalyte, PRBCs
bolus can be given ___mL to ____ L
250 ml - 1L
Bolus should be considered in what two situations?
hypovolemia due to dehydration or acute blood loss
What is the commonly used preparation of maintenance IVF?
D5W/0.5NS with 20mEq KCl
When is maintenance IVF considered?
NPO patients
Can potassium-containing IVF be given as a bolus?
no, NEVER
potassium is as osmotically active as…
sodium
When can potassium be added to IVF?
maintenance if NPO or hypokalemia
What type of IVF therapy can be given to correct existing water/electrolyte deficit from GI, GU, Skin, blood loss or third spacing?
replacement IVF
what can be used as a guide for post-op fluid repletion?
urine output and vitals
Parkland formula…
percent burned x body weight (kg) x 4 ml
The following are indications for…
small bowel resection bowel obstruction IBD bowel rest can't tolerate enteral inadequate energy intake PO multisystem dx
TPN
what type of parenteral nutrition?
- central line
- MC
- > 7 days
TPN
Which type of parenteral nutrition?
- infrequently used
- uses IV/peripheral access
- short term < 7 days
PPN
What should be monitored while on TPN?
Is and Os
daily weights
CMP, LFTs, TGs
How often should monitoring occur on TPN while inpatient?
daily to weekly
How often should monitoring occur on TPN while outpatient?
weekly to monthly
The following TPN complications are related to what?
air embolism PTX DVT infx thrombophlebitis
catheter
