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Clinical Skills > IVFT > Flashcards

IVFT Flashcards

1
Q

What semipermeable membranes are found in the body?

A

Capillary membranes - between blood and interstitial space

Cell membranes - between cells and interstitial space

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2
Q

Fluid moves from high to low HSP. What affects HSP?

A 
Osmotic pressure (by ions)
Oncotic pressure (by proteins)
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3
Q

How can fluids usually be delivered?

A

IV, SC, IP, IO

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4
Q

What are the 3 types of fluids?

A

Crystalloids
Colloids
Protein based solutions

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5
Q

What is in crystalloid fluids?

A

Water
NaCl
Other solutes

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6
Q

What is in colloid fluids?

A

Water
NaCl
Starch
Other solutes

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7
Q

Colloids contain macromolecules. What do these do in terms of fluid retention?

A

Lead to retention of fluid in intravascular space

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8
Q

What are the 2 types of protein based solutions?

A 
Non-oxygen carriers (plasma)
Oxygen carriers (blood)
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9
Q

Concentration of fluids is described by tonicity in comparison to plasma. What are the percentages of salinity for each type of tonicity solution?

A

Isotonic - 0.9% saline (dehydration)
Hypotonic - 0.4% saline (long term use - prevent Na accumulation)
Hypertonic - 7.5% saline (shock - rapid increases circulatory volume, not for dehydration)

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10
Q

Isotonic fluids cause no net movement. What movement do hypotonic fluids cause?

A

Causes water to be drawn from blood vessels into interstitial space

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11
Q

Isotonic fluids cause no net movement. What movement do hypertonic fluids cause?

A

Cause water to be drawn from interstitial space to intravascular space

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12
Q

How is mls of dehydration estimated?

A

Times % of dehydration by 1000 and bodyweight

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13
Q

<5% of dehydration shows no clinical signs. 5% dehydration causes what clinical signs

A

Normal demeanour
Normal skin elasticity
Sticky to dry mm
Normal globe position

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14
Q

What are the signs for 7% dehydration?

A

Normal eye
Dry mm
Mildly depressed
Mildly decreased skin tugor

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15
Q

What are the clinical signs of 10% dehydration

A

Moderately depressed
Moderately decreased skin tugor
Dry mm
Slightly sunken globe

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16
Q

What are the clinical signs of 12% dehydration

A

Close to death - moribund
Skin tent
Dry mm
Deeply sunken globe

17
Q

What is maintenance fluid?

A

2ml/kg/hr

18
Q

What is dehydration?

A

Loss of fluid from intravascular and interstitial space

19
Q

How are ongoing losses estimated?

A

4ml/kg/episode

20
Q

When treating mild dehydration, you should administer fluids how long? What are the 2 ways to do this? What should you do after this period?

A

24hrs
Gravity or infusion pump
Reevaluate HR, RR, mm and pulse quality

21
Q

Hypovolaemic shock is an emergency and needs an increased intravascular volume ASAP. What restricts treating hypovolaemic shock by IVFT?

A

Size of catheter

Consider using 2

22
Q

How should you administer fluids whilst treating hyovolaemic shock?

A

Administer bolus of fluids
Not using gravity
Apply pressure by squeezing bag

23
Q

Hypovolaemic shock can be with or without dehydration. Give an example of each

A

With dehydration - chronic D+ or V+

Without dehydration - loss of blood e.g. RTA

24
Q

When giving bolus administration of fluids, how much should you give per kg of patient and over what time period?

A

10ml/kg

Over 30 minutes then re-evaluate: if still in shock repeat, if no longer in shock switch to continuous infusion fluid

25
Q

Giving too much fluid can lead to…

A

Pulmonary oedema

26
Q

When setting up a fluid set, you attach the fluid bag to the drip stand. What is the normal volume of drips? What should be done next?

A

20 drops/ml - adult
60 drops/ml - paediatric
Slowly run through set to eliminate air bubbles and stop before attaching catheter

27
Q

How do you prepare for inserting an IV catheter?

A

Clip and prep skin like a surgical site

Wear non-sterile gloves

28
Q

When inserting an IV catheter, you withdraw the needle back. What can happen if you withdraw the catheter back over the needle?

A

The needle severs the catheter

Catheter can enter the venous system

29
Q

What should you do if you’ve slid the catheter over the needle?

A

Withdraw the needle and catheter and start again

30
Q

What should you do after inserting and taping the catheter?

A

Check it is still in the vein
Flush the catheter
Attach a giving set and start fluids running

Clinical Skills (12 decks)

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