L7+8 IV Therapy Flashcards
Fluid intake
1200mL from water
1000 from food
200 from food metabolism
=2.5L
Fluid intake
Thirst response from hypothalamus
1.Osmotic pressure decrease
2.vascular volume decrease
Causing sensation of thirst
Importance of electrolyte
- Maintain fluid balance
- Transmit neuron’s reaction
Type of electrolytes
Sodium
1. Regulate extracellular fluid
2. Maintain blood volume
Potassium
1.Regulate intracellular fluid
2. Transmitt nerve impulse
3.insulin helps move potassium into cell
Bicarbonate
1. Major buffer for acid-base regulation
Factors affecting body fluid& electrolyte balance
- Age
2.gender - Body size
4.environmental temperature
5.lifestyle
Age factor related to fluid & electrolyte balance
Infant
—) high metabolism
—) high rr
More fluid loss
Less able to conserve water
Older:
1.Thirst response weakened
—) less hydrated
2.Nephron less able to conserve water
Gender and body size factor related to fluid & electrolyte balance
Lean muscle has great amount of water content
Woman usually have more fat—) less water
Environmental temperature factor related to fluid & electrolyte balance
Fluid loss faster at hot places
Both water and electrolyte loss when sweating
Water refilled but electrolyte not: headache, anorexia, nausea
Liefstyle( diet, exercise, alcohol consumption)
- Malnourish ppl cause edema
2.weight bearing exercise helps calcium balance - Stress will decrease urine production
Fluid volume excess
When body retain too much water and sodium
- )hypervolemia( too much blood)
Pushing excessive fluid to interstitial muscle—) edema
Risk factors of fluid volume excess
Excess intake sodium-containing IV fluid
Excess ingest sodium in diet
—)heart failure
Renal failure
Liver cirrhosis
Manifestation
2%=mild
5%=moderate
8%=severe
Intervention
Monitor vital sign
Asses of edema
Asses of breath sound.
Fluid imbalance: dehydration vs overhydration
Dehydration
Reason: prolonged high fever
Ketoacidosis
Overhydration
Cause: drink alot of water after sweat
Assessment of fluid/ electrolyte imbalance-history taking
1.Your intake?
2.Any imbalance?—gain or lost weight
3.Any problem like swelling?
4.current medical and treatment
Physical assesment
Skin
-colour, temp, moist
(Flushed, warm, dry)
Mucous membrane
-colour, moisture
(Dry and crack)
Eye
-stiffness
(Soft to palpate)
Cardiovascular system
-hr
(Bradycardia, tachycardia)
Respiratory
-frequent
(Quick)
Diagnosis
Risk:
1. Reduced icf
2. Impaired oral mucous membrane
3. Decreased cardiac output related to hyvolemia
4. Acute confusion related to electrolyte imbalance
Planning for imbalance
1.Restore normal fluid balance
2. Restore normal electrolyte balance in ecf+icf.
3. Prevent risk associated: tissue breakdown, decreased cardiac output, confusion
Implementation- enteral fluid 腸內液
can orally if
no vomit
No excessive fluid loss
No NPO
Have intact GI tract
Drink 6-8 glasses water
Avoid food in high salt, sugar and caffeine
Avoid alcohol as it is diuretic
More milk product to maintain calcium level
Fluid intake modification-restriction
Place water in small containner
Provide frequent mouth care to prevent thirst
Restrict food contain sugar like candy or gum as it produce thirst
Fluid intake modification-dietary change
Oral supplements
Sodium supplement
Potassium supplements
Calcium supplements
Parental-IVF
- Intravenous fluid is need ed when client not able to take sufficient food & fluid orally
- Provide salt + other nutrients to maintain electrolyte balance
- Rapid rescue for medication or blood transfusion
Iv fluid saturation
Hypotonic 0.45% normal saline
Isotonic 0.9% normal saline
Hypertonic 5% normal saline
IVF equipment
IVF catheter
1. With different gauze size
2. Less than 72hr
Butterfly
1.needle with plastic flaps
2. Less than 24hr
Venipuncture site
Dos and dont
Usually on arm
Most distal site to make sure IVF move up
Yes:
Easily palpate and soft
Naturally hold by bones
NO:
Highly visible( will slip from needle)
Damaged by previous use
Flexible site
Ivf-central venous access device
For long term iv therapy
Promote freedom of ambulation
BUT greater risk at hemothorax, pneumothorax, cardiac perforation, thrombosis
AT SUBCLAVIAN VEIN
