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CNUR 103 > Unit 11: Fluid, electrolytes, and IV therapy > Flashcards

Unit 11: Fluid, electrolytes, and IV therapy Flashcards

1
Q

Function of body fluid

A
  • Building of body cells and tissues
  • Tx of nutrients, electrolytes
  • Carrying waste products from cells
  • Regulation of body temp (sweating)
  • Lubrication of joints and membranes
  • Medium for food breakdown and digestion
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2
Q

2 types of fluid

A
  • Intracellular

- Extracellular

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3
Q

What is extracellular plasma made of?

A
  • Plasma: 3L
  • Interstitial: 10 L
  • Intracellular: 28 L
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4
Q

Solution

A

A mixture of solutes dissolved in a solvent

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5
Q

Osmosis

A

Movement of water through semipermeable membrane.

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6
Q

Osmotic pressure

A

Pressure needed to stop osmotic flow of water.

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7
Q

Osmolality

A

Solute concentration by weight of solvent.

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8
Q

Tonicity

A

Concentration of solutes dissolved into a solution, determines the direction and extent of fluid diffusion.

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9
Q

Crenation

A

shrink

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10
Q

Electrolyte

A

Substances whose molecules dissociate or split into ions when placed in solution.

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11
Q

Ions

A

Electrically charged particles

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12
Q

Cations

A

Positively charged ions

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13
Q

Anions

A

Negatively charged ions.

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14
Q

What anions and cations are present within the plasma?

A

Ca, K, Mg, Cl, HCO3, negatively charged proteins, other, and PO4

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15
Q

What anions and cations are present within the Intracellular?

A

K, Na, Mg, PO4, negatively charged proteins, HCO3, Cl

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16
Q

K

A
  • Muscle and nerve impulses
  • ICK cation
  • Maintains cardiac rhythm
  • Acid-base balance
  • Promotes cellular growth
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17
Q

Na

A
  • ECF cation
  • Controls H2O distribution between ECF and ICF
  • Generation and transmission of nerve impulses
  • Acid-base balance
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18
Q

Ca

A
  • Transmission of nerve impulses
  • Myocardial and other muscle contractions
  • Blood clotting
  • Formation of bones and teeth.
19
Q

Mg

A
  • Coenzyme in carb and protein metabolism
  • Metabolism of nucleic acids
  • Helps maintain cardiac function
20
Q

Cl

A
  • Acid-base balance
  • ECF anion
  • Water balance
  • Part of gastric acid for digestion and activation of enzymes
21
Q

PO4

A
  • ICF anion
  • Muscle, RBC, and nervous system Fx
  • Formation of bones and teeth with calcium
  • Acid-base balance
  • Mitochondrial energy production of ATP
  • Cellular uptake and use of glucose
  • Metabolism of carbs, proteins, and fats
22
Q

Subjective data

A
  • PMHx (disorders)
  • Meds
  • Surgery and/or treatments (dialysis, ostomy, GI Sx)
  • Diet (Fad diets and prescribed diets)
  • Elimination patterns (Nocturia, polyuria, and diarrhea)
  • Exercise patterns (Replenishing electrolytes)
  • Changes in sensation, muscle weakness, mentation, or alertness.
23
Q

Objective data: Physical examination

A
  • VS
  • Integumentary system
  • Respiratory system
  • MSK
  • Behaviour and mental state
24
Q

Objective data: Lab values

A
  • Serum electrolytes, renal panel
  • U/A
  • ABG
25
Q

Correcting imbalances: Oral fluid and electrolyte replacement

A
  • Mild imbalances

- Solutions containing H2O, electrolytes, and glucose

26
Q

Correcting imbalances: IV fluids

A
  • Peripheral IV

- Central venous access device (CVAD): thread into superior vena cava

27
Q

What are IV fluids used for?

A
  • Correct fluid and electrolyte balance
  • Administer meds
  • Diagnostic tests or anesthesia
  • Correct or maintain code status
28
Q

Types of IV fluids: Isotonic solutions

A
  • Fluid replacement

- Can cause fluid overload in patient with renal or cardiac disease

29
Q

Types of IV fluids: Hypotonic solutions

A
  • Causes movement of H2O from ECF to ICF
  • Can cause hemolysis of RBCs and cerebral edema
  • Used for fluid maintenance
30
Q

Types of IV fluids: Hypertonic solutions

A
  • H2O from ICF into ECF
  • Increase risk for heart failure and intracellular dehydration
  • Used to treat hypovolemia and decrease Na
31
Q

Names, tonicity and functions of IV fluids

A
  • D(dextrose)5W Isotonic: Supplies H2O, treats increased Na, 170 cal/L
  • D(dextrose)10W Hypertonic: Supplies H2O, 340 cal/L
  • 0.9 % NaCl Isotonic (nm saline): Expands intravascular fluid volume, replaces ECF losses.
  • 0.45 % NaCl hypotonic (1/2 nm saline): Replaces fluid volume for pt with increased Na.
  • 3-5 % NaCl (3-5 %nm saline) hypertonic: Treats symptomatic decrease in Na.
  • Ringer’s (lactated) Isotonic: Expand intravascular fluid volume, replaces ECF losses.
32
Q

Complications of IV therapy: Infiltration

A
  • Fluid leaks into interstitial space
  • S & S:
    + Coldness
    + Pain
    + Pallor
    + Swelling around
    infusion site
33
Q

Actions to correct complications of IV therapy

A
  • Assess IV site q/h
  • Stop infusion and restart at a different site
  • Limit movement of extremity with IV.
34
Q

Stages of one IV infiltration

A

Painful IV site, no erythema, no swelling

35
Q

Stages of two IV infiltration

A

Pain, slight swelling, no blanching of finger, good pulse and brisk cap refill

36
Q

Stages of three IV infiltration

A

Pain, marked swelling, blanching, skin cool to touch, good pulse, and brisk cap refill

37
Q

Stages of four IV infiltration

A

Pain, very noticeable swelling, blanching, skin cool to touch, decrease or absent of pulse, cap refill more than 4 seconds, skin breakdown or necrosis

38
Q

Complications of IV therapy: Extravasation (what is it? S & S, and action)

A

What is it?
- Infiltration of chemotherapy or other harmful drug into tissues around IV site.

S & S:

  • Pain
  • Edema
  • Blistering
  • Tissue destruction
  • Infection
  • Loss of function in extremity

Nursing Action:

  • Stop infusion
  • Treat symptoms and alert physician of any changes
39
Q

Complications of IV therapy: Phlebitis (what is it? S & S, and action)

A

What is it?

  • Irritation and inflammation of vein
  • Formation of clots = thrombophlebitis

S & S:

  • Discomfort
  • Edema
  • Erythema
  • Warmth

Nursing Action:

  • Stop infusion
  • Apply warm, moist compress
  • Start IV in another site
40
Q

Complications of IV therapy: Infection (what is it? S & S, and action)

A

What is it?
- Introduction of microorganisms

S & S:

  • Pain
  • Edema
  • Erythema
  • Warmth
  • Fever

Nursing Action:

  • Surgical asepsis when inserting and caring for IVs
  • Assess q1h
41
Q

Complications of IV therapy: Fluid overload (what is it? S & S, and action)

A

What is it?

  • Rapid administration of IV fluids
  • Those who are most vulnerable include: babies, elderly, cardiac or renal disease.

S & S:

  • Increase BP
  • Resp. distress
  • Crackles over lung fields
  • Edema
  • Weight gain

Nursing Action:

  • Stop infusion rate
  • Monitor VS
  • Notify physician
42
Q

Electrolyte imbalance assessments

A
  • Review physician’s orders
  • Check order for solution, volume, flow rate, duration of therapy
  • Asses lab values, allergies, other health conditions, behaviour, LOC, pt knowledge.
  • Skin turgor, dependent edema, oral mucosa
  • Assess IV insertion site
43
Q

Process to hook up an IV

A
  • Gather supplies
  • Prime and label line
  • Flush saline lock
  • Regulate flow rate
  • Regulate flow rate by gravity
    gtts/min = (mL/hr x drop factor)/(time in mins)
  • Regulate flow rate by pump
44
Q

Removing IV

A
  • Check physician’s orders
  • Assess IV site and note whether pt is on any anticoagulants
  • Remove tape and dressing
  • Stabilize catheter
  • Remove catheter, ensuring there’s a tip.
  • Place gauze over site
  • Apply bandage and gauze with tape

CNUR 103 (11 decks)

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