Fluids (vn15)

Question 1

Body fluid is a mixture of what

Answer 1

oWater
oElectrolytes
oNonelectrolytes
oBlood cells
oWastes
oOxygen

Question 2

Fluid and Electrolyte Distribution Mechanisms

Answer 2

-Osmosis
●Filtration
●Passive diffusion
●Facilitated diffusion
●Active transport

Question 3

Fluid Volume Assessment

Answer 3

●Intake and output (I&O) measurement
●Intake: Sum of all fluid consumed/instilled
●Output: Sum of liquid eliminated from the body

Question 4

Extracellular and Intracellular

Answer 4

●Extracellular:
oOutside cell 1/3 of total body fluid
●Intravascular: in vessels
●Interstitial: between cells and tissues
●Intracellular:
oInside cell 2/3 of total body fluid

Electrolytes (found in both): chemical compounds with electrical charge (ions)
cations are positive
anions are negative

Question 5

Common Fluid Imbalances

Answer 5

●Hypovolemia: low volume of extracellular fluid
●Hypervolemia: higher-than-normal volume of water in the intravascular fluid compartment
●Third-spacing: movement of intravascular fluid to nonvascular fluid compartments, where it becomes trapped

Question 6

Manifestations of Hypovolemia:

Answer 6

oTachycardia
oThready pulse
oHypotension
oDry mucous membranes
oNo change in lung sounds

Question 7

manifestations of Hypervolemia

Answer 7

oBounding pulse
ohypertension
omoist mucous membranes
oCrackles in lungs
-pitting edema

Question 8

Restoring Fluid Volume

Answer 8

●Treating the cause of hypovolemia
●Increasing oral intake
●Administering IV fluid replacements
●Controlling fluid losses
●Using a combination of these measures

Question 9

Reducing Fluid Volume

Answer 9

●Treating the disorder contributing to the increased fluid volume
●Restricting or limiting oral fluids
●Reducing salt consumption
●Discontinuing IV fluid infusions or reducing the infusing volume
●Administering drugs that promote urine elimination
●Using a combination of the above interventions

Question 10

Intravenous Fluid Administration

Answer 10

●Maintain or restore fluid balance when oral replacement is inadequate or impossible
●Maintain or replace electrolytes
●Administer water-soluble vitamins
●Provide a source of calories
●Administer drugs
●Replace blood and blood products

Question 11

Crystalloid solutions

Answer 11

made of water and other uniformly dissolved crystals (e.g., salt and sugar)

Question 12

Colloid solutions

Answer 12

made of water and molecules of suspended substances such as blood cells and blood products (e.g., albumin)

Question 13

Types of Crystalloid Solutions

Answer 13

Hypotonic: contains fewer dissolved substances than normally found in plasma
o Example of use: hypernatremia (cells swell)

Hypertonic: is more concentrated than body fluid and draws cellular and interstitial water into the intravascular compartment
o Example of use: give to patient with edema (cells shrink)

Isotonic: contains the same concentration of dissolved substances as normally found in plasma
o Example of use: hypotension; hemorrhage; calories (fluid volume)

Question 14

IV Administration

Answer 14

●Types of tubing
oPrimary (long) or secondary (short) tubing
oVented or unvented tubing
oMicrodrip (small drops) or macrodrip (large drops) chamber
oUnfiltered or filtered tubing
oNeedle or needleless access ports

Question 15

Infusion Techniques

Answer 15

●Gravity infusion
●Electronic infusion devices
oInfusion pumps
oVolumetric controllers

Question 16

TPN client

Answer 16

Almost always using an infusion pump to gravity doesn’t really matter

Question 17

Venipuncture

Answer 17

●Vein selection
oPotential venipuncture device insertion locations:
●Hand or forearm
●Scalp for infants and small children

Question 18

Complications with IV Administration

Answer 18

●Circulatory overload
●Infiltration* (especially with TPN)
●Phlebitis*(especially with TPN)
●Thrombus formation
●Pulmonary embolus
●Infection
●Air embolism

Question 19

Inserting an Intermittent Venous Access Device

Answer 19

●When client no longer needs continuous infusions of fluid
●When client needs intermittent administrations of IV medication
●When client may need emergency IV fluid or medications if his/her condition deteriorates

Question 20

Blood Administration

Answer 20

●Blood transfusion
●Blood transfusion equipment
oCatheter or needle gauge-18 gauge
oBlood transfusion tubing-make sure it is patent
oNormal saline prime only
oNo meds in same line, blood only
oVitals before administration then stay with them for 15 minutes, repeat vitals.

Question 21

Transfusion Reactions

Answer 21

●Stop infusion
●Administer 0.9% NaCl through a different line
●Monitor VS q 5 minutes
●Possible meds w/order: corticosteroids; fluids; antihistamines, antipyretics

Question 22

Transfusion Reactions (usually 2-5 hours after)

Answer 22

●Incompatibility: low back pain, fever, chills, tachycardia, tachypnea, hypotension
●Febrile: fever, chills, hypotension, tachycardia, tachypnea***(most common)
●Anaphylactic: wheezing, decrease o2, hypotension
●Septic: fever, chills, abdominal pain
●Mild Allergic
-Itching, flushing
●Circulatory Overload: fluid volume excess

Question 23

Parenteral Nutrition

Answer 23

●Intravenous administration of nutrients such as protein, carbohydrate, fat, vitamins, minerals, and trace elements
oPeripheral parenteral nutrition
oTotal parenteral nutrition (TPN)
oLipid emulsions: watch for reactions