IV Fluids Flashcards
What are the four isotonic solutions?
0.9% NS, LR, D5W, D5-1/4 NS
What do isotonic solutions do?
Moves fluid into the vascular space and helps it stay there. Increases blood pressure.
What type of clients are isotonic solutions used to treat?
The client that has lost fluids through nausea, vomiting, burns, sweating, and trauma.
What type of IVF is used when administering blood?
Normal Saline
Which three types of clients should we not use isotonic solutions to treat?
Hypertensive, cardiac disease, or renal disease.
What three main things do we need to watch for when administering isotonic solutions?
Fluid volume excess, hypertension, or hypernatremia*
*Only concerning with solutions that contain sodium
What do hypotonic solutions do for the client?
Moves fluid into the vascular space then shifts it out into the cells to replace cellular fluid. Makes the cells fat and juicy!
What are the three hypotonic solutions?
D2.5W, 1/2 NS (0.45% NS), 0.33% NS
Which clients would we use hypotonic solutions to treat?
A client who has hypertension, renal, or cardiac disease and needs fluid replacement due to nausea, vomiting, burns, hemorrhage, etc.
Also used for dilution when a client has hypernatremia and cellular dehydration.
What do we watch for when treating clients with hypotonic solutions?
We watch for cellular edema because this fluid is moving out to the cells, which could lead to fluid volume deficit and decreased blood pressure.
What do hypertonic solutions do for clients?
Hypertonic solutions are packed with particles so they are volume expanders that will draw fluid into the vascular space from the cells.
Think “hyper”; hyperactivity tends to make people “skinny”, as with hypertonic solutions making the cells “skinny”.
What are the eight hypertonic solutions?
D10W, 3% NS, 5% NS, D5LR, D5 1/2 NS, D5NS, TPN, albumin
Which clients benefit from hypertonic solutions?
Clients with hyponatremia or client who has shifted large amounts of vascular volume to a third space such as severe edema, burns, or ascites.
A hypertonic solution will return the fluid volume to the vascular space.
What should we watch for when treating clients with hypertonic solutions?
Watch for fluid volume excess. Monitor in an ICU setting with frequent monitoring of blood pressure, pulse, and CVP, especially if they are receiving 3% NS or 5% NS.
Normal CVP is between 2 to 6 mmHG
What seven high alert medications should we double check with a second licensed nurse?
Insulin, opiates, narcotics, injectable potassium chloride, phosphate concentrate, IV anticoagulants such as heparin, and sodium chloride solutions above 0.9%.
