Exam 1: IV Fluids

Question 1

Electrolyte solutions classified as isotonic

Answer 1

if between 250 and 375 mEq/L

Question 2

Electrolyte solutions classified as hypotonic if

Answer 2

total electrolyte content is less than 250 mEq/L

Question 3

Electrolyte solutions classified as hypertonic if

Answer 3

total electrolyte content is greater than 375 mEq/L

Question 4

Isotonic Fluid; how much needed to replace 1 L of blood loss?

Answer 4

3 L of isotonic fluid

Question 5

pH>7,4?

Answer 5

Alkalosis

Question 6

pH<7.4

Answer 6

Acidosis

Question 7

pH=7.4

Answer 7

Normal

Question 8

What is D5W used for?

Answer 8

Used mainly to supply water and to correct an increased serum osmolality

Question 9

What percentage is normal saline solution?

Answer 9

0.9%, and contains water, salt and chloride

Question 10

What deos Lactated Ringer solution contain?

Answer 10

Potassium and Calcium, in addition to sodium chloride

Question 11

What is Lactated Ringer used for?

Answer 11

To correct dehydration and sodium depletion and replace GI losses.

Question 12

What is Hypotonic Fluid used for?

Answer 12

Used to replace cellular fluid because it is hypotonic compared with plasma.

Question 13

What saline is used in a Hypotonic Fluid?

Answer 13

0.45% Sodium Chloride solution.

Question 14

Where must higher concentrations of Dextrose be given?

Answer 14

50% dextose in water are strongly hypertonic and must be given into centrl veins so they can be diluted by rapid blood flow

Question 15

What does an air embolism do?

Answer 15

Its when air enters the central vein and gets into the right ventricle, where it lodges against the pulmonary valve and blocks the flow of blood.

Question 16

What is Phlebitis?

Answer 16

An inflammation of a vein that can be categorized as chemical, mechical, or bacterial

Question 17

Thrombophlebitis

Answer 17

Thrombophlebitis refers to the presence of a clot plus inflammation in the vein

Question 18

Hematoma

Answer 18

Results when blood leaks into tissues surrounding the IV insertion site.

Question 19

Isotonic: Fluids classififed as that have osmolality close to that of

Answer 19

ECF and do not cause red blood cells to srhink or swell.

Question 20

Isotonic: 1L expands ECF by

Answer 20

1 L

Question 21

D5W: SOlution of D5W unique in that it may be both

Answer 21

isotonic and hypotonic

Question 22

D5W: Once given, glucose is

Answer 22

rapidly metabolized and this isotinic solution disperses as a hypotonic fluid, (1/3 ECF, 2/3 ICF)

Question 23

D5W: During fluid resuscitation, this soltuon should not be given bc

Answer 23

hyperglycemia can result.

Question 24

D5W: Used mainly to supply

Answer 24

water and correct and increased serum osmolality

Question 25

Normal Saline: Because the osmolality is entirely contributed by the electorlytes,

Answer 25

solution remains within the ECF.

Question 26

Normal Saline: What is this often used for?

Answer 26

Correct an extracellular volume deficit but is not identical to ECF.

Question 27

Normal Saline: What is this used with

Answer 27

administration of blood transfusions and to replace large sodium loses, such as in burn injuries

Question 28

Normal Saline: What is not used for

Answer 28

heart failure, pulmonary edema, renal impairment or sodium retention

Question 29

Another use of Hypotonic Fluids?

Answer 29

Provide free water for excretion of body wastes

Question 30

Hypotonic: Used to treat what electrolyte imbalance

Answer 30

hypernatremia and other hyperosmolar conditions

Question 31

Hypotonic: Excessive infusions of hypotonic solutions can led to

Answer 31

intravascular fluid depletion, decrease bp, cellular edema, and cell damage

Question 32

Hypertonic: When normal saline solution or lactated ringer solution contains 5% dextrose, the total osmolality exceeds

Answer 32

that of the ECF. However dextrose is quickly metabolisc and only isotonic solution remains

Question 33

Hypertonic: What do saline solutions do?

Answer 33

If available in osmolar concentration greater than that of ECF, it will draw water from ICF to ECF and cause cells to shrink

Question 34

What happens when Saline HYpertonic solution given too quickly?

Answer 34

will cause extracellular volume excess and precipitate cirrulatory overload and dehydration

Question 35

Overloading the circulatory system with excessive IV fludis causes

Answer 35

increased blood pressure and central venous pressure

Question 36

Signs and Symptoms of FLuid Overload?

Answer 36

``` Moist crackles on auscultation of the lungs Cough Restlessness Distended Neck Veins Edema Weight Gain Dyspnea And Shallow Rapid Respirations ```

Question 37

Possible causes of fluid overload include

Answer 37

rapid infusion of iv solution or hepatic, cardiac, or renal disease

Question 38

Manifestations of air embolism include

Answer 38

palpitations, dyspnea, continued coughing, jugular venous distenion, wheezing and cyanosis hypotension, weak/rapid pulse , AMS, and chest, lower, and back pain

Question 39

Treatmet for air embolism includes

Answer 39

clamping the canula and replace a leaking or open infusion system , place patient on left side , assess VS and breath sounds

Question 40

Complications of air emolism include

Answer 40

shock and death

Question 41

S&S of blood stream infections include

Answer 41

``` abrupt temperture elevation backache headache increase pulse and rate nausea/v diarrhea chills shaking ```

Question 42

What is Infiltration?

Answer 42

The unintentional administration of nonvesicant solution or medication into surrounding tissue . Can occur when IV cannula dislodges and perforates wall of vein

Question 43

Infiltration characterized by

Answer 43

edema around insertion site, leaking of IV fluid, discomfort, coolness and significant decrease in the flow rate

Question 44

What should be done as soon as infilitration detected?

Answer 44

Infusion should be stopped and sterile dressing applies to site

Question 45

What is Extravasation?

Answer 45

Inadvertent administration of vesicant or irritant solution or medication into the surrounding tissue.

Question 46

What can occur in Extravasation?

Answer 46

Blistering Inflammation, and Necrosis

Question 47

What should be done when Extravasation occurs?

Answer 47

Infusion stopped. May require antidotes specific to medication that extravasated.

Question 48

Normal definition of Hypotonic Solution

Answer 48

Fluid shifts from hypotonic solution inmore more concentrated solution to create balance (cells swell)

Question 49

Normal definition of Hypertonic?

Answer 49

Fluids is drawn into the hypertonic soution to create a balance (cells shrink)

Question 50

Phlebitis: Chemical phlebitis caused by

Answer 50

irritating medication or solution, rapid infusion rates, and mediction incompatibilities

Question 51

Phlebitis: Mechanical phlebitis results from

Answer 51

long periods of cannulation catheters in flexed areas, catheter gauges larger than vein and poorly secrured catheters

Question 52

Phlebitis: Bacterial phlebitis can develop from poor

Answer 52

hand hygiene, lack of aseptic technique, failure to check all equipment before use

Question 53

Phlebitis: Characterized by

Answer 53

reddened, warm area around insertion site or along path of vein, pain or tenderness at site, along with swelling

Question 54

Phlebitis: Treamtent consists of

Answer 54

Stopping IV and apply warm, moist coompress to site

Question 55

Thrombophlebitis; Evidenced by

Answer 55

localized pain, redness, warmth, and swelling around the insertion site or along the path of the vein , immobility of extremity and swelling, sluggish fow rate, fever

Question 56

Thrombophlebitis; Treatment

Answer 56

discontinuing the IV infusion, applying cold compress to dress flow of blood , folowed by wamr compress ; elevating extremity.

Question 57

Hematoma: Leakage can result if

Answer 57

the opposite vein wall if perforated during venipuncture, the needle slips out of the vein, cannula too large, or insufficient pressure ina pplied

Question 58

Hematoma: Signs include

Answer 58

ecchymosis, immediate swelling at site, or leakage of blood at the inserting site

Question 59

Hematoma: Treatment

Answer 59

removing need, applying light pressure. Apply ice for 24 hours and elevate the extremity.

Question 60

Clotting and Obstruction: Blood clots may form in the IV line as result of

Answer 60

kinked IV tubing, very slow infusion rate, empty IV bag, or failure to flush the IV line after intermittent medication

Question 61

Signs of Clots?

Answer 61

Decreased flow rate and blood backflow