Fluid Therapy Flashcards
(42 cards)
What are some causes of Fluid Volume Deficit?
Abnormal loss of body fluids (diarrhea, fistula drainage, hemorrhage, polyuria), inadequate intake, or fluid shift from plasma to interstitial fluid.
What would you do from a nurse’s perspective for Fluid Volume Deficit?
Correct underlying cause and replace water and any needed electrolytes.
What are common fluids administered for Fluid Volume Deficit?
- Lactated Ringers
- 0.9 Sodium Chloride
- Packed Red Blood Cells when due to blood loss
What is something to be be worried about when administering fluid for someone with Fluid Volume Deficit?
Monitor for signs of fluid volume excess during volume repletion.
What are causes of Fluid Volume Excess?
Excessive fluid intake, abnormal retention of fluids (heart/renal failure), or shift form interstitial space into plasma fluid.
What are some nursing considerations when it comes to Fluid Volume Excess?
Correct underlying cause, diuretics, fluid restriction, and sodium restriction
What are some things that nurses should assess for dealing with Fluid Balance?
- Jugular Vein Distention
- Dyspnea, cough, moist crackles
- Increased RR
- Neuro Changes
- Skin turgor
What are some nursing interventions for Fluid Balance?
- Strict I/O
- Daily weight
- Vital signs
- Skin care
Which is more important, strict I/O, or daily weights?
Daily weights are going to be most important, because they can account for insensible loss.
*It is important to get a weight that is important. When taking weights, compare to day before.
White Blood Cells (WBC)
4,000- 11,000 uL
-Total number of leukocytes
Elevated:
-associated with infection, inflammation, tissue injury/death, malignancies (leukemia and lymphoma)
Decreased:
-Associate with bone marrow depression, severe/chronic illness, some types of leukemia
Hemoglobin (Hgb)
(female) 11.7- 16 g/dL
(male) 13.2- 17.3 g/dL
GENERAL: 12-17 g/dL
-measurement of gas carrying capacity of red blood cells
Elevated:
-Associated with polycythemia, hemoconcentrated states (dehydration)
Decreased: associated with anemia, hemorrhage, demodilution states (fluid volume excess)
Hematocrit (Hct)
(female) 35-47%
(male) 39-50%
- measurement of packed cell volume of RBCs expressed as a percentage of the total volume
- generally 3x hemoglobin
Platelet
150,000- 400,000 uL
- Number of platelets available to maintain platelet clotting functions
- Does not measure quality of platelet FUNCTION
Where are blood group antigens found?
They are found only on RBC membranes
(True/False) Presence of absence of blood group antigens (AB) is the basis for the four blood types.
True
Rh is based on what antigen?
The D antigen
Rh negative people (have/don’t have) the D antigen
Do NOT have
Each person has _____ in the serum, that interact with A or B antigens.
Antibodies
What blood types is considered the universal donor?
O negative
What blood type is considered the universal recipient?
AB+
Why would you use plasma, as opposed to WBC?
For clotting factors
Packed Red Blood Cells
Volume: 250-310 ml
Description: Prepared from whole blood with 85-90% of the plasma removed
Expected Response: One unit of packed red blood cells should increase a 70kg recipient’s Hgb by one g/dL, Htc by 3 g/dL
Complications: Infectious diseases, alloimmunizations, and transfusion reactions. Massive transfusions may precipitate hypothermia, coagulation disorders, citrate, and/or ammonia intoxication.
Fresh Frozen Plasma
Volume: 225-250
Description: Several different ways to manufacture. Contains all coagulation proteins.
Indications: Deficit of multiple plasma coagulation factors. liver disease associated with hemostatic deficit, DIC, thrombotic thrombocytopenia, purpora
Expected Response: Hemostatis and/or improvement in coagulation parameters
Complications: Infectious disease, volume overload, allergic and febrile transfusion reactions
Platelets (Pooled and Pheresis)
Volume: Variable; 30-60 mL/unit. At VCUHS, adult standard dose is 4 units
Description:
-pooled: prepared form fresh, whole blood (multiple donors)
-pheresis: single-donor obtained from plateletpheresis
Indications: Thrombocytopenia (low platelet count) with bleeding; platelet dysfunction
Expected Response: Increase platelet count 30,000-50,000/ mm3 in average 30kg adult
Complications: Frequent platelet transfusions may compromise future ability to control bleeding (via alloimmunization), infectious diseases, transfusion reactions (allergic and febrile)
