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Fluids And Iv Therapy Flashcards

(80 cards)

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1
Q

How much of your fluid in the body is water

A

60%

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2
Q

What affects the fluids

A

Age
Gender
Body fat

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3
Q

Where do solutes move for diffusion

A

Move from area of higher concentration to area with lower concentration
This results in equal distribution

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4
Q

Where do fluids move for osmosis

A

Moves from areas with lower solute concentration to areas with higher concentration

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5
Q

What does hydrostatic push out of the capillaries

A

Pushes fluid out

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6
Q

What organ produces hydrostatics

A

The heart

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7
Q

What does oncotic movement mean

A

Means fluid is being pulled out of the capillaries

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8
Q

What exerts oncotic pressure

A

Exerted by non-diffusible plasma proteins such as albumin

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9
Q

What is third spacing

A

Condition where fluid accumulates in a pocket that is not serving a purpose

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10
Q

What is anasarca

A

Severe, generalized edema marked by profound swelling of sub-q tissues and accumulation of fluid in body cavities

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11
Q

Where is icf

A

Fluid in cells

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12
Q

Where is the ECF

A

Fluid outside the cell’s:
Intravascular
Interstitial
Transcellular

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13
Q

What is the name for the isotonic fluid concentration

A

Normal saline(0.9%NaCl)

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14
Q

Normal saline= isotonic due to?

A

The same concentration of sodium in the blood

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15
Q

What is the hypotonic fluid concentration

A

1/2 normal saline

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16
Q

What happens to the cells when we give 1/2 n.s.

A

The cells swell

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17
Q

What is the fluid concentration for a hypertonic solution

A

D5 n.s.

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18
Q

What happens to the cells when hypertonic solution is introduced

A

Fluid is pulled from the cells so they shrink

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19
Q

What helps maintain fluid balance

A

Kidneys
ADH
Renin-Angiotensin-Aldosterone System (RAAS)
Aldosterone
Atrial natriuretic peptide
Thirst

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20
Q

What are the 7 functions of the kidneys

A

A-controlling ACID-base balance
W-controlling WATER balance
E- maintaining ELECTROLYTE balance
T-removing TOXINS and waste products from the body
B- controlling BLOOD PRESSURE
E- producing the hormone ERYTHROPOIETIN
D- activating vitamin D

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21
Q

How does ADH restore blood volume

A

Reducing diuresis
Increasing water retention
Vasoconstricts

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22
Q

What happens as the ECF decreases

A

Renin acts to produce angiotensin

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23
Q

What happens after renin produces angiotensin

A

Angiotensin 1 is produced which converts into angiotensin 2 which equals massive vasoconstriction

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24
Q

What does A2 stimulate the release of

A

Release of aldosterone

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25
What is retained after this release of aldosterone
Retention of sodium and water
26
Aldosterone does what to water
Regulates water
27
What does aldosterone cause the kidneys to retain
Na and water
28
What causes aldosterone to be released
If Na is too low and k+ is high
29
Where is atrial natriuertic peptide produced and stored
In the atria
30
What does ANP stop
Stops action of RAAS
31
How does ANP decrease bp
By vasodilation
32
How does ANP reduce fluid volume
By increasing the secretion of Na+ and water
33
Thirst is regulated by
Hypothalamus
34
Thirst is stimulated by
Increase in ECF and drying of mucous membranes
35
What depletes electrolytes (VPPS)
Vomiting Peeing Pooping Sweating
36
What causes hypovolemia
Deficit of isotonic fluid in ECF Diuretics Third spacing Chronic diseases
37
What causes fluid deficit of isotonic fluid in ECF
Abnormal: Fluidloss Fever Hemorrhage Vomiting Diarrhea GI suction Decreased fluid intake
38
What causes an excess of isotonic fluid in the ECF
Abnormal retention of water and sodium in about same proportions which they normally exist in ECF
39
Hypervolemia can cause
Isotonic fluid overload Excess sodium intake Heart failure, renal failure, liver cirrhosis
40
What are some signs of fluid deficit
Restlessness Cold clammy skin Decreased skin turgor Weave, rapid heart rate Rapid respirations Orthostatic hypotension Decreased urine output
41
What are some signs of fluid excess
Headache Confusion Peripheral edema Jugular vein distention S3 heart sound Bounding pulse, increased bp Dyspnea, tachycardia, crackles, pulmonary edema Weight gain
42
How can we manage hypervolemia
Asses for s/s of fluid imbalance Give iv fluids and meds as orders O2 as ordered Fall precautions Daily wts Accurate I&o Eval edematous extremities Encourage oral fluids when appropriate
43
What are the advantages of iv therapy
Replace fluid Transfuse blood Deliver meds Correct electrolyte imbalances
44
What are the disadvantages of iv therapy
Adverse reactions Incompatibilities Infections Damage Fluid overload Overdose Hindrance Potential electrolyte imbalances
45
Isotonic iv solutions
D5W - 5% Dextrose in water NS - 0.9% Sodium Chloride LR -Lactated Ringers
46
Hypotonic iv solutions
1/2 NS-0.45% Sodium chloride 1/3 NS-0.33% Sodium chloride 1/4 NS-0.25% Sodium chloride D2.5W-2.5% Dextrose in Water
47
Hypertonic solutions
D5 1/2 NS - 5% Dextrose 0.45% Sodium chloride D5NS - 5% Dextrose 0.9% sodium chloride D5LR - 5% Dextrose Lactated Ringers D10W -10% Dextrose in Water
48
Where do we start looking for an iv site
Start lower (around hand) then work up if unable to stick hand
49
When starting a non-trauma iv what vein is our last option
The AC
50
Where are iv sites to avoid
Legs, ankles, and feet Sclerosed or thromboses veins Veins that are knotted or tortuous Veins below an infiltrated site ov areas of phlebitis Areas of inflammation, disease, bruising, or breakdown Veins of surgically compromised or injured extremities Dominant hands (if possible) and extremities with AV shunts
51
What considerations should we use when selecting a vein
Condition of vein Reason for iv What solutions/ meds will be used
52
What should we do before sticking
Palpate the vein
53
Suitable veins should be
Round Firm Elastic
54
What are 14g or 16 g good for
Trauma Surgery Needing rapid infusion
55
What is an 18g good for
Surgery Receiving blood or caustic meds
56
What is the most common needle size for adults
20g or 22g
57
What is the most common needle for peds or adults with small and fragile veins
24g
58
What are complications of iv therapy
Fluid overload Infection Phlebitis Infiltration Extraversation
59
What are the methods of iv admin
Intermittent Continuous Bolus Push
60
What are intermittent iv meds
Meds on scheduled dose daily or several times per day
61
What are continuous iv meds
iv solutions continuously
62
What are bolus iv meds
Specified amount of solution to be admin in a specific time frame
63
What are push iv meds
Specified amount of med to be admin in a specific time frame
64
What are the nurses responsibilities with iv sites
Assess site Know the meds Assess for adverse affects Teach pt
65
What causes an air embolism
Solutions run dry Air in line Loose connections Improper removal of CVAD Poor technique with dressing or tubing changes
66
What are s/s of an air embolism
Dyspnea Tachypnea Lightheadedness Palpations Drop in bp Weakness Cyanosis Expiratory wheezes
67
What are the nurses interventions when they know there is an air embolism
Call for help Position pt in trendelenburg on their left side Admin o2 Monitor vitals Have crash cart
68
What are s/s of extravasation
Pain or burning @ iv site Skin lightness @sight Blanching and coolness of skin Dependent edema
69
How can we prevent extravasation
Dilute meds as recommended Avoid use of high pressure pumps Assess and monitor iv site Reach pt what to report
70
What causes a venous spasm
Viscous solutions Too rapid admin Cold or irritating solutions
71
What are symps of a venous spasm
Sharp pain@ iv sight Pain radiating up the arm with the iv site
72
How can we prevent venous spasm
Dilute meds as recommended Admin solutions and meds @room temp Admin @recommended rate Restart questionable ivs Consider a warm compress during infusion
73
How do access med vials
Nurse uses syringe and blunt fill needle
74
How long do we clean the lumen after removing the cap and before administering the med
15 secs
75
What do we do after cleaning the lumen
Purge air from flush Attach syringe
76
How many mLs do we flush line
9mL
77
What do we do after flushing line
Clean access Then do med admin
78
After giving iv push med, how are we supposed to flush the line
Flush slowly for 2-3mL then vigorously for the rest of the flush
79
After removing post flesh for iv push med do we do
Clamp lumen Attach new green cap
80
What is our drops per min for gravity infusion formula
Total volume x drop factor/ time in mins =gtts/min mL x gtts/min = gtts/min

IM2 (17 decks)

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