Fluids (vn15) Flashcards
Body fluid is a mixture of what
oWater
oElectrolytes
oNonelectrolytes
oBlood cells
oWastes
oOxygen
Fluid and Electrolyte Distribution Mechanisms
-Osmosis
●Filtration
●Passive diffusion
●Facilitated diffusion
●Active transport
Fluid Volume Assessment
●Intake and output (I&O) measurement
●Intake: Sum of all fluid consumed/instilled
●Output: Sum of liquid eliminated from the body
Extracellular and Intracellular
●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
Common Fluid Imbalances
●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
Manifestations of Hypovolemia:
oTachycardia
oThready pulse
oHypotension
oDry mucous membranes
oNo change in lung sounds
manifestations of Hypervolemia
oBounding pulse
ohypertension
omoist mucous membranes
oCrackles in lungs
-pitting edema
Restoring Fluid Volume
●Treating the cause of hypovolemia
●Increasing oral intake
●Administering IV fluid replacements
●Controlling fluid losses
●Using a combination of these measures
Reducing Fluid Volume
●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
Intravenous Fluid Administration
●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
Crystalloid solutions
made of water and other uniformly dissolved crystals (e.g., salt and sugar)
Colloid solutions
made of water and molecules of suspended substances such as blood cells and blood products (e.g., albumin)
Types of Crystalloid Solutions
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)
IV Administration
●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
Infusion Techniques
●Gravity infusion
●Electronic infusion devices
oInfusion pumps
oVolumetric controllers
TPN client
Almost always using an infusion pump to gravity doesn’t really matter
Venipuncture
●Vein selection
oPotential venipuncture device insertion locations:
●Hand or forearm
●Scalp for infants and small children
Complications with IV Administration
●Circulatory overload
●Infiltration* (especially with TPN)
●Phlebitis*(especially with TPN)
●Thrombus formation
●Pulmonary embolus
●Infection
●Air embolism
Inserting an Intermittent Venous Access Device
●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
Blood Administration
●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.
Transfusion Reactions
●Stop infusion
●Administer 0.9% NaCl through a different line
●Monitor VS q 5 minutes
●Possible meds w/order: corticosteroids; fluids; antihistamines, antipyretics
Transfusion Reactions (usually 2-5 hours after)
●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
Parenteral Nutrition
●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
