Iv And Fluid Administration Flashcards
(27 cards)
What is the measurement for electrolytes?
Millimole (mmol)
1 mmol of any cation is able to react completely with 1 mmol of any anion
Dehydration
Inadequate total systemic fluid volume
Dehydration happens over a period of time, so must be corrected slowly (Ie., don’t use too much fluid)
Overhydration
Total systemic fluid volume increases
Colloids
Expands plasma volume by drawing fluid from interstitial space into vascular compartments (eg., Albumin, pentaspan)
Used for hypovolemic states
Forms a suspension (does not dissolve)
Water crosses the membrane through osmosis to equalize concentrations
* use of colloids drastically reducing because of unexplained renal failure/mortality
Crystalloid
A solution that dissolves. Molecules or atoms separate and disperse completely and equally through the solvent
- dissolved molecules cross the membrane through osmosis to equalize unequal concentrations
What are crystalloid solutions used for?
- Isotonic, hypotonic, and hypertonic
- Electrolyte replacement
- As a route for medication
- Short-term intravascular volume expansion
What does an isotonic solution do?
Increases volume in the intravascular compartment without moving fluid to or from other compartments (eg., normal saline 0.9%, Ringer’s Lactate)
- fluids that have equal osmotic pressure with the body under normal conditions
- same concentration of sodium concentration as body water
Do not overload fluids; causes heart failure, renal impairment, hypertension
What is the 3 to 1 rule for isotonic solutions?
3 mL of isotonic crystalloid solution is needed to replace 1 mL of a patient’s blood
How much IV fluid is lost in one hour?
2/3 of infused IV fluid will leave the vascular space in 1 hour
How does a crystalloid replace patient’s blood?
Crystalloid solution cannot carry oxygen, but works by diluting remaining blood volume and proportional hemoglobin
Electrolytes
Salts dissolved in water with the potential to conduct electricity
- sodium most prominent in blood and interstitial fluid
- potassium is most prominent in body cells
How much of a crystalloid is required to compensate for loss of blood?
At least three times the amount of blood lost
- because of large volume of IV fluid distribution, fluids shift or leak out of the vascular space
Autoresuscitate
Body responds to blood loss by shifting fluid from the intracelluar and interstitial space into the vascular system
- Cells can become dehydrated, causing malfunction and organ failure
Hypotonic
Fluids have LESS osmotic pressure than the body
Hypertonic
Fluids have GREATER than normal osmotic pressure than the body
How much fluid is in a typical fluid bolus for adults?
Typical fluid bolus is 1000 mL (1 L)
- usually given through a 14 or 16 gauge IV
Hyperkalemia
Elevated levels of potassium that can be life-threatening. Patient presents with:
- renal failure
- nausea
- abdo pain
- diarrhea
- leads to cardiac arrest if not treated
Caused by burns, crush injuries, diabetic ketoacidosis, severe infection
Hypokalemia
Low serum concentrations of potassium (rarely diagnosable without lab tests)
Patient presents with:
- muscle weakness
- abdo distension
- constipation
Caused by low dietary intake of K+, diuretic therapy, diarrhea, vomiting, burns
Hypocalcemia
Low levels of calcium in the blood
Signs and symptoms: irritability, twitching and tetany, convulsions, parenthesis, abdo and muscle cramps, neural excitability
Causes: sepsis, inadequate vitamin D, pancreatitis, parathyroid disease
Hypercalemia
High levels of calcium in the blood
Signs/symptoms: weakness, irritability, dehydration, headache, hypertension, renal stones
Causes: cancer, parathyroid disease, overactivity
Drop factor
The number of drops in the chamber required to administer 1 mL of fluid
- microdrip = 60 gtt/mL
- macrodrip = 10, 12, 15, 20 gtt/mL
To keep vein open (TKO)
IV to keep vein open, usually run with a microdrip set at 30-50 gtt/mL
IV piggyback
Infusions that are secondary infusions attached the primary infusion line
Rather than directly injecting the medication into the line as an IV push, the medication is added to a smaller bag of IV fluid and slowly infused through the medication port of the main IV line
Infiltration (complication of IV)
When the tip of the catheter dislodges from the lumen of the vein. Fluid or medication goes into soft tissues surrounding vein and can cause tissue destruction/necrosis
