IV Fluids Flashcards
1
Q
What is an example of a colloid?
A
- albumin
- dextran
- hetastarch
- mannitol
2
Q
Indications
- correct interstitial pulmonary edema and hypoproteinemia associated with acute respiratory distress
- hemolytic disease of newborns
- large volume paracentesis in patients with cirrhotic ascites
- emergency treatment of hypovolemia
- edema treatement with diuretics in pts with acute nephrosis
- spontaneous bacterial peritonitis
A
Human Albumin
3
Q
- naturally occuring colloid constitutes 50-50% of plasma proteins and 80-85% of the oncotic pressure
- available as 5% and 25% (25% has less volume)
- infuse with filtered tubing
- used to keep fluid in the intravascular space or as a volume expander
- SE: hypersensitivity, fluid overload (pulmonary edema) bleeding, (transient prolongation of bleeding time, interference with platelet function)
A
Human albumin
4
Q
Indications
- blood volume expander used in treatment of shock or impending shock when blood or blood products are not immediately available
Contraindications
- HF, renal failure, bleeding disorders (thrombocyotpenia, hypofibringenemia)
A
Dextran-40 10%
5
Q
- A semi- synthetic glucose polymer
- available in dextrose or sodium chloride
- used for vascular expansion- shifts fluid from tissues into blood vessels
- SE: Hypersensitivity, fluid overload (pulmonary edema) bleeding (transient prolongation of bleeding time, interference with platelet function)
A
Dextran-40 10%
6
Q
Indication
- blood volume expander used in the treatment of hypovolemia
Contraindication
- hypersenitivity, critically ill adults, severe liver disease, renal failure, and fluid overload condition, preexisting coagulation or bleeding disorders
SE: anaphylactic reactions, bleeding, thrombocytopenia, fluid overload
A
hetastarch
7
Q
- a semi-synthetic hydroxyethyl starch
- available as 6% or 10%
- used for vascular expansion- shifts fluid into blood vessels
A
Hetastarch
8
Q
- Produces osmotic diuresis by increasing osmotic pressure of glomerular filtrate, which inhibits tubular reabsorption of water and electrolytes and increases urinary output
- Available as 25% solution
- inspect for crystals prior to administration, if present redissolve by warming
- admnister into a large central veing
- extravasation risk
A
Mannitol
9
Q
- water with ions or sugar (or both) in solution
- sodium chloride in water
- lactated ringers (plasma-lyte is another example of a balanced solution)
- dextrose in water
- combination of dextrose with sodium chloride, potassium chloride or lactated ringers
A
Crysalloids
10
Q
what has a sodium concentration similar to plasma?
what has a sodium concentration lower than plasma?
A
- Isotonic has a sodium concentration similar to plasma
- hypotonic is lower and hypertonic is a higher plasma
11
Q
what IV solutions are hypotonic?
A
- 0.2% NaCl
- 0.45 % NACl
- D5W/ 0.2% NaCl
- D5W/ 0.45% NaCl
D5W can be isotonic and hypotonic
12
Q
what solutions are isotonic?
A
- 0.9% NaCl
- lactated ringers
- D5LR
- D5W/ 0.9% NaCl
13
Q
what solutions are hypertonic?
A
3% NaCl
5% NaCl
14
Q
what are the indications for IV therapy?
A
The 5 R’s
- resuscitation
- routine maintenance
- redistribution
- replacement
- reassessment
Also
- replace extracellular fluid volume losses
- maintain fluid and electrolyte balance in patients who cannot take orals
- correct existing electrolyte or acid-base disorders
- provide a source of glucose
- provide a medium for administering medications and nutritional support
15
Q
when do you use peripheral vs central vein?
A
- most patients receive IV fluids through a peripheral hand vein
- central vein: IV solutions with higher osmolarities may be used safely because central veins have a higher blood flow rate than in peripheral
