IV Fluids 2 SG Flashcards

1
Q

What is the treatment for pts w/ thrombocytopenia or impaired platelet function to prevent or treat bleeding?

A

Platelets

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2
Q

Which treatment?

  • Contains all factors of the soluble coagulation system
  • Used to correct major bleeding complications in patients on warfarin and/or with a Vitamin K deficiency
A

Fresh Frozen Plasma (FFP)

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3
Q

What tx is given if pt has:

  • Increased INR
  • Bleeding
A

Prothrombin Complex Concentrates (PCC)

–As a last resort..

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4
Q

Which Treatment?

  • Prepared by thawing fresh frozen plasma & collecting the precipitate
  • Contains high concentrations of factor VIII & fibrinogen (also factor XIII & vonWillebrand factor
  • ***Used in pts w/ low fibrinogen, typically in the setting of massive hemorrhage or consumptive coagulopathy (esp. liver dz pts)***
A

Cryoprecipitate

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5
Q

What are the 3 boluses of IVF (isotonic crystalloids) which can be given depending on the clinical situation such as:

  • Hypovolemia (dehydration & acute blood loss)
    • Give PRBCs
  • How much can be given at a time?
  • Use caution in patients with which condition?
A
  • Normal Saline (NS)
  • Lactated Ringers (LR)
  • Plasma-Lyte
  • 250 - 1L
  • Heart Failure
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6
Q

What treatment?

  • Maintains/Accounts for ongoing losses of water & electrolytes under normal physiologic conditions via urine, sweat, respirations, and stool
  • Used when pts are not eating or drinking normally
  • Goal is to provide water and electrolyte balance
  • Rate calculated, but is always dependent on clinical scenaria
A

Maintenance IVF

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7
Q

What are the 3 common fluids used for Maintenance IVF?

A
  • NS
  • Plasma-Lyte
  • LR
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8
Q

When giving Maintenance IVF, what ist he method for peds and adult pts?

A

The kg Method: body weight is used to determine water needs

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9
Q

Who requires more sodium in IVF?

A

Children (as compared to adults)

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10
Q

What are the 3 most common rates for maintenance fluids in adults?

A
  • 75 ml/hr
  • 100 ml/hr
  • 125 ml/hr
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11
Q

When determining the rate for IV fluids in adults, what can the numbers be rounded to?

A

Closest 5 or 10 number

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12
Q

Maintenance IVF & Potassium

  • Is K or Na more osmotically active?
  • Additional K can be added to IVF to treat _____ or for maintenance fluids if the patient is NPO
  • Never _____ potassium containing IVF!!
    • It’s okay to ____ LR & Plasma-Lyte, but not NS!
  • Use caution when replacing potassium in patients with what condition?
A
  • K is as osmotically active as Na
  • hypokalemia
  • bolus
  • Kidney Disease
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13
Q

What treatment?

  • Corrects any existing water & electrolyte deficits caused by GI, urinary, skin, or blood losses, or “third spacing”
    • Type of IVF used depends upon what 2 things?
  • Monitor what 3 things to determine effectiveness?
A

Replacement IVF

  • Underlying electrolyte disturbances & Type of fluid lost
  • Vital signs, urine output, clinical picture
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14
Q

Replacement IVF

  • If a pt is significantly ____ or _____, caution must be exercised to avoid _______ which could lead to ____.
A
  • hyponatremic / hypernatremic
  • overly rapid correction
  • osmotic demyelination/central pontine myelinosis (CPM)
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15
Q

Replacement in Surgical Patients

  • In addition to maintenance fluids, surgical pts need replacement of fluids lost in which 3 ways?
  • Which surgery has the most fluid loss?
  • What are 2 things to monitor as guides to the amount of additional fluid needed?
  • What is normal UOP in post-op pts?
A
  • Urine output, blood loss, “third spacing” due to surgical intervention at the operative site w/ resultant leakage of fluids
  • Abdominal surgery
  • UOP / VS
  • 0.5 ml/kg/hr
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16
Q

Replacement in Burn Patients

  • What is used to determine amount of fluids to give a burn pt?
  • Replace with which type of fluid?
  • Use what to estimate percentage of body burned?
A
  • Parkland Formula

(% of 2nd & 3rd degree burns) X (body weight in kg) X 4 mL

  • LR
  • Rule of Nines
17
Q

What is the Rule of Nines?

  • Each arm =
  • Head =
  • Ant / Post trunks each =
  • Each leg =
  • Perineum =
A
  • Each arm = 9%
  • Head = 9%
  • Ant / Post trunks each = 18% / 18%
  • Each leg = 18% / 18%
  • Perineum = 1%