IV therapy Flashcards
isotonic solutions
250-375 mOsm/L
- NS (0.9% NaCl)
- D5W (5% dextrose in water)
- Ringer’s lactate
Hypotonic solns
below 250 mOsm/L
- 0.45% NaCl (1/2 NS)
fluid leaves blood -> cells (hydrates cells, lowers blood Na+, can cause HYPOTENSION)
Hypertonic solns
over 375 mOsm/L
- most vitamin/mineral infusions
can cause circulatory overload, irritates vein walls, may be painful –> give slowly (1-5 mL/min); use large vein (not hand)
Osmolarity calculation
[(Vol (mL) x mOsm/mL) / Vol] x 1000
Tx for Phlebitis
= redness/swelling of vein. this occurs commonly (less common in short infusions); 100% (high) risk with hypertonic >600 mOsm; moderate risk 450-600 mOsm, low risk 150-450 mOsm
Tx: prevention, slow IV, flush with NS, D/C line, apply ice
pH for blood, pH for IV mixtures
blood 7.35-7.45
IV should be b/w 5-9
What IV nutrients does Calcium channel blockers (CCBs) interact with
- EDTA
- Mg+
What problem can Rauwolfia/Reserpine cause when IV nutrients are given
makes autonomic response to sudden hypotnesion (Mg, Ca, EDTA) SLOW or impossible
Beta blockers interact with what IV nutrient
Magnesium
Most common IV nutrient cause of hypoglycemia
high dose IV Vit C and EDTA chelation (have Pt eat during these)
What IV nutrients will reverse hypoglycemia?
D5W infusion OR slow push of D-50 (50% dextrose) – 5-50 mL D50 will reverse
effect of isotonic soln on intravascular compartment (blood) & fluid overload potential
increases volume of blood (hydrates ECF); MODERATE fluid overload potential
effect of hypotonic soln on intravascular compartment (blood) & fluid overload potential
dehydrates blood (moves to cells); NO fluid overload potential
effect of hypertonic soln on intravascular compartment (blood) & fluid overload potential
greatly increases volume (dehydrates cells); HIGH potential for fluid overload
D5W isotonic or hypotonic
both - starts isotonic but can act hypotonic if Pt metabolizes sugar quickly
