IV Therapy Ch4 Wk6
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| To understand the use of parenteral solutions the nurse must understand two important concepts: | show 🗑
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| IV fluids are ordered for the following purposes | show 🗑
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| Isotonic | show 🗑
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| show | below 250
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| show | above 375
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| Key Elements of Parenteral Solutions | show 🗑
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| Isotonic (Iso-osmolar) Solutions | show 🗑
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| Isotonic (Iso-osmolar) Solution examples | show 🗑
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| Hypotonic Solutions | show 🗑
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| Hypotonic Solution examples | show 🗑
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| show | Tonicity exceeding 350-375 mEq/L. Most admixed medications infused intravenously fall into this category; When infused, osmosis pulls water out of the cells. This causes the cells to shrink.
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| Hypertonic Solution examples | show 🗑
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| IV Solutions | show 🗑
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| Crystalloids | show 🗑
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| show | Albumin Dextran Hydroxyethyl starches Gelatins
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| Crystalloids examples | show 🗑
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| show | Used to provide calories for energy, reduce catabolism of protein, and reduce protein breakdown of glucose to help prevent a negative nitrogen balance.
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| Dextrose Solutions percentages | show 🗑
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| show | Acts as a vehicle for administration of medications Provides nutrition Can be used as treatment for hyperkalemia Used for treatment in dehydration Provides free water
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| show | Vein irritation! rapid infusion of 5% in dextrose in water causes Hyponatremic encephalopathy with (especially in premenopausal women) Solutions of 20 – 70% can act like osmotic diuretic if administered too rapidly Transient hyper-insulin reaction
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| show | 0.9% often referred to as “normal saline”; uses: treatment of shock, hyponatremia, given with blood transfusions, resuscitation, fluid challenges, metabolic alkalosis hypercalcemia, and fluid replacement in diabetic ketoacidosis.
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| show | 0.25, 0.45, 0.9, 3, and 5
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| Sodium Chloride Solutions advantages | show 🗑
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| Sodium chloride solutions disadvantages | show 🗑
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| show | Combination of dextrose and sodium chloride solutions; for excessive loss of fluid through sweating, vomiting, or gastric suctioning; potassium free
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| Hydrating Solutions advantages | show 🗑
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| show | Same as for sodium chloride solutions Requires cautious administration in edematous patients
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| show | used in patients with trauma, alimentary tract fluid losses, dehydration, sodium depletion, acidosis, diarrhea, excessive vomiting, fistula drainage, and burns; used for restoration of fluid balance pre- and post-surgery
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| show | Ringer’s solutions Lactated Ringer’s
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| show | Similar to .9%; Treatment of any type of dehydration; Use for patients with liver disease who are unable to metabolize lactate
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| Ringer’s Solution advantages | show 🗑
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| Ringer's solution disadvantages | show 🗑
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| show | AKA Hartmann’s solution; Most commonly prescribed balanced solution Electrolyte concentration closely resembling ECF compartment; used for Restoring fluid volume deficits Replacing fluid lost due to burns, vomiting, and diarrhea; Treating mild metabolic
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| Lactated Ringer’s Solution advantages | show 🗑
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| Lactated Ringer’s Solution disadvantages | show 🗑
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| Alkalizing & Acidifying Infusion Fluids | show 🗑
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| Crystalloid Solutions key points | show 🗑
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| Colloid Solutions key points | show 🗑
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| Albumin | show 🗑
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| Albumin advantages | show 🗑
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| Albumin disadvantages | show 🗑
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| show | polysaccharide that behaves as a colloid Used as plasma volume expanders; Used as adjunct in treatment of impending shock or shock states Expands volume by once or twice its own volume Improves microcirculation
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| Dextran advantages | show 🗑
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| show | Possibility of hypersensitivity reactions Increased risk of bleeding Circulatory overload For IV use only
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| show | Synthetic colloid made from starch and is similar to human albumin Use for the prevention and treatment of critically low blood volume
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| show | Hetastarch and Pentastarch do not interfere with blood typing and crossmatching Provides hemodynamically significant plasma volume expansion Permits retention of intravascular fluid
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| Hydroxyethyl Starches disadvantages | show 🗑
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| Gelatins | show 🗑
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| 3 types of gelatins | show 🗑
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| gelatins advantages | show 🗑
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| gelatins disadvantages | show 🗑
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| show | Carefully assess history of allergic responses Monitor urinary output Monitor laboratory values Monitor CVP or jugular venous distension Maintain infusion rate Monitor for fluid overload Monitor for bleeding
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| Potassium Chloride Solutions | show 🗑
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