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iv numbers

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Question
Answer
Isotonic   Tonicity falls within or near the noral range of serum 275-295 mili/osmol per kilogram. pertaining to a solution that causes no change in cell volume.  
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Only iv fluid to be given with blood?   normal saline  
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Hypotonic   osmoloartiy that is less than 250 mili/osmol per kilogram.. a solution having a lower concentration of solute than another solution, hence exerting less osmotic pressure than that solution.( pertaining to a solution that causes cells to swell)  
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How high above the IV site should I hang the IV fluid bag?   For an optimal flow rate, position the IV bag about 36 inches above the IV site.  
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Hang lipid-containing solutions for no longer than   24 hours.  
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Hang lipid-only emulsions for no longer than   12 hours.  
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Hang blood and blood products for no longer than   4 hours.  
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Hypertonic   Tonicity greater than 350 mili osmol/ per kilogram. pertaining to a solution that causes cells to shrink.(a solution that increases the degree of osmotic pressure on a semipermeable membrane).  
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Isotonic fluids…(4)   0.9% normal saline; 5% dextrose in water; 5% dextrose in 0.225% normal saline; Ringers lactate.  
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0.9% normal saline indications   (isotonic) shock; hyponatremia; blood transfusions; resuscitation; fluid challenges; DKA…(can lead to overload; use with caution in heart failure or edema)  
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5% dextrose in water indications   (isotonic) fluid loss; dehydration; hypernatremia …( use cautiously in renal and cardiac patients; can cause fluid overload)  
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Indications for Ringers lactate   (isotonic) dehydration; burns; lower GI fluid loss; acute blood loss; hypovolemia d/t 3rd spacing…( contains potassium, do not use with renal failure pt; do not use with liver disease b/c they can not metabolize lactate)  
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Hypotonic fluids …   0.45% normal saline;  
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0.45% normal saline indications   (hypotonic) water replacement; DKA; gastric fluid loss from NG or vomiting… (use w/ caution; may cause CV collapse or increased ICP from fluid shift; do not use with liver disease, trauma or burns)  
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Hypertonic fluids…   5% dextrose in 0.45% normal saline; 5% dextrose in 0.9% normal saline; 10% dextrose in water  
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Indications for 10% dextrose in water   (hypertonic) water replacement; conditions where some nutrition with glucose is required...(monitor blood sugar levels)  
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5% dextrose in 0.9% normal saline indications   (hypertonic) temporary treatment for shock if plasma expanders aren’t available; Addison’s crisis….(do not use in cardiac or renal patients)  
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5% dextrose in 0.45% normal saline indications   (hypertonic) later in DKA treatment (use only when FSBS falls below 250 mg/dl)  
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Vesicant   a solution that can cause extravasation if it were to infiltrate the iv site. labeled by the pharmacy as a high alert drug  
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Irritant   an agent that produces inflammation or irritation.  
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Extravasation… escape into tissue of antineoplastic chemotherapeutic drugs. S/S may be sudden onset of localized pain at an injection site, sudden redness or extreme pallor at an injection site, or loss of blood return in an IV needle. Necrosis may occur.   Tx depends on causative agent. Nursing actions include maintaining the patient IV line, elevating affected area, applying ice packs, & notifying physician of need for antidote injections.  
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Flare (Flare Reaction)   localized sensitivity, expanding skin flush, spreading from an infective lesion or extending from the principal site of a reaction to an irritant. Its a normal reaction. Can be the precursor to a Hypersensitivity reaction (especially in the next infusion)  
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Infiltration   the process whereby a fluid passes into the tissues, (a non vesicant)  
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Hypersensitivity…inappropriate & excessive response of the immune system to a sensitizing antigen, called an allergen. Several factors determine the degree of response:   the person's genetic predisposition for an exaggerated response, amount of allergen, kind of allergen, route of entrance into the body, timing of the exposures, & site of the allergen–immune mediator reaction.  
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If infiltration occurs   remove catheter, heating pads, elevate, remove catheter.  
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If extravasation occurs (Vesicants)   stop the infusion, try to withdraw vesicant back through catheter; leave catheter in place, call pharmacy, call provider  
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