IV Fluids/Elyte Word Scramble
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Question | Answer |
Types of IV solutions | Isotonic, Hyptonic, Hypertonic. |
Isotonic Fluids | Osmolarity: 270-300. No cellular effects, stays in vessels. (0.9% NS, LR). Keeps organ profused; volume expanders. Given for dehydration, surgery, etc. S/E: circulatory fl. volume overload (^ B/P). Monitor I&O, VS changes. |
Hypotonic Fluids | Osmolarity <270. Causes cells to swell. (D5W [most common], .45% NS [1/2 strength saline], .33% NS [1/3 strength saline]. Used to shift fluids back in to the cell, used in cellular dehydration. Will see extremely high Na level before IV ther. |
Hypertonic Fluids | Osmolarity >300. Causes cells to shrink. Fluid shifts from cells to blood plasma/vascular compartment. (D51/2 NS is most common) |
Infiltration | Cannula is no longer in proper placement. IV fluids are entering into surrounding tissue. |
S & S of Infiltration | Site is edematous. Cool to touch. Pale. Pain may be present. Rate of IV may slow (early symptom). |
Tx for Infiltration | Discontinue IV fluids, elevate extremity, apply cool compress, 20 mins, tid. Restart IV in opposite extremity. |
Extravasation | Cannula no longer in proper placement. IV meds are leaking into surrounding tissue. |
S & S Extravasation | Cool to touch, edema, blanching or discoloration, burning or discomfort. |
Tx for Extravasation | Similar to infiltration Tx. Cannula may be left in if antidote is being admin. Some drugs may cause necrosis. Additional Tx: debridement, wide excision, grafting, last resort- amputation. |
Manifestations of Phlebitis | Erythema, warm to touch, edema, IV rate may slow, streak formation, palpable venous cord, purulent drainage. |
Causes of Phlebitis | Mechanical (cannula has caused trauma), Chemical (due to highly acidic or alkaline fluids/meds), Bacterial (infection at the cannula). |
Tx for Phlebitis | Discontinue IV fluid, apply warm, moist compress (20 mins, tid), monitor for signs of infection, restart IV in opposite extremity. |
Intracellular fluids | Within the cell. Approximate 40% of total body weight. |
Extracellular fluids | Outside the cell. Approximate 20% total body weight. Subdivisions: Interstitial 15%, Intravascular 5%. |
First spacing | Normal. Fluids are inside the cell and where they should be. There is a normal distribution in the intracellular and extracellular spaces. |
Second spacing | There is an excess of fluid accumulation between the cells (edema) |
Third spacing | Accumulation of fluid in areas where there is normally minimal amt. (ascites, anasarca) |
Plasma to interstitial | Edema |
Interstitial to plasma | Dehydration |
Cations | K +, Na +, Mg +, Ca + |
Anions | Cl-, PO4- (phosphate), SO4- (sulfate), HCO3- (bicarbonate) |
Main elytes in the intracellular fluid | Potassium and Phosphate |
Main elytes in extracellular fluid | Sodium and Chloride |
Main Elyte functions | Regulate H2O distribution, especially sodium. Regulate acid base balance. Help with all body functions. |
Osmosis | H2O moves across selective membrane from area of low concentration to high concentration. (Water/fluids move from intracellular to extracellular) |
Diffusion | Solute molecules are moving from high concentration to low concentration and becoming evenly distributed. |
Filtration | Water and solutes move from area of high hydrostatic pressure to lower hydrostatic pressure, usually across capillary membranes. |
2 major hormones affecting fluid and elytes | ADH (antidiuretic hormone) and Aldosterone. Renin is an important enzyme affecting fluid and elytes. |
Renin | Enzyme produced by kidneys. Released when blood volume or B/P falls. Causes release of aldosterone |
Aldosterone | Produced in adrenal cortex. Regulates Na and K balance. Causes excretion of K and reabsorption of Na. Na absorption results in water reabsorption. |
Created by:
fulk_90
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