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60 Cards in this Set
- Front
- Back
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What causes extracellular volume excess?
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Heart failure, Renal failure, Excessive infusion of IV fluids
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S/S of extracellular volume excess
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-weight gain
-decreased H & H -decreased plasma protiens -bounding pulse -Jugular vein distention -may lead to pulmonary edema |
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What happens to ANP and BNP in fluid volume excess?
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They are elevated.
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What happens to urine specific gravity in fluid volume excess?
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It is decreased.
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What happens to BUN when dehydrated?
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It is falsely elevated.
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The higher the osmolality of a solution the pulling power will be?
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Greater
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With isotonic fluids what happens to your cell size?
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They remain the same.
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What is normal saline?
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0.9% NaCl
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What is the baseline for % of solutes in IVF?
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0.9%
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What type of solution are lactated ringers?
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Isotonic
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What type of IV fluid has a concentration of dissolved particles equal to ICF and ECF?
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Isontonic
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What type of IV fluid has a concentration of dissolved particles greater than ICF?
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Hypertonic
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Why do the cells shrink with hypertonic fluids?
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Because there is more "stuff" (osmolitiy) in the IVF than the cell.
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What type of IVF has concentration of dissolved particcles less than ICF?
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Hypotonic
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Why do cells swell with hypotonic solutions?
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Because there is less "stuff" (osmolity) in the IVF than the cells.
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What type of IV fluid has a concentration of dissolved particles equal to ICF and ECF?
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Isontonic
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What type of IV fluid has a concentration of dissolved particles greater than ICF?
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Hypertonic
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Why do the cells shrink with hypertonic fluids?
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Because there is more "stuff" (osmolitiy) in the IVF than the cell.
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What type of IVF has concentration of dissolved particcles less than ICF?
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Hypotonic
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Why do cells swell with hypotonic solutions?
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Because there is less "stuff" (osmolity) in the IVF than the cells.
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What do hypertonic fluids do to other fluids?
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Pulls it toward's itself.
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Water moves from what to what with hypertonic fluids?
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From ICF (cells) to ECF (blood)
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What type of solution is 3% Saline?
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Hypertonic
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What type of solution is Dextrose 5% in 0.45%NS?
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Hypertonic
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What type of solution is Dextrose 10% in water?
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Hypertonic
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What determines if a solution is hypertonic?
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If the solute is higher than the 0.9% baseline.
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What determines if a solution is hypotonic?
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If the solute is less than the 0.9% baseline.
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With a hypotonic solution water will go from what to what?
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In ICF (cell) from ECF (blood)
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What type of solution is 0.45% Saline?
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Hypotonic
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What type of solution is D5W?
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Hypotonic. Though D5W is isotonic in the bag, it has a hypotonic effect in the body.
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What is usually the first fluid ordered for emergency volume replacement?
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Isotonic
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When are isotonic solutions commonly used?
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For dehydration
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What are hypertonic solutions commonly used for?
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To expand ECF volume and decrease cellular swelling.
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What type of fluid would you use with a pt who has intracranial pressure?
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Hypertonic.
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What are hypotonic fluids used for?
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Cellular dehydration resulting from excessive diuresis.
Hypernatremic dehydration. |
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If you have Hypernatremic dehydration which type of IVF would you want?
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Hypotonic.
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What is one absolute contradiction with hypotonic fluids?
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NEVER USE FOR CEREBRAL EDEMA (increased intracrainal pressure)
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What type of IVF is most commonly used to treat isotonic dehydration?
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Isotonic
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Which IVF do you have to worry about getting into the intravascular space?
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Hypertonic
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Which type of IVF would have the highest potential to lead to intravascular fluid volume overload?
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Hypertonic because the fluid will go into the intravascular space.
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What nursing assessments would be critical to monitor for complications related to hypertonic solutions?
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Lung sounds, Pulse quality, BP
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What does a bounding pulse indicate?
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Too much fluid.
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What causes palpable edema?
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excess fluid within the interstitial space.
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When can edema be visually observed?
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When volume has increased 2.5-3 liters.
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What are 4 causes of edema?
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-Increased capillary hydrostatic pressure
-decreased capillary osmotic pressure -increased capillary permeability -obstruction of lymph flow |
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What is an example of increased capillary hydrostatic pressure?
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fluid volume excesses, venous obstruction (thromboplebitis)
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What is an example of decreased capillary osmotic pressure?
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Starvation, liver failure (decreased intake/production of plasma protiens).
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What is an example of increased capillary permeability?
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trauma, burns, infammation
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What will happen if anything (blood pressure, etc) is done on the same side a mastectomy is done?
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It will cause lymphedema.
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What is localized edema?
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Edema associated with hives.
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Inflammation of a vein r/t a blood clot
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thromboplebitis
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Usually as a result of fluid volume excess (common in CHF)
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Generalized edema
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Fluid accumulating around the lungs
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Pulmonary Edema
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Dependent Edema
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Fluid accumulates in lower extremities usually d/t prolonged standing
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Lymph channels blocked or surgically removed
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Lymphedema
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What is the number one assessment for edema?
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Weight gain (2.2 lbs in 24 hours is significant)
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What type of edema would you be assessing for by listening to lung sounds?
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Pulmonary Edema
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Your pt has new audible crackles, a non-productive cough, and a respiratory rate of 35bpm. What specific type of edema is this pt experiencing?
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Pulmonary Edema
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What is a possible cause for pulmonary edema?
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Fluid volume overload
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Substances that dissolve in solution to form ions.
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Electrolytes
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