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55 Cards in this Set
- Front
- Back
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osmolarity/tonicity
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# of particles in our blood
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Isotonic solution
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-240-340
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hypotonic solution
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<-240
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Hypertonic solution
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>340
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lactated ringers
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balance of normal electrolytes
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Colloid solutions
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blood products, always have back up of normal saline ready
ex: whole bl, red bl, plasma, wbc, etc |
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TPN
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Total Parental Nutrition
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IV basic rules
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distal to proximal
avoid flexion never start on same side as mastectomy only use adult leg with physician order |
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Broviac/Hickman
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tunneled under skin to superior vena cava
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Groshong catheter
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tunneled under SVC
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dialysis catheters
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never use for any other purpose!!
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Implanted ports
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for very long term. Port under skin. inserted in OR. Special needle called HUBER needle
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PICC
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Peripherally Inserted Central Catheter
Sterile procedure |
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Intraosseous
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No other access available
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Potassium and IV
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never hang potassium on a gravity IV
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bolus or push
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flush before and after every medication
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When giving a medication...
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ALWAYS check the compatability with the flush and any other medications!!
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phlebitis
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inflammation of the vein
pain, redness, warm, swelling, sluggish infusion |
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infiltration/extravasation
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leaking out of the vein into tissue outside the vein
same but causes damage to tissue |
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circulatory overload
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^ in HR and RR, shortness of breath, distended neck veins crackles, cough, DOE-Dyspnea On Exertion
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signs of Air embolism
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hypotension, cyanosis, tachycardia, wheeze, cough, dyspnea, substernal chest pain
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speed shock
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rapid infusion of substance, usually medication, into circulation
Signs: Flushing, HA, chest pain, VS change |
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Isotonic
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osmolarity of solution=body fluid
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hypertonic
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osmolarity of solution>body fluid
fluid flows out |
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hypotonic
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osmolarity of solution<body fluid
fluid flows in |
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aldosterone
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hormone secreted by adrenal cortex that reabsorbs Na and H2O and excretes K
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dehydration
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results in FVD
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actual dehydration
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decrease in h2o
isotonic loss |
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Relative dehydration
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H2O shift
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Isotonic FVD
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Normal Osmolarity
no fluid shift Decreased tissue perfusion most common type of dehydration |
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causes of isotonic FVD
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decreased intake
Loss of isotonic fluids |
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Compensatory mechanism for isotonic FVD
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^ sympathetic nervous system activity
^ Hr, stroke volume, and cardiac output vasoconstriction ^ aldosterone, which causes H20 and Na+ reabsorption Decreased urinary output |
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Hypertonic FVD
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osmolarity increases
H2O moves from ICF into plasma and interstitial spaces electrolyte imbalance |
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causes of hypertonic FVD
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loss of H2O
hyperventilation prolonged fever early renal failure |
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Compensatory Mechanisms for hypertonic FVD
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Increase secretion of ADH
Increased reabsorption of H20 decr. urine output stim. of hypothalamus |
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5 fluid compensations
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ADH, ANP, sympathetic NS, Thirst, aldosterone
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Hypotonic FVD (Least common)
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Osmolarity decreases
H2O from plasma to interstitial spaces swelling cells plasma volume decreases na and k imbalance |
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Causes of Hypotonic FVD
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Loss of Na
ingesting too much h2o chronic renal failure siadh- syndrome of inapppropriate ADH secretion |
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Overhydration
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fluid volume excess FVE
actual overhydration relative overhydration |
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actual overhydration
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increase in h20
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relative overhydration
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fluid excess in one or more of body fluid spaces
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Isotonic-FVE
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normal osmolarity
increase in circulatory blood volume circulatory overload |
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causes of isotonic FVE
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increased admin. of IV
Renal failure liver or heart disease corticosteroids-causes body to retain fluid |
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compensation mechanisms for isotonic FVE
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Decreased release of ADH and aldosterone- increased excretion of h20, Na, and urine output
formation of edema and ascites incr. cardiac contractility/ bp |
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hypertonic FVE (rare)
-cause and action |
caused by Na intake
fluid shift from icf to ecf |
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causes of hypotonic FVE
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excessive hypotonic intake
disease process |
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affects of hypotonic FVE
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osmolarity decr. in ECF
fluid shift into ICF Electrolyte imbalance |
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Hyponatremia
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Na<135
too little sodium or too much h2o causing cellular swelling |
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causes of hyponatremia
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h20 excess
SIADH |
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symptoms of hyponatremia
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Neuro
-HA, stupor, coma, cerebral edema N/V peripheral edema, Polyuria-incr. output, decreased thirst |
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treatment for hyponatremia
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fluid restrictions/replacement
hypertonic IV solutions correct slowly to prevent neuro damage |
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hypernatremia
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>145
h20 shifts fromcellso to ecf-cells shrink |
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causes of hypernatremia
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impaired thirst, dysphagia-trouble swallowing, watery diarrhea, polyurea,
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symptoms of hypernatremia
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thirst, lethargy, agitation, seizures, coma
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treatment for hypernatremia
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hypotonic saline IV solution
restrict Na intake diuretics reduce Na level slowly |
