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73 Cards in this Set
- Front
- Back
- 3rd side (hint)
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NS
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Normal Saline
0.9% Sodium Chloride |
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1/2 NS
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0.45% Sodium Chloride
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D5 NS
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Dextrose 5% in 0.9% Sodium Chloride
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D5 1/2 NS
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Dextrose 5% in 0.45% Sodium Chloride
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LR (or RL)
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Lactated Ringers
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D5LR or D5RL
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Dextrose 5% in Lactated Ringers
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D5W
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Dextrose 5% in Water
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ABGs
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pH 7.35 - 7.45
PaCO2 35-45 PaO2 80-100 SaO2 94-100% HCO3 22-26 |
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BUN
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5-25
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Creatinine
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male 0.6 - 1.5
female 0.6 - 1.1 |
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K+
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3.5 -5.0
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WBC
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5,000 - 10,000
> 12,000 indicates infection present |
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Platelets
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150,000 - 400,000
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Hgb
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male 14 -18
female 12 -16 |
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Hct
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male 40-54%
female 38-47% |
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albumin
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3.5 - 5.0
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Glucose - FBS
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70 - 115
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Glucose - diabetic
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>126
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Glucose - critical
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>400 or <50
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HgbA1C
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6.0 for diabetic
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2 hr PPBS
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70-140
diabetic >140 |
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UA - Specific Gravity
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1.01 - 1.03
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UA - Protein, Glucose
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negative
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Digoxin Level
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0.5 - 2.0
(also see potassium) |
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BNP
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0-100
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INR
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2.0 - 3.0 (Coumadin)
2.5 - 3.5 for mechanical valves |
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PTT
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protime for heparin
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Isotonic
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same as blood - zero net fluid movement
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Hypertonic
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concentrated - draws fluid into the vascular space
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Hypotonic
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dilute - draws fluid out of the vascular space
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2 hr PPBS
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70-140
diabetic >140 |
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UA - Specific Gravity
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1.01 - 1.03
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UA - Protein, Glucose
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negative
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Digoxin Level
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0.5 - 2.0
(also see potassium) |
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BNP
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0-100
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INR
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2.0 - 3.0 (Coumadin)
2.5 - 3.5 for mechanical valves |
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PTT
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protime for heparin
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Isotonic
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same as blood - zero net fluid movement
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Hypertonic
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concentrated - draws fluid into the vascular space - irritates vein
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Hypotonic
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dilute - draws fluid out of the vascular space
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critical urine output
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< 30 mL / hr call physician
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IV therapy change times
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Change tubing q 72 hours
Change fluids q 24 hours Change site q 72 hours |
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Flush IV site
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q 8 hrs
use 2-5 mL NS |
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Types of IVs - Peripheral
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Continuous
Intermittent (usually through Hep Lock - IVPB) |
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Types of IVs - Central
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PICC/PIC (peripherally inserted catheter)
External Access - Triple Lumen, Hickman Hyperalimentation |
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Complications of IV Therapy
Infiltration |
- cool skin, pale, lack of blood return
Stop Infusion, elevate extremity |
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Phlebitis/Thrombophlebitis
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Redness, pain ,swelling, red line streak, fever, sluggish flow of solution
Remove IV, monitor VS, notify MD, Warm Soaks |
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Sepsis
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erythema, warmth, hardness, purulent drainage
fever, chills, elevated WBC Culture, notify MD, monitor VS |
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Circulatory Overload
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JVD, increased BP, crackles, Dyspnea, cough, SOB, increased R, cardiac arrest
Notify MD, slow infusion, O2, diuretics and other meds as ordered by MD, keep warm, elevate HOB |
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Electrolyte imbalances (K+, NA+, Cl)
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replace as ordered
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Air Embolism
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hypotension, cyanosis, weak rapid P, increased intracranial pressures, loss of consciousness
Clamp off IV, notify MD, place pt on left side and lower head, O2, monitor VS |
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Blood
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2 licensed personnel must check and sign
Y-tubing watch for fever, chills, rash, SOB Stop blood, infuse NS with new tubing, notify MD, send urine sample and blood sample to lab STAT |
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Limits for IV fluids
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1000 mL over 4 - 8 hrs unless emergency or shock
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Fluid for replacement - vascular space expansion
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NS and LR
bolus of 500 mL for adults in children 20 mL/kg infants 10 mL/kg |
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First spacing
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normal equilibrium between intra and extra cellular
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second spacing
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accumulation of interstitial fluid and edema
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third spacing
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fluid accumulation in areas that normally have no fluid or a minimal amount of fluid
a sudden weight change is the best indicator of a fluid gain or loss |
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Air Embolism
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hypotension, cyanosis, weak rapid P, increased intracranial pressures, loss of consciousness
Clamp off IV, notify MD, place pt on left side and lower head, O2, monitor VS |
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Blood
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2 licensed personnel must check and sign
Y-tubing watch for fever, chills, rash, SOB Stop blood, infuse NS with new tubing, notify MD, send urine sample and blood sample to lab STAT |
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1 L of water weights 2.2 lbs (1 kg)
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240 cc water = 0.5 lbs
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1 pint = 1 pound
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Limits for IV fluids
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1000 mL over 4 - 8 hrs unless emergency or shock
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Fluid for replacement - vascular space expansion
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NS and LR
bolus of 500 mL for adults in children 20 mL/kg infants 10 mL/kg |
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First spacing
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normal equilibrium between intra and extra cellular
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second spacing
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accumulation of interstitial fluid and edema
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third spacing
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fluid accumulation in areas that normally have no fluid or a minimal amount of fluid
a sudden weight change is the best indicator of a fluid gain or loss |
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ADH or vasopressin
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causes kidneys to become more permeable to water, reabsorbs water, increases blood volume, decreases osmolality, decreased circulating volume, decreased blood pressure.
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Renin and angiotensin
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decreased serum or decreased plasma volume cause the cells in the glomerulus to secrete renin, converts to angiotensin 1 in the liver, then travels to lungs, converted to angiotensin 2, a powerful vasoconstrictor, travels to adrenal glands on top of kidneys and stimulates the production of aldosterone
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atrial natriuretic peptide - AND or ANP (BNP)
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cardiac hormone released by atria - opposes renin-angiotensin-aldosterone - increases glomerular filtration which increases urinary excretion of sodium and water
decreases ADH release by posterior pitutitary, reduces vascular resistance by causing vasodilation |
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water intoxication
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confusion
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Hypernatremia
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causes: increased water loss, decreased water intake, decreased sodium excretion
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S/S: dry mucous membranes, loss of skin turgor, intense thirst, decreased urine output with increased specific gravity
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Hyponatremia
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causes: inadequate sodium intake, increased sodium loss through diuretics, sweating, wound drainage, kidney failure, excessive intake of water
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S/S: mental confusion, altered LOC, anxiety, rapid pulse
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