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73 Cards in this Set

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NS
Normal Saline
0.9% Sodium Chloride
1/2 NS
0.45% Sodium Chloride
D5 NS
Dextrose 5% in 0.9% Sodium Chloride
D5 1/2 NS
Dextrose 5% in 0.45% Sodium Chloride
LR (or RL)
Lactated Ringers
D5LR or D5RL
Dextrose 5% in Lactated Ringers
D5W
Dextrose 5% in Water
ABGs
pH 7.35 - 7.45
PaCO2 35-45
PaO2 80-100
SaO2 94-100%
HCO3 22-26
BUN
5-25
Creatinine
male 0.6 - 1.5
female 0.6 - 1.1
K+
3.5 -5.0
WBC
5,000 - 10,000
> 12,000 indicates infection present
Platelets
150,000 - 400,000
Hgb
male 14 -18
female 12 -16
Hct
male 40-54%
female 38-47%
albumin
3.5 - 5.0
Glucose - FBS
70 - 115
Glucose - diabetic
>126
Glucose - critical
>400 or <50
HgbA1C
6.0 for diabetic
2 hr PPBS
70-140
diabetic >140
UA - Specific Gravity
1.01 - 1.03
UA - Protein, Glucose
negative
Digoxin Level
0.5 - 2.0
(also see potassium)
BNP
0-100
INR
2.0 - 3.0 (Coumadin)
2.5 - 3.5 for mechanical valves
PTT
protime for heparin
Isotonic
same as blood - zero net fluid movement
Hypertonic
concentrated - draws fluid into the vascular space
Hypotonic
dilute - draws fluid out of the vascular space
2 hr PPBS
70-140
diabetic >140
UA - Specific Gravity
1.01 - 1.03
UA - Protein, Glucose
negative
Digoxin Level
0.5 - 2.0
(also see potassium)
BNP
0-100
INR
2.0 - 3.0 (Coumadin)
2.5 - 3.5 for mechanical valves
PTT
protime for heparin
Isotonic
same as blood - zero net fluid movement
Hypertonic
concentrated - draws fluid into the vascular space - irritates vein
Hypotonic
dilute - draws fluid out of the vascular space
critical urine output
< 30 mL / hr call physician
IV therapy change times
Change tubing q 72 hours
Change fluids q 24 hours
Change site q 72 hours
Flush IV site
q 8 hrs
use 2-5 mL NS
Types of IVs - Peripheral
Continuous
Intermittent (usually through Hep Lock - IVPB)
Types of IVs - Central
PICC/PIC (peripherally inserted catheter)
External Access - Triple Lumen, Hickman
Hyperalimentation
Complications of IV Therapy
Infiltration
- cool skin, pale, lack of blood return
Stop Infusion, elevate extremity
Phlebitis/Thrombophlebitis
Redness, pain ,swelling, red line streak, fever, sluggish flow of solution
Remove IV, monitor VS, notify MD, Warm Soaks
Sepsis
erythema, warmth, hardness, purulent drainage
fever, chills, elevated WBC
Culture, notify MD, monitor VS
Circulatory Overload
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
Electrolyte imbalances (K+, NA+, Cl)
replace as ordered
Air Embolism
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
Blood
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
Limits for IV fluids
1000 mL over 4 - 8 hrs unless emergency or shock
Fluid for replacement - vascular space expansion
NS and LR
bolus of 500 mL for adults
in children 20 mL/kg
infants 10 mL/kg
First spacing
normal equilibrium between intra and extra cellular
second spacing
accumulation of interstitial fluid and edema
third spacing
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
Air Embolism
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
Blood
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
1 L of water weights 2.2 lbs (1 kg)
.
240 cc water = 0.5 lbs
.
1 pint = 1 pound
.
Limits for IV fluids
1000 mL over 4 - 8 hrs unless emergency or shock
Fluid for replacement - vascular space expansion
NS and LR
bolus of 500 mL for adults
in children 20 mL/kg
infants 10 mL/kg
First spacing
normal equilibrium between intra and extra cellular
second spacing
accumulation of interstitial fluid and edema
third spacing
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
ADH or vasopressin
causes kidneys to become more permeable to water, reabsorbs water, increases blood volume, decreases osmolality, decreased circulating volume, decreased blood pressure.
Renin and angiotensin
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
atrial natriuretic peptide - AND or ANP (BNP)
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
water intoxication
confusion
Hypernatremia
causes: increased water loss, decreased water intake, decreased sodium excretion
S/S: dry mucous membranes, loss of skin turgor, intense thirst, decreased urine output with increased specific gravity
Hyponatremia
causes: inadequate sodium intake, increased sodium loss through diuretics, sweating, wound drainage, kidney failure, excessive intake of water
S/S: mental confusion, altered LOC, anxiety, rapid pulse