Scott Gardner Tcc Nursing Q3S05 N132 Fluid Imbalance

Front 1

What is the most common fluid and electroylte imbalance in the US?

What is the morbidity rate from this imbalance?

Back 1

Dehydratation

17-45%

Front 2

Describe ECFVD and the Level it can be manifested in.

Back 2

Extra Cellular Fluid Volume Deficite, more commonly called dehydration.
Mild 1-2L 2%
Moderate 3-5L 5%
Severe 5-10L 8%

Front 3

What is the average daily fluid intake from fluids and solid foods?

Back 3

Fluid 1500-2000ml

Solid 800ml

Front 4

Who is at greatest risk for dehydration?

Back 4

Nursing home residents over the age of 85

Front 5

What is another name for Third Spacing, and where is it commonly seen?

Back 5

Ascites is a common name for Third Spacing.

It is seen in the peritoneal, pericardial, pleural and join cavaties.

Front 6

What are the three spaces wehre fluid is seen?

Back 6

Inside the Cells (Intracellular)
Around the Cells (Interstitial)
The Bloodstream (Intravascular)

Front 7

What is the most accurate measurement of fluid volume status?

Back 7

Weight.

Front 8

Is thirst always a good tool to measure ECFVD?

Back 8

No, thirst is diminished in older adults.

Front 9

When is a client considered to have oliguria?

Back 9

When urine output is between 10-500ml/day (16-20ml/h)

Front 10

What vital sign changes are seen with inadequate fluid volumes?

Back 10

Decrease in SBP, weak pulse, decrease in central venous pressure. Every L of lost fluid caused cardiac output to decrease by 1L/min. HR to increase 8bpm and core temperature to increase 0.3C

Front 11

Describe some clinical manifestations of Cellular Dehydration.

Back 11

MM of the mouth and eyes become dry.
Lips crack, tongue furrows,
swallowing is difficult.
Skin tenting is seen.
Feces become hard and less numerous.

Front 12

Describe some diagnostic findings of fluid deficite.

Back 12

Osmolality >295
Plasma Na >145
BUN > 25
Plasma Glucose >120
Hematocrit >55%
Urine Specific Gravity >1.030

Front 13

Is Cola a good source of oral Fluid Volume Replacement?

Back 13

No, they don't contain adequate electolyte, sugar content may lead to osmotic diuresis, caffeine may lead to diuresis.

Front 14

What is a danger of giving IV fluids too quickly?

Back 14

Cerebral Edema

Front 15

Describe D5W.

Back 15

It is Hypotonic.
50g dextrose, no electorlytes
Replaces deficites of total body water.

Front 16

Describe NS or 0.9%NS

Back 16

It is Isotonic
154mEq/L of Na and Cl
Given for ECF deficites in patients with low Na/CL
Given before/after infusion of blood products.

Front 17

Describe LR

Back 17

Lactated Ringers * Isotonic
Na/K/Ca/Cl/Lactate
Burns/Bleeding/Bile Loss/Diarrhea.
No Mg or PO4

Front 18

Describe D5/LR

Back 18

Lactated Ringers with Descrose
Hypertonic

Front 19

Describe D5/NS

Back 19

Hypertonic
Dextrose and Normal Saline

Front 20

Describe D5/0.45NS

Back 20

Hypertonic
D5 and a 1/2
Used as a Maintenance fluid

Front 21

Describe D5/0.225

Back 21

Hypertonic
D5 and a 1/4
Used as a Maintainence fluid

Front 22

What is the ratio of ice chips to fluid water?

Back 22

2/1
1 Cup of Ice Chips = 1/2 C of Water

Front 23

Why is tenting not appropriate tool for measuring fluid volumes in older adults?

Back 23

There is a loss of adipose tissue which causes tenting in addition to fluid volumes.

Front 24

Name two ways that ECFVE can develop.

Back 24

Extra Cellurar Fluid Volume Excess can come from 1)Simple Overloading of Fluids
2)Filure to excrete fluids.

Front 25

What is anasarca?

Back 25

Massive fluid retention.

Front 26

Provide some of the typical laboratory findings with FVE.

Back 26

Plasma Osmalality <275
Plasma Na <135mEq/L
Hematacrit <45%
Specifici gravity <1.010
BUN <8mg/dl

Front 27

Define 3rd Spacing.

Back 27

Fluid that shifts into the interstitial space and remains there.

Front 28

What type of therapy is IV fluid and electrolyte?

Back 28

Crystalloids

Front 29

What type of IV fluid is a colloid?

Back 29

Blood and blood products

Front 30

Name the three types of infusion based fluid replacements.

Back 30

TPN - Total Parenteral Nutrition
Crystalloid - IV Fluids and Lytes
Colloids - IV Blood and Blood Products

Front 31

What is a VAD?

Back 31

Vascular Access Device

Front 32

Name three types of VAD.

Back 32

Valcular Access Devices include Catheters, Cannulas, or Infusion ports designed for repeated access to the vascular system.

Front 33

When are peripherally placed catheters used?

Back 33

For short term fluid replacement or post-operative antibiotic administration.

Front 34

When are central line catheters or Peripherally Inserted Catheters used?

Back 34

Long term IV therapy.

Front 35

Define a Macrodrip Tubing.

Back 35

One that delivers drops that are 10-15gtt/ml.

Front 36

Define a Microgrip Tubing

Back 36

One that delivers drops that are 60gtt/ml.

Front 37

When should KCl be given IV Push?

Back 37

NEVER. It can be fatal.

Front 38

Why is the foot avoided as a placement site for an IV in adults?

Back 38

Development of Thrombophlebitis.

Front 39

Name 3 Isotonic IV Solutions

Back 39

NS 0.9%
Lactated Ringers
D5W Dextrose 5% in Water

Front 40

What can be said about Dextrose in Saline Solutions?

Back 40

They are always Hypertonic

Front 41

What parts of IV Fluid Administration can be delegated to AP?

Back 41

The Venapuncture and IV Placement CAN NOT be delegated.
-AP should advise of burning at site
-Advise if flowrate has changed
-Advise if dressing gets wet
-Advise nurse if fluid in bag becomes low

Front 42

What size needle is appropritae for
-Fluid placement?
-Surgery?

Back 42

-Fluid Therapy 22gage is appropriate
-Surgery requires 16-18 guage.

Front 43

What are benefits and risks for longer tubing?

Back 43

Longer allows for mobility, but also increases risk for infection, and tripping hazzards.

Front 44

How far above the proposed site of placment should the tourniqute be placed?

Back 44

4-6 Inches.

Front 45

What are some common IV sites for adults?

Back 45

Cephalic, basilic and median cubital.

Front 46

What are some rules for selecting an IV site?

Back 46

Use the Non-Dominate arm, with the most distal site possible.
Avoid areas that are painful to palpation.
Avoid site that will interfere with ADLs.

Front 47

Define the Phlebitis Scale

Back 47

0-No Symptoms
1-Erythema w or S pain
2-Pain @ access site w/eryth and/or edema
3-Same as 2 w/strek formation and palpable venous cord.
4-Same as 3 with cord >1 in and purulent drainage

Front 48

How many steps are there in Infiltration scale?

Back 48

5 which include 0-4

Front 49

When should a bag of IV fluids be changed?

Back 49

When there is less than 50ml in the old bag.

Front 50

When changing a bag, how much fluid should be in the drip chanmber?

Back 50

Between 1/3 and 1/2 full.

Front 51

What is an infiltration?

Back 51

Occurs when IV fluids enter the surrounding space around the venipuncture site.