Looks like no one added any tags here yet for you.
Intravenous fluids
are chemically prepared solutions that are administered to the patient
Euromed
Famous manufacturer of IVF in the Philippines
Braun
Famous international manufacturer of IVF
Abbott
Old, glass form of IVF
Replace — Rehydrate — Resuscitate
Maintain — Medicate — Monitor
A. Uses/Objectives
1. Crystalloids
2. Colloids
3. Blood and Blood products
B. IV fluids come in 4 different forms:
crystalloid solution
are the primary fluid used for pre-hospital IV therapy
contain electrolytes but lack the large proteins and molecules found in colloids
tonicity
Crystalloids come in many preparations and are classified according to their "__________"
Hypotonic, Isotonic, Hypertonic
Tonicity effect on cell:
Cell swells → bursts (Hemolysis)
Hypotonic
Cell shrinks → death
Hypertonic
a. Saline Solutions (H2O + Na+)
b. Dextrose Solutions
c. Lactated Ringer's Solution
Different Families of IV Fluids (Crystalloid Solutions)
1. 0.9% Sodium Chloride
2. 0.45% Sodium Chloride
3. 0.3% Sodium Chloride
4. 3% Saline solution
a. Saline Solutions (H2O + Na+)
1. 0.9% Sodium Chloride
Normal Saline/PNSS
2. 0.45% Sodium Chloride
1/2 Saline
3. 0.3% Sodium Chloride
1/3 Saline
3. 0.3% Sodium Chloride
IVF of choice for infants/children
4. 3% Saline solution
Induce abortion
Dextrose
is the simplest form of glucose
1. 5% Dextrose in water (D5W)
2. 10% Dextrose in water (D5W)
3. 5% Dextrose in 0.3% NaCl
4. 5% Dextrose in 0.9% NaCl
5. 5% Dextrose in Lactated Ringer's Solution
6. 50% Dextrose in water
b. Dextrose Solutions
1. 5% Dextrose in water (D5W)
Isotonic form
50
1 gram of Dextrose = ______ calories
3. 5% Dextrose in 0.3% NaCl
Popular in children/infants
5. 5% Dextrose in Lactated Ringer's Solution
IV of choice for patient in surgery
c. Lactated Ringer's Solution
Multiple electrolyte solution
1. Multi-ion MB
2. Multi-ion M
3. Multi-ion MR
4. Multi-ion K+
c. Lactated Ringer's Solution
1. Multi-ion MB
Maintenace for babies
2. Multi-ion M
Maintenance for adults
3. Multi-ion MR
Maintenance for replacement
4. Multi-ion K+
Maintenance with potassium
2. Colloid Solutions
Are IV fluids that contain solute in the form of large proteins (large molecules)
2. Colloid Solutions
They cannot pass through the walls of capillaries and onto the cell — remain in blood vessels — Increase IV volume (Blood)
1. Explain to the client/family
2. Determine preferred fluids/intake patterns
3. Offer fluids in small glasses
4. Offer ice chips, sugarless chewing gum
5. Provide mouth care
6. Divide fluid allowance: 1.2 am, 1.3 pm, remaining amt. = night
C. Fluid Restriction Guidelines
first-degree burn
A __________ is superficial and causes local inflammation of skin.
first-degree burn
Sunburns are often categorized as ____________
first-degree burn
Inflammation is characterized by pain, redness, and a mild amount of swelling; skin may be very tender to touch.
second-degree burn
A __________ is deeper and in addition to the pain, redness, and inflammation, there is also blistering of the skin.
third-degree burn
A __________ is deeper still, involving all layers of the skin, in effect killing that area of skin.
third-degree burn
Because the nerves and blood vessels are damaged, these burns appear white and leathery and tend to be relatively painless.
B. Rule of Nines
Burns are measured as a percentage of total body area affected; this measurement is adjusted (Body is measured in multiples of nine)
1. Head = 9%
2. Chest (front) = 9%
3. Abdomen (front) = 9%
4. Upper, mid/low back and buttocks = 18%
5. Each arm = 9%
6. Each palm = 1%
7. Groin = 1%
8. Each leg = 18% total
- Front = 9%
- Back = 9%
B. Rule of Nines
100
Total Body Surface Area (TBSA) = _____%
Minor type
Below 20% = ?
Major type
20-40% = ?
Critical type
Above 40% = ?
severe fluid loss
It is a widely accepted fact that ________ is the greatest problem following major burn injuries
effective fluid resuscitation
Therefore, ___________ is one of the cornerstones of modern burn treatment
1. Monitor using clinical and laboratory parameters.
2. If peripheral intravenous access cannot be achieved, central venous/surgical vascular access must be considered.
3. A urinary catheter and a nasogastric tube should be inserted to control and monitor the patient's fluid balance.
D. Fluid Management in Major Burns
1. Regulation of blood volume
2. Regulation of the pH of the blood
3. Regulation of blood pressure
4. Regulation of the ionic composition of blood
5. Production of red blood cells
6. Synthesis of vitamin D
7. Excretion of waste products and foreign substances
A. Kidney functions
Described as a decrease in glomerular filtration rate
serum creatinine level
Biochemically, renal failure is typically detected by an elevated ____________
glomerular filtration rate; checks the blood for creatinine (a waste product)
The best measure of kidney function is the _________, which can be estimated from a blood test that ______________
Higher than 90 ml/min
Normal result: __________
less than 60 ml/min
If result is persistently _________ for at least three months, this confirms that the person has kidney disease
C. Renal Failure: Dialysis
Blood is filtered and cleaned in a dialyzer, then blood is returned
Hypervolemia
Regulation of blood volume
Increased BP
Regulation of blood pressure
Increased Na+ retention, Increased potassium
Regulation of the ionic composition of blood
Anemia
Production of red blood cells
Increased Ca++ level = Hypercalcemia
Synthesis of vitamin D
1. MONITOR: V/S, IO, LOC, Lab results, Weight, Level of hydration
2. PROVIDE: Adequate dietary sources
3. INSTITUTE: Safety/seizure precautions
4. CHECK: IVF, Catheters, CVP lines, NGT
5. BE ALERT: Neonates, Infants, Children, Elderly, Pregnant women, Chronically ill
E. Nursing Interventions (Renal failure)