Chapter 13

2 types of IV solutions

Crystalloid (electrolytes and glucose)

Colloid (solid liquid gas)

Crystalloid solution

Contains dissolved crystals (salt/sugar) in water.

Fluid replacement for body fluid loss

Can be isotonic, hypotonic or hypertonic

Colloid solution

Contains molecules (proteins) that are too large to pass out of the capillary membranes and remain in the vascular compartment. (Material equally suspended in liquid)

Needs to be administered in controlled setting.

Works well reducing edema and expanding vascular compartments.

3 categories of tonicity

Isotonic (=)

Hypotonic (low)

Hypertonic (high)

What are Isotonic solutions

0.9% sodium chloride( normal saline) and LR.

Stay inside intravascular compartment and don’t shift fluid to or from other compartments.

Will remain in vascular space

Hypotonic solutions

Lower sodium concentration than the cell. Hydrates the cells while depleting vascular compartment.

Dilutes serum by introducing more solvent.

Quickly leave vascular space

Hypertonic solutions

Pulls fluid and electrolytes from the intercellular and interstitial compartments into the intravascular compartment.

Shift body fluids into vascular spaces and help stabilize BP, increase urine output, and reduce edema.

Requires careful monitoring for fluid overload.

Will draw fluid into vascular space

Third spacing

Abnormal fluid shift into the serous linings of the body ( thick membranes that cover organs).

Tonicity

Concentration of sodium in a solution and the movement of water in relation to sodium levels inside and outside the cell.

Osmolarity

Concentration of certain particles in a solution - particles that influence the movement of water across a semipermeable membrane

2 drip set sizes

Microdrip

Macro drip

Microdrip set size

Allows 60 drops/mL through small needle area inside drip chamber

Macro drop set

Allows 10 to 15 drops/mL through large opening spike and drip chamber (rapid fluid replacement)

Sclerosis

Hardening of tissue

2 problems associated with IV therapy

Local reactions

Systemic complications

What does FAST stand for

First

Access for

Shock and

Trauma

How to do Volume conversion

1L = 1,000mL

Move decimal 3 places to the left to convert mL to L, (divide)

or 3 places to the right to convert L to mL (multiply)

How to do weight conversion

1g = 1,000 mg and 1,000 mg = 1,000 mcg

Smaller to larger unit (mg-g or mcg-mg) - divide smaller unit by 1,000 ( move decimal 3 places to left)

Larger unit to smaller unit (g-mg) - multiply larger unit by 1000 ( move decimal 3 places to right)

How to convert pounds to Kilograms

1kg = 2.2 lbs

Divide patients weight in pounds by 2.2

Example: 170/2.2= 77.27

How to do Drip rate calculation

Volume ( in mL) x drip set \ time in minutes = gtt\min

How to calculate med dosage

Total weight of medication \total volume in mL = weight per mL

Total weight / total volume = g/mL

Example: administer 70g of med “Y” to pt. Med is 100mg in 5mL of saline. How many mL do you need to give to achieve dose ?

1. Determine concentration (dose on hand -

   100mg / 5mL = 20 mg/mL (dose on hand)

2. Determine how much volume to administer-

   70 mg (desired dose) / 20mg/mL (dose on hand) = 3.5 mL

3. Answer - You need to administer 3.5 mL of medication.