Fluid and Electrolytes: Hypertonic Solutions and High Alert Medications

Flashcards covering the characteristics, examples, and nursing considerations for hypertonic solutions, as well as the Joint Commission's Top 5 high-alert medications.

Hypertonic Solutions (HIGH ALERT!)

Volume expanders that draw fluid into the vascular space from the cell; characterized as being "Packed w/ particles".

Hypertonic Solution Examples

D5LR, D5% NS, D5NS, TPN, and Albumin.

TPN/PN/TNA

Terms for Parenteral Nutrition or Total Nutrient Admixture.

Indications for Hypertonic Solutions

Used for clients with hyponatremia, shifts of vascular volume to a 3rd space, severe edema, burns, or ascites.

Hypertonic Solution Monitoring

Alert: Watch for fluid volume excess! Monitor in an ICU setting with frequent monitoring of blood pressure, pulse, and CVP(central venous pressure), especially if they are receiving $3\%$ NS or $5\%$ NS.

Side note: 3% or higher, you have to be in critical care.

Joint Commission Top 5 High Alert Medications

Insulin, Opiates and Narcotics, Injectable Potassium Chloride or Phosphate Concentrate, Intravenous Anticoagulants (Heparin), and Sodium Chloride Solutions above $0.9$ percent.

High Alert Medication Safety Protocol

These medications must be double checked with a 2nd Licensed Nurse.

Isotonic Solutions (Quick Tip)

"Stay where I put it!"

Hypotonic Solutions (Quick Tip)

"Go Out of the vessel"

Hypertonic Solutions (Quick Tip)

"Enter the vessel"