NU 211-Ch. 34: Fluid Volume Excess and IV Solutions

Vocabulary practice flashcards covering fluid volume excess (hypervolemia), its signs and symptoms, and hypotonic, isotonic, and hypertonic intravenous solutions from Chapter 34.

Hypervolemia

The excessive retention of sodium and water in the extracellular fluid compartment.

Hypervolemia Cardiovascular Signs

Elevated blood pressure, bounding pulse, and jugular vein distension.

Hypervolemia Respiratory Signs

Crackles (rales) in lungs, dyspnea, and orthopnea.

Hypervolemia Tissue Changes and Weight Gain

Pale, cool skin; peripheral edema; ascites; and weight gain of $3\,\text{lbs}$ in $24\,\text{hr}$ or $5\,\text{lbs}$ in a week.

Hypotonic IV Solutions

IV fluids that contain fewer electrolytes and less sodium than blood.

Cellular Effect of Hypotonic Solutions

Causes cells to swell and potentially burst due to water influx.

Clinical Purposes of Hypotonic IV Solutions

Provide free water for waste excretion, treat cellular dehydration, replace cellular fluid, and treat diabetic ketoacidosis.

Common Hypotonic IV Solutions

$0.45\%$ NaCl (half-normal saline), $0.33\%$ NaCl, $0.2\%$ NaCl, and $2.5\%$ dextrose in water.

Isotonic IV Solutions

IV fluids with a similar concentration of dissolved particles as blood plasma, used for hypocolemuc patients to raise blood pressure and store circulating volume.

Clinical Indications for Isotonic IV Solutions

Dehydration, blood loss, vomiting, diarrhea, and fluid volume deficit.

D5W (5% Dextrose in Water)

An intravenous solution containing $5\%$ dextrose in water that is isotonic in the bag but becomes hypotonic in the body.

Lactated Ringer's (LR)

A balanced electrolyte solution classified as an isotonic IV fluid.

Hypertonic Solutions Mechanism of Action

Pulls fluids and electrolytes from intracellular and interstitial compartments into the intravascular space.

Clinical Uses of Hypertonic Solutions

Stablaize blood pressure, increase urine output, decrease edema, treat severe hyponatremia, and reduce cerebral edema.

Hypertonic Salt Solutions

Solutions with a higher sodium concentration than cells, exemplified by $3\%$ NaCl and $5\%$ NaCl.

Hypertonic Sugar Solutions

Solutions with a higher glucose concentration than cells, exemplified by D10W, D20W, and D50W.

Mannitol Solutions

A sugar alcohol hypertonic solution used to reduce brain swelling and increase renal excretion.

Acute Renal Failure Fluid Assessment Scenario

A clinical presentation featuring distended neck veins, cool and pale skin, and crackles in the lungs, indicating hypervolemia.