NSG 116 IV Fluids and Electrolytes

What is third space fluid loss

also known as third-spacing

condition where fluid builds up in areas that normally have little to no fluid such as the interstitial space

The three types of tonicity

hypertonic

hypotonic

isotonic

Hypotonic

0.45% NaCl

D5W (5% dextrose in water)

Hypertonic

2% and 3% NaCl

D5 0.45% NaCl

D5 0.9% NaCl

What is intracellular fluid

Fluid within a cell

What is extra cellular fluid

Fluid outside of the cell

There are two types: intravaecular and interstitial

Intravascular fluid is

Fluid that’s contained within the blood vessel like circulating blood

Interstitial fluid is

Fluid surrounding the cells like that which causes peripheral edema

Isotonic

Lactated ringers

D5W (5% dextrose in water)

0.9% NaCl

Continuous Dose

employs a steady, hourly delivery

Bolus Dose

the administration of a single, relatively large dose of a substance

typically given over about 1 to 30 minutes.

How do we know if fluids are working

The skin and mucous membrane is hydrated

There is no skin tenting

They have adequate urine output

Fluids are given orally or

Intravenously

When fluid goes from the intercellular to the

intravascular that is hypertonic

Isotonic fluids are

balanced

When the cell needs fluids from the

intravascular that is hypotonic

Hyponatremia

A condition that occurs when the level of sodium in the blood is too low.

With this condition, the body holds onto too much water. This dilutes the amount of sodium in the blood and causes levels to be low.

What can cause fluid loss

Dehydration

Hemorrhage

Third spacing fluid shifts

What is the purpose of IV fluids

Replace fluid loss

Improve perfusion

Replace electrolytes

Maintain hydration

Fluid can be given continuously or as a

Bolus

Bolus are given when

Patient needs support quickly usually for dehydration or low BP

Maintenance fluids are given

As a steady dose over a long period of time to maintain the level of hydration

Ex) 125 ml/ hr

KVO (keep vein open )

Is an ambiguous term for super slow infusion which is a dose to maintain the IV patient

Ex) 10 ml /hr

IV push

Medication route is pushed by RN for 5 minutes or less

Slow IV push is administered

By RN for over 5-10 minutes

IV piggyback is a

Medication that infuses usually alongside a maintenance fluid over a longer period of time like 15 minutes to 4 hours, commonly are antibiotics or potassium

IV drip GTT or infusion

Is a medication that infuses continuousLy such as heparin and may be titrated based on parameters

What does dehydration look like in patients

Skin tenting

Dry, flaky skin

Pale mucosa

Dry cracked lips

Thirst

Dry mouth

Dark urine

Dizziness

Fatigue

Sunken eyes

Bradycardia

Hypotension

Rapid but shallow breathing

What does fluid overload look in patients

Edema

High blood pressure

Shortness of breath

Rapid weight gain

Abdominal dissensions

Crackles or wheezing in lungs

What is an adverse effect of IV fluids

Fluid overload