IVF, FVE, FVD Krueger

isotonic patho

-No fluid shifts
-Dilutes hemoglobin

isotonic use

-Vascular Expansion
-Electrolyte Replacement
-Keep vein open

isotonic complications

-Can cause fluid overload
-Generalized edema

isotonic types

0.9% NS, Lactated Ringers (LR), D5W

isotonic in bag, hypotonic in body

what is special about D5W?

infants, head injury

Don't give D5W to ___, ___ patients because they can have cerebral edema

hypertonic patho

-Shifts fluid back into circulation

hypertonic use

-Replaces Electrolytes
-Hyponatremia
-Cerebral edema in brain injuries
-Used in patient in DKA after initial treatment to decrease their blood sugar to help maintain blood sugar

hypertonic complications

-May cause fluid overload
-Hypernatremia
-Use with caution with patients that have cardiac or renal or liver diseases (ie CHF, renal, liver, failure patients)
-use cautiously and 3% or higher is typically only given in ICU settings

hypertonic types

D5 0.45% NS (d% ½ NS), D5 0.9% NS (d5NS), HS 3% or 5%

hypotonic patho

Shifts fluid out of vessel into cell

hypotonic use

-Hydrate cell
-DKA
-HHS

hypotonic complication

-Can increase edema
- May cause hyponatremia
-Worsen hypotension
-Cardiovascular collapse from vascular depletion
-Do not administer to burn/trauma, incr ICP patients

hypotonic types

0.25% NS ( ¼ NS), 0.45%NS ( ½ NS), D5W

hypovolemia causes and manifestations

-Excessive fluid loss (they are dry)
-Insufficient po intake, ie: stroke, oral injury
-Excessive use of diuretics
-Trauma, burns, heart failure-third spacing
-Manifestations: weight loss, poor skin turgor, oliguria, rapid peripheral pulses, flattened neck veins, anxiety, cool, clammy skin, pale, restlessness

hypovolemia lab/ management

-Electrolytes
-Hgb & hct high if hemodiluted
-Hgb & hct low if bleeding
-Elevated bun & creatinine
-Increase po/iv intake
-May need additional medication for hypotension if fluids does not correct

hypovolemia care

-Monitor intake and output
-Close monitoring of iv fluids
-Physical assessment
-Monitoring lab data
-Vital signs
-Watch for postural hypotension
-Assess for adequate oral intake
-Assess urinary output
-Daily weights
-Fall risk

30

How many __ml/hr of urine output is expected in a day?

hypervolemia causes and manifestations

-Excessive fluid intake (they are wet)
-Retention of sodium/water: chf, cirrhosis, renal failure, increase oral intake of na, adrenal gland disorders-cushing, use of corticosteroids
-Manifestations: weight gain, ascites, edema, ANASARCA (edema over all the body), tachycardia, s3 heart sound, jvd, increased urinary output

hypervolemia lab/management

-Electrolytes
-Hgb & hct low
-Low bun
-Decrease po/iv intake
-Use of diuretics

colloids

albulmin, dextran, mannitol

hypervolemia care

-Monitor intake and output
-Close monitoring of iv fluids
-Physical assessment
-Monitoring lab data
-Vital signs
-Watch for pulmonary edema-complication of FVE
-Assess urinary output
-Daily weights
-Fluid restriction

IV lasik, IV nitroglycerin

If someone has pulmonary edema from hypervolemia, what meds to give?

2000

What is the fluid restriction ___ml/day for hypervolemia patients?

albumin

works to help shift fluid back into the vasculature instead of the tissues such as in edema, etc or when your body is not making enough albumin itself

dextran

is plasma volume expander made from natural sources of sugar (glucose). It works by restoring blood plasma lost through severe bleeding. Used in severe cases of hypovolemia

mannitol

works to increase diuresis by decreasing absorption of water in the kidneys....Also increasing the excretion of Na+ and Cl