fluid volume and electrolytes
what are the types of fluids that can be given?
- isotonic (lactated ringers)
isotonic fluids are_______
- same as our blood. fluids = particle and water.
- it can be given without fluid shifting
- eg: 0.9% NS, lactated ringers
in a hypotonic solution, where is the fluid going? what is an example of a hypotonic fluid
- the fluid is going into the cell because that is where concentration is, the cell is going to swell.
- this is given to dehydrated patients, not given in bolus
- 0.45% NS, half normal saline
where does fluid shift from in a hypertonic solution? what will happen to the cell? where can a hypertonic solution be given?
- 3% NS, it pulls fluid out of cell, the cell will shrink.
- given in a controlled environment like the ICU or OR, it works like mannitol.
- given to HF patients. you can give less volume and see change
what are some things you have to consider while replacing fluid in a patient?
- the route of intake and loss
- water, electrolyte, and protein requirements
- weight and caloric needs
- body surface area
- illness and surgery
packed RBCs are given to what type of patient? why is that safe?
given to CHF patients. only the packed RBCs are given so no extra fluid is given
plasma is given for what? platelets?
- given for more volume
- platelets are given to people with clotting problems
lipid emulsion is given to patients______
who cannot get nutrition through oral diet
who is supposed to be at the bedside for the first 15mins during a blood transfusion? how are blood transfusions supposed to be given.
- an RN is supposed to be at bedside first 15 minutes to monitor for any signs of rejection
- give first 30 minutes slow, and speed up as it goes. it also depends on hospital policies
- normal vol: 3.5-5mEq/L
- neuromuscular activity
- normal kidney function
- contraction of skeletal, cardiac and skeletal muscles
hypokalemia is caused by_________ what are the clinical manifestations of hypokalemia. how do you resolve it? what should you never do?
- caused by insufficient intake of potassium
- give patient potassium or potassium rich foods. never push potassium, it burns
hyperkalemia can be caused by? what are the S/S of hyperkalemia? what can be given to resolve it?
- caused by excessive intake, impaired renal excretion, medications
- give insulin, sodium polystyrene, furosemide all to eliminate the excess potassium
what should potassium tablets be given with?
- give oral K with at least 8oz of water or juice. tell patient to tuck chin, it makes swallowing easier
S/S of hyponatremia and how do you resolve it
- tremors, cerebral edema that can decompensate into seizure, coma, or death.
- correction of a sodium deficit
hypernatremia can be caused by? what are the S/S? how do you resolve
- can be caused by intake of foods high in sodium (pork, soda)
what is the function of calcium?normal calcium values?
- muscle contraction
- bone fractures
S/S of hypercalcemia? how do you resolve?
- chvostek and trousseau signs
- give phosphorus
colloids are given to what kind of patients? what is it?
they are given to burn patients. it is albumin and treated as blood product. used in severe cases. physician's preference.