IV CHapter 3-4

Questions and Answers

What percentage of total body weight is typically comprised of water in adults?

50%

70%

40%

60%>>>>>>>>>.BODY OF WATER IN WHICH ELECTROLYTES DISSOLVE • ~60% OF TOTAL BODY WEIGHT (TBW) IS WATER • VARIES WITH AGE AND GENDER • DECREASES WITH AGE • PURPOSE • MEDIUM IN WHICH CELLULAR REACTIONS TAKE PLACE • IMBALANCES CAN BE LIFE-THREATENING (correct)

What are the different types of fluids in the body

Interstitial fluid

Extracellular fluid

Intracellular fluid (correct)

Intravascular fluid(BLOOD)-------interstitial space(inbetween)---intracellular is the cells of course------we must monitor I & O for 3 days (correct)

What are some fluid functions

Colloid solution

Isotonic solution

Hypotonic solution (correct)

MAINTAINS BLOOD VOLUME • REGULATES BODY TEMPERATURE • TRANSPORTS MATERIAL TO AND FROM THE CELL • SERVES AS AQUEOUS MEDIUM • ASSISTS DIGESTION OF GOOD FOOD • ACTS AS A SOLVENT • SERVES AS A MEDIUM FOR THE EXCRETION OF WASTE (correct)

What are fluid replacemnt and loss ideas

Life-threatening conditions Signup and view all the answers

Simple tonicity definitions to remember

Isotonic – no effect on fluid volume • Hypotonic – move water into cells • Hypertonic –move water into extracellular space ..>>>Tonicity-- Tension that effective osmotic pressure exerts on cell size>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>Hypotonic cells are dehydrated and goin into cell they need less salty solution_________ Hypertonic is cell overload and trying to get them to decrease they need salty solution-------------------Osmolality lab value tells you if they are dehydrated or fluid overload Signup and view all the answers

What is a physical assessment of fluid and electrolyte needs

NEUROLOGICAL SYSTEM/LEVEL OF CONSCIOUSNESS; CHANGES OCCUR WITH • SERUM OSMOLALITY OR SERUM SODIUM CHANGES • ACID–BASE IMBALANCES • ABNORMAL REFLEXES – CALCIUM/MAGNESIUM LEVELS • CARDIOVASCULAR SYSTEM: INDICATORS OF FLUID VOLUME STATUS • PULSE QUALITY/RATE • ORTHOSTATIC HYPOTENSION • PRESENCE OF EDEMA___________Pulse can be increased with fluid overload and deficit Coarse crackles for overload Signup and view all the answers

Which finding would least suggest hypovolemia during a physical assessment?

NDICATORS OF FLUID VOLUME STATUS • RESPIRATORY • CHANGES IN RESPIRATORY RATE AND DEPTH • DYSPNEA/TACHYPNEA • SKIN APPEARANCE AND TEMPERATURE • SKIN TURGOR • FINGERPRINTING EDEMA Signup and view all the answers

Things to watch for in fluid and elextrolyte needs

special senses-mucous membranes,tongue,tearing salivation,body weight and periorbital edema Signup and view all the answers

What are Iv treatment electrolyte needs caused from

HYPOVOLEMIA – FLUID VOLUME DEFICIT – AKA DEHYDRATION • EXCESSIVE LOSS OF BODY WATER OR INADEQUATE INTAKE OF FLUIDS • HEMORRHAGE • GI LOSS – V/D/NG TUBE • FEVER • BURNS • MEDS - DIURETIC______________HYPERVOLEMIA – FLUID VOLUME EXCESS • EXPANSION OF ECF • PRIMARY CAUSE IS CARDIAC DYSFUNCTION • SECONDARY TO INCREASE IN TOTAL BODY NA CONTENT • RENAL FAILURE – HOLDING ONTO H20+NA • S/SX: WEIGHT GAIN, EDEMA, LUNG SOUNDS Signup and view all the answers

What are hyponatremia and hypernatremia symptoms

Increased fluid retention Signup and view all the answers

What are IV treatment for electrolyte needs in potassium

Dehydration symptoms Signup and view all the answers

What is a characteristic sign of calcium deficiency? you also get trousseaus sign with arm and chvosteks with face for hypocalcemia

Abnormal reflexes Signup and view all the answers

What are the differences between hypomagnesmia and hypermagnesmia

Diuretic medication use Signup and view all the answers

What are age related concerns

Weight gain Signup and view all the answers

What are crytalloid solutions (Crystalloid-normal saline, lactated ringers

CONTAIN FLUIDS AND ELECTROLYTES • SHORT-TERM USE BECAUSE THEY CONTAIN NO PROTEINS • MAINLY TREAT DEHYDRATION AND ELECTROLYTE IMBALANCES • 3 CLASSIFICATIONS • ISOTONIC • HYPOTONIC • HYPERTONIC Signup and view all the answers

What are isotonic solutions

3% Sodium Chloride Signup and view all the answers

What are hypotonic solutions

Circulatory overload Signup and view all the answers

What are hypertonic solutions

Causes water to move into the cell Signup and view all the answers

What are colloidal solutions

Called Plasma or Volume Expanders Types of colloids • Albumin • dextran.>.>>>>>>Use this for low BP Helps pull fluid from extracellular space Like for somoen in hypovolemic shock Signup and view all the answers

What does albumin help with In IV

5% Dextrose and 0.9% Sodium Chloride Signup and view all the answers

Study Notes

Body Fluid

Body fluid refers to water within the body where electrolytes dissolve; it constitutes approximately 60% of total body weight, varying with age and gender, and decreasing as one ages.
Essential for cellular reactions, imbalances in body fluid can be life-threatening.

Fluid Distribution

Comprises intracellular fluid (ICF), extracellular fluid (ECF), and intravascular fluid.
Water loss occurs through sensible (measurable) and insensible (not measurable) means, averaging 1000 mL/day in adults.

Fluid Functions

Maintains blood volume, regulates body temperature, and transports materials to/from cells.
Acts as an aqueous medium for digestion, a solvent for substances, and facilitates waste excretion.

Fluid Replacement

Replacement is necessary in cases of dehydration, illness, blood loss, or surgical recovery.
Evaluation of patient status is crucial for determining appropriate IV fluids based on individual needs.

Tonicity of Solutions

Tonicity describes the osmotic pressure effect on cell volume, affecting fluid movement.
Types include:
- Isotonic: No change in fluid volume.
- Hypotonic: Water moves into cells, causing swelling.
- Hypertonic: Water moves from cells to the extracellular space, causing cell shrinkage.

Physical Assessment of Fluid and Electrolyte Needs

Assessment includes monitoring neurological status and consciousness, especially in relation to serum osmolality and sodium levels.
Acid-base imbalances and abnormal reflexes can indicate electrolyte issues related to calcium and magnesium.
Cardiovascular evaluation focuses on fluid volume indicators such as pulse quality and rate, orthostatic hypotension, and presence of edema.

Neurological System and Fluid Balance

Level of consciousness can change due to variations in serum osmolality and sodium levels.
Acid-base imbalances may lead to alterations in neurological function.
Abnormal reflexes may indicate calcium and magnesium level issues.

Cardiovascular Assessment

Indicators of fluid volume status include pulse quality and rate.
Orthostatic hypotension may be present due to fluid imbalance.
Edema serves as a visible sign of altered fluid homeostasis.

Respiratory System Evaluation

Changes in respiratory rate and depth can indicate fluid status.
Dyspnea (difficulty breathing) and tachypnea (rapid breathing) are critical signs.
Skin appearance, temperature, and skin turgor can reflect hydration levels.
Fingerprinting edema is a practical assessment for fluid retention.

Importance of Special Senses

Mucous membrane condition and tongue appearance can provide insights into hydration.
Tearing and salivation levels are also essential indicators.
Regular monitoring of body weight is crucial for assessing fluid balance.

Hypovolemia: Fluid Volume Deficit

Caused by excessive body water loss or inadequate fluid intake.
Common causes include hemorrhage, gastrointestinal losses (vomiting, diarrhea, NG tube), fever, burns, and diuretic medications.

Hypervolemia: Fluid Volume Excess

Characterized by expansion of extracellular fluid (ECF).
Often caused by cardiac dysfunction or an increase in total body sodium content.
Renal failure can lead to retention of water and sodium, leading to symptoms like weight gain, edema, and abnormal lung sounds.

Hyponatremia Effects

Significant impact on central nervous system (CNS) cells.
Symptoms include impaired taste sensation, anorexia, muscle cramps, fatigue, and anxiety.
Critical when serum sodium falls below 2.5 MEQ/L, possibly decreasing respiration rates.
Treatment may involve diuretics, 0.45% sodium solutions, and dialysis in severe situations.
The most common cause of hyponatremia is renal failure.

Infants/Children:
- Have less body surface area and immature renal structures.
- Higher metabolic rate predisposes them to fluid and electrolyte imbalances.
Older Adults:
- Potassium (K+) not stored effectively, increasing risk of deficiency.
- Medications like diuretics and steroids can exacerbate potassium loss.
- Decreased thirst sensation and muscle mass contribute to fluid challenges.
- Older adults are less able to process large fluid volumes, heightening risk of fluid volume excess (FVE) and deficit (FVD).
- Monthly monitoring of weight is recommended to identify changes in fluid status.

Crystalloid Solutions

Isotonic Solutions: Maintain same osmolarity as normal body fluids.
- Lactated Ringer's
- 0.9% Sodium Chloride
- 5% Dextrose in Water
- Plasmalyte
Hypotonic Solutions: Lower osmolarity, causing water to move into cells.
- 0.45% Sodium Chloride
- 0.225% Sodium Chloride
Hypertonic Solutions: Higher osmolarity, leading to water moving out of cells.
- 3% Sodium Chloride
- 5% Sodium Chloride
- 5% Dextrose and 0.45% Sodium Chloride
- 5% Dextrose and 0.9% Sodium Chloride
- 10% Dextrose in Water (DW), 20% DW, 50% DW
- Mannitol

Colloidal Solutions

Known as plasma or volume expanders.
Main types of colloids include Albumin and Dextran.

Albumin

Composition: Natural plasma protein, commercially extracted from donor plasma; considered a blood product.
Types:
- 5% Albumin - Isotonic
- 25% Albumin - Hypertonic
Usage: Must adhere to manufacturer recommendations and used within 4 hours of opening.
Indications:
- Hypovolemia with or without shock
- Hypovolemia in presence of hemorrhage
- 5% for general hypovolemia; 25% when edema is present
- Hypoalbuminemia
Risks:
- Allergic reactions
- Circulatory overload (greatest risk with 25% solution)
- Pulmonary edema
- Contraindicated in patients with traumatic brain injury (TBI) due to potential increase in intracranial pressure (ICP)

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Description

Explore the essential concepts of body fluids, including the definition, purpose, and distribution in the human body. This quiz covers the significance of electrolytes, total body water, and the impact of age and gender on water composition. Test your understanding of homeostasis and fluid balance related to health.