Fluid Balance and Management in Healthcare

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Questions and Answers

What is the primary goal of managing Mr. Elliot's intravenous infusion?

To prevent complications of IV therapy (correct)

To achieve fluid overload

To minimize interaction with the infusion site

To ensure frequent changes of infusion equipment

When should the infusion site be checked?

Only at the end of every shift

When dressing the patient and before drug administration (correct)

Only when the patient complains of pain

Only before starting a new infusion

What should be observed for at the cannula insertion site?

Normal flow rate only

Only redness around the site

Dryness of the surrounding skin

Swelling, inflammation, and leakage (correct)

What action should be taken if evidence of infiltration is observed?

Stop the infusion and report to senior staff Signup and view all the answers

What indicates a need for adjusting the dressing or securing the cannula?

The cannula is loose and may irritate the vein Signup and view all the answers

What should be done if the cannula has been in place for more than 48-72 hours?

Remove it immediately if not needed Signup and view all the answers

What is the first step before manipulating the IV infusion equipment?

Wash hands thoroughly Signup and view all the answers

Why is it important to check the infusion rate frequently?

To ensure it matches the prescribed dosage Signup and view all the answers

What is the term used to describe the balance that the body maintains between fluid intake and fluid output?

Homeostasis Signup and view all the answers

Which factor can contribute to a patient's need for increased fluid intake?

Increased physical activity Signup and view all the answers

What is the estimated daily fluid intake requirement for a healthy person?

2–2.5 litres Signup and view all the answers

What is one common sign of dehydration?

Dry mouth and lips Signup and view all the answers

Which route is NOT typically used for fluid intake?

Injection Signup and view all the answers

Which of the following is NOT a method of monitoring fluid output?

Blood pressure Signup and view all the answers

What complication can arise from improper IV therapy?

Hypernatremia Signup and view all the answers

Which symptom might indicate poor peripheral perfusion due to dehydration?

Pallor Signup and view all the answers

What is a primary function of volumetric pumps?

To infuse fluids with high accuracy Signup and view all the answers

Which feature is NOT associated with modern volumetric pumps?

Adjusting medication based on patient weight Signup and view all the answers

What is essential to prevent free-flow when using a volumetric pump?

Using the correct infusion set for the machine Signup and view all the answers

Syringe drivers typically deliver fluids in what unit of measurement?

Millimeters per hour Signup and view all the answers

How should the position of the syringe on a syringe pump be monitored?

Regularly throughout the shift Signup and view all the answers

What should be done to the tubing in the controller of a volumetric pump every few hours?

Move it to prevent compression or damage Signup and view all the answers

Why is it important to check the battery indicator on a syringe driver regularly?

To maintain accuracy in medication delivery Signup and view all the answers

What should a qualified nurse do to assess the patency of a cannula?

Flush the cannula with saline Signup and view all the answers

Which group of patients is particularly vulnerable to dehydration due to neglecting to drink enough fluids?

Elderly patients Signup and view all the answers

What condition could lead a confused patient to neglect their fluid intake?

Neurological disorder Signup and view all the answers

In what situation might a patient's fluid needs initially be underestimated?

During an emergency admission Signup and view all the answers

Which of the following conditions is NOT likely to increase a patient's fluid requirements?

Cold environments Signup and view all the answers

What is Mrs. May's primary nursing problem related to her hydration status?

Dehydration Signup and view all the answers

What specific oral fluid intake goal has been set for Mrs. May?

2 litres per day Signup and view all the answers

How can a nurse ensure that a patient’s fluid intake is monitored effectively?

By following a fluid balance chart Signup and view all the answers

What strategy can help patients achieve their daily fluid intake goals?

Specifying a specific amount to consume per time period Signup and view all the answers

What is the primary concern when administering sodium chloride by infusion?

Fluid and sodium overload. Signup and view all the answers

What is the caloric content of 1 liter of 5% dextrose in water?

170 calories. Signup and view all the answers

Which concentration of dextrose may be used for patients who cannot eat?

10% or 20%. Signup and view all the answers

What complication may arise from prolonged dextrose infusion?

Phlebitis. Signup and view all the answers

Which intravenous cannula size is typically used for adult patients?

Green (21G) or pink (23G). Signup and view all the answers

What could be used to expand intravascular volume aside from dextrose solutions?

Artificial colloids. Signup and view all the answers

What is the initial step when commencing intravenous therapy?

Explaining the procedure to the patient. Signup and view all the answers

Which of the following is NOT required for initiating intravenous therapy?

Patient's dietary history. Signup and view all the answers

Study Notes

Maintaining Fluid Balance

Patients require an intake of at least 2-2.5 liters of fluids daily.
Fluid intake can come from oral drinks, food, tube feeds, and intravenous fluids.
Fluid output can occur through urine, vomiting, feces, diarrhea, sweat, gastric secretions, or wound drainage.
Dehydration may present as dry mouth and lips, dry skin, weakness, lethargy, thirst, sunken eyes, small concentrated urine output, confusion, tachycardia, and poor peripheral perfusion.
Patients at risk of dehydration include the elderly, confused or neurologically disordered, those with deteriorating conditions, post-operative patients, and those on nil-by-mouth.

Factors Affecting Fluid Balance

Fluid requirements increase in hot weather, with a pyrexia, if a urinary catheter is in situ, if constipated, and with fluid loss from the gastrointestinal tract.

Intravenous Fluid Types

0.9% Sodium Chloride (Normal Saline): Isotonic fluid used for fluid replacement.
5% Dextrose in Water: Isotonic fluid for fluid replacement and provides energy.
Stronger Dextrose Solutions (10% or 20%): Provides calorie intake for patients unable to eat.
Blood and Blood Derivatives: Used for large blood losses.
Artificial Colloids (Dextrans, HES, Gelatin Derivatives): Used to expand plasma volume in cases of large blood losses.

Intravenous Fluid Administration

Peripheral Cannula: Green (21G) or pink (23G) are common sizes.
Volumetric Pumps: Used for accurate administration of fluids and drugs.
Syringe Pumps: Deliver small amounts of fluids or drugs accurately.
Syringe Drivers: Used for complex drug regimens and deliver small amounts of fluids accurately.

Complications of Intravenous Therapy (IVT)

Infiltration or Extravasation: Swelling and color change in the limb or around the cannula entry site.
Phlebitis, Infection, or Nerve Injury: Inflammation, redness, or pain around the cannula site.
Blocked Cannula: Leakage from the cannula site, slowing or stopping of infusion flow.
Fluid Overload: Too much fluid administered.
Speedshock: Rapid administration of a drug, leading to adverse effects.

Nursing Interventions for IVT

Secure Dressing: Ensure the dressing is secure to prevent cannula movement.
Monitor Flow Rate: Ensure the fluid is delivering at the correct rate.
Cannula Site Care: Check the site before and after each infusion, when assisting the patient with washing or dressing, and during IV drug administration.
Remove Cannula: Remove the cannula within 48-72 hours of insertion if not in use to prevent complications.

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Description

This quiz explores the critical aspects of maintaining fluid balance in patients, including daily intake requirements, output factors, and signs of dehydration. It also covers the various types of intravenous fluids and conditions affecting fluid requirements. Perfect for healthcare professionals and nursing students.