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Questions and Answers
What is the primary use of IV fluids?
What is the primary use of IV fluids?
Which of the following is NOT a general nursing consideration for IV fluids?
Which of the following is NOT a general nursing consideration for IV fluids?
What is the primary difference between crystalloids and colloids?
What is the primary difference between crystalloids and colloids?
What is the primary purpose of a hypertonic solution?
What is the primary purpose of a hypertonic solution?
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Lactated Ringer's solution is contraindicated in patients with liver disease.
Lactated Ringer's solution is contraindicated in patients with liver disease.
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Which IV fluid is often recommended as a maintenance fluid for pediatric patients?
Which IV fluid is often recommended as a maintenance fluid for pediatric patients?
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Which of the following is NOT a consideration when administering Albumin?
Which of the following is NOT a consideration when administering Albumin?
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What is the main reason to use a colloid instead of a crystalloid?
What is the main reason to use a colloid instead of a crystalloid?
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A solution that has a higher concentration of dissolved particles than blood plasma, and an osmolality greater than ______ mOsm/l, is considered a ______ solution.
A solution that has a higher concentration of dissolved particles than blood plasma, and an osmolality greater than ______ mOsm/l, is considered a ______ solution.
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What are two potential complications of rapid infusion of hypertonic solutions?
What are two potential complications of rapid infusion of hypertonic solutions?
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Colloids are indicated for patients in malnourished states who cannot tolerate large infusions of fluids.
Colloids are indicated for patients in malnourished states who cannot tolerate large infusions of fluids.
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D5W is a hypotonic solution.
D5W is a hypotonic solution.
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Study Notes
Intravenous (IV) Fluids
- IV fluids are used for resuscitation, replacing fluid loss, and maintaining hydration in patients unable or disallowed from drinking.
- Like medications, IV fluids have benefits and risks; careful administration is crucial to avoid fluid overload or acid-base imbalances.
- Crystalloid solutions contain small molecules readily crossing semi-permeable membranes.
- Crystalloids are categorized as isotonic, hypotonic, or hypertonic based on their relative tonicity to plasma.
- Isotonic solutions have similar dissolved particle concentration to plasma and osmolality (mOsm/L).
- Isotonic solutions are primarily used to correct fluid volume deficits, remaining within the extracellular compartment (blood vessels, interstitial spaces).
General Nursing Considerations
- Document baseline vital signs, body weight, lung and heart sounds, note edema presence. Continuous monitoring is necessary.
- Monitor for signs of hypovolemia: weak pulse, poor skin turgor, hypotension, urine output < 0.5 mL/kg/hour.
- Monitor for signs of hypervolemia: bounding pulse, hypertension, pulmonary crackles, dyspnea, peripheral edema, JVD, S3 heart sound.
- Daily serum metabolic panels are advised for patients on continuous IV fluids, monitoring sodium, potassium, glucose, and renal function.
I.V. Fluid Osmolarity/Composition
-
0.9% NaCl (Normal Saline Solution, NSS):
- Used for resuscitation, hemorrhage, severe vomiting, diarrhea, GI drainage, fistulas, wounds, mild hyponatremia, metabolic acidosis, hypercalcemia.
- 308 mOsm/L
- Na+ 154 mmol/L
- Cl- 154 mmol/L
- Caution in cardiac or renal disease. Should only be administered with blood products.
- Monitor for hyperchloremic acidosis with large volumes.
-
Lactated Ringer's Solution (LR).
- First-line fluid for burn and trauma patients, acute blood loss, hypovolemia, GI loss, metabolic acidosis.
- Contraindicated for liver disease.
-
5% Dextrose in Water (D5W):
- Isotonic/hypotonic.
- Initially hypotonic (dilutes extracellular fluid).
- Provides free water for kidneys.
- Used in hypernatremia.
-
Ringer's Solution:
- Similar to LR, but without lactate.
- Not for patients with metabolic acidosis.
-
PlasmaLyte:
- Electrolyte composition similar to plasma.
- Less likely to cause dilutional or hyperchloremic acidosis.
-
0.33% NaCl:
- Allows kidneys to retain water.
- Caution in patients with heart failure or severe renal insufficiency; often administered with dextrose to increase osmolality.
-
0.45% NaCl (1/2 NS):
- Used in hypernatremia.
- Caution in patients with heart failure.
Additional Isotonic Solutions
-
0.45% NaCl:
- Similar to LR but without lactate. Not for patients with metabolic acidosis.
-
PlasmaLyte:
- Electrolyte composition similar to plasma.
- Less likely to cause electrolyte imbalances.
Hypotonic Solutions
- Hypotonic solutions have a lower concentration of dissolved particles than plasma (<250 mOsm/L).
- Fluid shifts from vascular space into cells, potentially worsening hypovolemia and hypotension.
- Generally used for intracellular dehydration (diabetic ketoacidosis).
Hypertonic Solutions
- Hypertonic solutions have a higher concentration of dissolved particles than plasma (>375 mOsm/L).
- Fluid shifts from cells into vascular space; used to treat hyponatremia and cerebral edema.
- Caution in patients with increased intracranial pressure (ICP), cardiac conditions, severe renal insufficiency.
Colloids
- Contain large molecules that remain within blood vessels. (e.g., albumin, starches)
- Expand intravascular volume through higher oncotic pressure.
- Used in situations needing rapid volume expansion (shock, significant blood loss).
- Monitor for fluid overload, edema.
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Description
This quiz covers the essential aspects of intravenous (IV) fluids used in nursing practice. It includes information on types of IV fluids, their classifications, and important nursing considerations for monitoring patients. Understanding the use and administration of IV fluids is critical for patient safety and effective treatment.
