IV Fluids and Their Applications

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Questions and Answers

Which fluid type is contraindicated in fluid overload?

Hypertonic fluid

Isotonic fluid (correct)

Hypotonic fluid

None of the above

What is the primary clinical indication for administering hypotonic fluids?

Cerebral edema

Hyponatremia

Fluid overload

Dehydrated cells (correct)

What can occur if hypotonic fluids are administered to patients with increased ICP?

Brain swelling (correct)

Fluid overload

Hypernatremia

Cell expansion

Which of the following fluid types does NOT change the size of cells?

Isotonic fluid Signup and view all the answers

Which solution is commonly ordered as a hypotonic fluid?

0.45% NS Signup and view all the answers

What is a critical reason for using hypertonic fluids in an ICU setting?

To pull water into the bloodstream Signup and view all the answers

What effect do hypertonic fluids have on the cells?

Cells shrink Signup and view all the answers

Which condition is a target for hypotonic fluid therapy?

Dehydrated cells Signup and view all the answers

Which scenario is appropriate for selecting an IV insertion site?

An arm with no previous complications Signup and view all the answers

What is the recommended action when applying a tourniquet for IV insertion?

Ensure it is applied for no more than 2 minutes Signup and view all the answers

What type of IV fluid remains within the intravascular compartment and does not cause cells to change shape?

Isotonic Signup and view all the answers

Which medication is associated with treating Blue Man Syndrome?

Amiodarone Signup and view all the answers

Which of the following represents the correct order of the nine rights of medication administration?

Right dose, right patient, right drug Signup and view all the answers

What causes cellulitis at an IV insertion site?

Inadequate aseptic techniques Signup and view all the answers

Which statement accurately describes the use of extension tubing in IV therapy?

It connects the IV catheter to a saline lock Signup and view all the answers

What is the primary purpose of IV fluid administration?

To correct imbalances of fluids and electrolytes Signup and view all the answers

What is the primary effect of hypotonic fluids on cells?

Cells swell due to water influx Signup and view all the answers

Which medication is classified as a guanosine analog used to treat herpesvirus infections?

Valacyclovir Signup and view all the answers

What mechanism of action does valacyclovir utilize to halt viral replication?

It inserts into the replicating viral DNA Signup and view all the answers

Which of the following is NOT a common side effect of valacyclovir?

Cardiac arrhythmia Signup and view all the answers

Which term describes the condition caused by valacyclovir leading to a severe rash and potential organ involvement?

Stevens-Johnson syndrome Signup and view all the answers

What is the main difference between hypotonic and hypertonic fluids?

Hypertonic fluids have a higher concentration of solutes than the cells Signup and view all the answers

What should be performed before administering antiviral medication like acyclovir for genital herpes?

Conduct a baseline assessment of symptoms Signup and view all the answers

Which serious but rare side effect can occur from the use of acyclovir and valacyclovir?

Hemolytic uremic syndrome Signup and view all the answers

What is the primary purpose of the antiviral medications used to treat herpesviruses?

To inhibit viral DNA replication Signup and view all the answers

Which of the following is NOT a recommended nursing consideration when caring for a client prescribed antiviral medication for herpes?

Immediately increase the medication dosage if symptoms worsen Signup and view all the answers

Why is it important for clients to refrain from sexual activity during herpes outbreaks?

It helps reduce the risk of transmission to others Signup and view all the answers

Which of the following side effects might indicate a serious reaction to antiviral medication in patients?

Nephrotoxicity and hemolytic uremic syndrome Signup and view all the answers

What should clients be instructed to do to ensure optimal effectiveness of their antiviral medication?

Stay well-hydrated and take medication on a regular schedule Signup and view all the answers

Which of the following laboratory tests would be expected to be reviewed for a patient undergoing treatment for herpes simplex virus?

Both B and C Signup and view all the answers

Which of the following best describes the action of guanosine analogs in treating herpesviruses?

They inhibit the replication of viral DNA Signup and view all the answers

In which situation is it inappropriate to choose a vein for IV insertion?

In an arm with a recent mastectomy Signup and view all the answers

What is the primary physiological effect of administering hypotonic intravenous fluids?

Pulls body water into the cells Signup and view all the answers

Which clinical problem is primarily targeted by the administration of hypotonic fluids?

Hyperglycemic conditions like DKA Signup and view all the answers

What is the antidote for opioid overdose?

Naloxone Signup and view all the answers

Which of the following conditions should contraindicate the use of hypotonic IV fluids?

Dehydration Signup and view all the answers

What complication can arise from improperly performed IV insertion that leads to cellulitis?

Inflammation of loose connective tissue Signup and view all the answers

What is the mechanism by which hypotonic fluids affect cellular structure?

They cause water to move into the cells, potentially leading to swelling Signup and view all the answers

Which of the following is NOT a purpose of establishing an IV?

To provide therapeutic hypothermia Signup and view all the answers

Which of these intravenous solutions is commonly considered hypotonic?

0.45% NaCl Signup and view all the answers

Study Notes

IVs

Never choose veins in an arm that has a mastectomy, extremity with dialysis shunts or AV fistulas, signs/symptoms of infection, extensive scarring, burns, or surgeries, CVA paralysis, or distal to previous puncture.
Technical pointers for IV insertion procedure:
- Prepare equipment using strict aseptic technique (alcohol or chlorhexidine).
- Apply a tourniquet 6-8 inches above the intended insertion site.
- Massage the vein as needed.
- Use heat as needed.
Extension Tubing connects to patient's IV catheter to make a saline lock.
Setting up an IV involves applying a tourniquet, palpating the vein, scrubbing the hub, using a saline flush to connect the tubing, and connecting the cap to the extension tubing.
Cellulitis is an inflammation of loose connective tissue around the insertion site, caused by poor aseptic technique. It's treated with antibiotics. The area spreads in a diffuse circular pattern.
9 Rights of medication administration:
- Right patient
- Right drug
- Right dose
- Right route
- Right time
- Right documentation
- Right to refuse
- Right assessment
- Right education

Monitoring/Nursing Interventions (IV Push)

Assess the patient before, during, and after medication administration, observing for adverse reactions.
Know what to do if an adverse reaction occurs (support airway, give oxygen, administer antidote).
Medications for Blue Man Syndrome: Amiodarone
Medications for Red Man Syndrome: Vancomycin

Types of IV Fluids

Isotonic Fluids: Remain within the intravascular compartment, maintaining the same concentration inside and outside cells.
- Examples: 0.9% Sodium chloride (Normal Saline), Lactated Ringers (LR).
Hypotonic Fluids: Have a lower solute concentration than cells, causing water to move into cells, potentially causing them to swell.
- Examples: 0.45% NS, 0.33% NS, 0.2% NS
Hypertonic Fluids: Have a higher solute concentration than cells, causing water to move out of cells, potentially causing them to shrink.
- Examples: D5 0.9%NS, D5 0.45%NS, D5 LR, 3% NS, D10W

IV Complications

Infiltration: Fluid leaking into surrounding tissue, causing swelling, discomfort, and blanching.
Phlebitis: Inflammation of a vein, causing redness, pain, and tenderness.
Cellulitis: Inflammation of tissue around the insertion site, often caused by poor aseptic technique.
Extravasation: Leaking of vesicant drugs into surrounding tissue. Results in tissue damage.
Overload: Excessive fluid intake, potentially leading to shortness of breath, increased blood pressure, and edema.
Air Embolism: Air entering the vein. Signs include sudden dyspnea and chest pain.

Other Information

IV insertion sites should avoid areas with shunts/fistulas, burns/scars or sites distal to previous punctures.
Medication administration and appropriate dosages:
Drug, dose, route, time, patient, documentation, right to refuse, assessment, education

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Description

This quiz covers critical concepts related to intravenous (IV) fluid types and their appropriate usage in clinical settings. It addresses hypotonic, hypertonic, and isotonic fluids, along with their effects on cells and specific patient conditions. Test your knowledge on IV insertion practices and medication administration.