Term
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Definition
| Homeostasis is defined as the state of dynamic equilibrium in the internal environment of the body maintained by adaptive processes. One way a nurse can determine if a patient has homeostasis is by measuring fluid volume. |
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Term
| How does the body maintain homeostasis in regard to fluid and electrolyte balance? |
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Definition
Four processes control the movement of fluids, electrolytes and other molecules between the intracellular and extracellular space. The qualities of the cell membrane allow the movement of body fluids between the different compartments by 1) diffusion, 2)osmosis,
3) colloid osmotic pressure, and 4) filtration. |
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Term
| When is fluid outside the cell isotonic to the cell fluid? |
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Definition
| When the concentration of fluid outside the cell is the same as inside the cell, there is no diffusion or osmosis, because there is no concentration gradient. The fluid outside the cell is isotonic to the cell fluid. |
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Term
| What happens when the fluid outside cell is hypertonic to the fluid inside the cell? |
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Definition
| If the solution outside the cell is more concentrated than the fluid inside of the cell, water is pulled out of the cell, causing the cell to shrink or dehydrate. The water moves out because the extracellular fluid is hypertonic to the cell fluid. |
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Term
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Definition
| If fluid outside of the cell is less concentrated than the inside of the cell and fluid enters into the cell by osmosis, and causes it to swell. The fluid outside the cell moves into the cell because it is hypotonic to the fluid inside the cell. this is inportant when evaluating the patient for correct IV fluids. |
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Term
| What are signs of FVE (Fluid volume excess)? |
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Definition
| Signs of FVE include sudden weight gain, edema, bounding pulses, hypertension, crackles, and dyspnea. |
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Term
| What are signs of FVD (Fluid voume deficit)? |
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Definition
| Signs of FVD include sudden weight loss, dizziness, confusion, weak pulse, and orthostatic hypotension. Urine output of less than 30mL /hr for two hours should be reported as well as excessive urine output of greater than 2500 mL in 24 hours. |
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Term
What is recorded as fluid intake?
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Definition
The nurse would record any liquids, including water flushes, that are
given through a nasogastric, gastronomy or jejunostomy tube. Any IV
intake including fluids, nutrition, and any blood products administered
are also recorded as intake on the patient record. |
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Term
| What is considered fluid output? |
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Definition
| Output documentation includes anything liquid that can be measured as it exits the body. Examples of output include urine, diarrhea, vomitus, gastric suction, wound drainage, and drainage from any tubes inserted into the body. |
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Term
| What is IV therapy used for? |
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Definition
| IV therapy is used to replace fluids and electrolytes, administer medications or contrast media, infuse blood and blood products, and provide nutrition for patients who cannot tolerate other methods of delivery. The three major types of IV fluids are total parenteral nutrition (TPN), crystalloids which replace fluid and electrolytes, and colloids which replace larger substances like blood and blood components. |
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Term
| [image]What are the subcategories for cystalloids? |
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Definition
| Crystalloids can be broken into three subcategories including isotonic, hypotonic, and hypertonic solutions based on their osmolarity. (Osmolarity is a way to measure the number of solutes in a liter of solution.) |
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Term
| What do isotonic IV fluids have? |
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Definition
| Isotonic fluids have the same portions of water and electrolytes as normal blood plasma. |
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Term
| What is the make up of hyPOtonic solutions? ANd what's the make up of hyPERtonic solutions? |
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Definition
| Hypotonic solutions contain more water than normal blood plasma and hypertonic solutions have more solutes (electrolytes) than the normal plasma. |
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Term
if patient has a FVD, where s/he has lost equal portions of H2O and electrolytes, from the plasma, then what type of solution would be administered?
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Definition
Which type of crystalloid solution is used for a patient depends on
what the serum osmolarity is at the time. If the patient has a fluid
volume deficit where he/she has lost equal portions of water and
electrolytes from the plasma then an isotonic solution would be
administered. |
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Term
| If Pt. requires electrolyte replacement, rather than H2O, what would be given? |
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Definition
| If the patient requires electrolyte replacement rather than water, a hypertonic solution would be given. |
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Term
| What are the ways to administer medication via an IV? |
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Definition
There are several ways to administer medication via an IV. 1) The medication can be mixed in the primary IV bag, 2) it can be given via a secondary IV bag or syringe pump (IV piggyback), 3) or it can be injected directly into the IV tubing (IV push).
Carefully review the Evolve online module 6. Nursing responsibilities related to IV medication administration |
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Term
| What should you always do before administering an IV medication? |
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Definition
Always:
- Read medication labels carefully
- Be aware of medications with similar names
- Question administration when multiple vials are needed for a single dose
- Double check drug calculations and decimal points
- Consult reliable source for new or unfamiliar drugs
- Question abrupt or excessive increases in dosage
- Identify your patient
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Term
| What are secondary medications when it comes to IV medication therapy? |
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Definition
Secondary medications are minibags or syringes of medications that are piggybacked into the main IV tubing.
This allows a slower infusion of the medication, usually 15 min to 2 hours depending on the medication and volume of fluid to be infused. |
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Term
| If using a pump device to infuse primary IV solution, what must you be sure to do with the piggyback (secondary) medication? |
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Definition
| If using a pump device to infuse the primary IV solution be sure to connect the piggyback tubing above the pump to allow the pump to control the fluid rate. The secondary bag needs to be higher than the primary bag in order to infuse first. Prior to connecting secondary tubing to a Y port in the primary tubing be sure to remove all air and swab off the Y connector with alcohol to prevent infection. Do not administer meds through tubing that is infusing blood, blood products or parenteral nutrition solutions (due to allergic reactions and also incompatibilities). |
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Term
| What should you NEVER give via IV bolus? (or push) |
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Definition
| NEVER give potassium by IV bolus. Follow your facility's policy regarding having IV push medications verified by a second RN prior to administering |
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Term
| What must you verify about a medication that you're about to administer by IV bolus? |
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Definition
| For patient safety not only do the 6 rights need to be observed but the nurse must also verify the right dilution, the right speed of delivery, and the right monitoring needed. Most drug references identify how fast a medication can be given by IV bolus and how it is to be diluted. |
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Term
| What is the purpose for a CVC (Central Venous Cath)? |
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Definition
| The purpose of CVC is for long-term fluid administration (including antibiotic therapy, blood transfusions), chemotherapy, TPN, infusions that could irritate or cause pain and even injury to smaller peripheral veins, or patients that have no viable peripheral access. |
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Term
| What is included in blood and blood products? |
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Definition
| Homeostasis is often improved with the transfusion of blood or blood products. These products can include whole blood, packed red blood cells (PRBCs), platelets, fresh frozen plasma (FFP), and cryoprecipitates. |
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