IV Fluids
This is the most commonly used IV isotonic fluid
0.9% Normal Saline
Your patient complains of weakness, N/V, abdominal cramping, and no desire to eat. They recently went on a low salt diet, due to hypertension, per their PCP instruction.
What is hyponatremia
Your patient has hypovolemia. They also have a history of congestive heart failure and decreased renal function. When administering IV fluids you are most concerned with the potential for this.
What is fluid volume overload
Positive Chvostek's and Trousseau ?signs
What is hypocalemia
Administer 3% Sodium Chloride IV 125/mL per hour.
What is an order that is dangerous as it can rapidly lead to hypernatremia?
This is the first action a nurse will take when administering IV fluids
What is an order for IV fluids?
Your patient has had diarrhea for 4 days and is disorientated, has a weak irregular pulse, ECG changes and hypoactive bowel sounds
What is hypokalemia?
Your patient has a sodium level of 122 (Hyponatremia). The doctor orders 3% normal saline at 125/mL per hour. You question the order because you are aware that this may occur
What is hypernatremia?
Increased pulse rate, bounding quality, increased BP, distended neck veings, increased respiratory rate, lung crackles, weight gain
What is fluid volume excess (Fluid Volume Overload)?
Administer potassium 40 mg IV Push now.
What is a dangerous order as you never give potassium IV push as it may cause cardiac arrest?
This IV fluid will make cells swell
What is hypotonic fluid?
Your patient is on renal dialysis for end-stage renal disease. They have muscle weakness, absent deep tendon reflexes, hypotension, bradycardia and confusion
What is hypermagesemia?
Your patient with CHF has a serum potassium level of 3.2 (Hypokalemia). The doctor orders 80 mg of Lasix IV push to be given now. The three best nursing actions to be taken are...
What is placing the patient on telemetry, questioning the order, administering a potassium supplement when safe order is received ?
Most common cause is renal failure, hypothyroidism and adrenal insufficiency. muscle weakness, N/V, flushing, headache, bradycardia
Hypermagnesemia
Give calcium carbonate 1000 mg orally, before each meal
What is an incorrect order as the medication should be taken 1-1.5 hour after meal and do not take with food or milk?
This type of IV fluid makes cells shrink
What is hypertonic IV fluids?
You just received a patient from the PACU who had a total thyroidectomy for cancer. You are aware that the patient has the potential to develop this electrolyte disorder
What is hypocalcemia?
Your are reviewing morning labs on your patient. Their sodium level is 128 (hyponatremia), their magnesium level is 0.9 (hypomagnesemia) and calcium level is 6.2 (hypocalcemia). This is your first action.
What is placing the patient on cardiac telemetry?
Causes are hyperthyroidism, cancer, kidney failure and immobility, S/S are confusion, lethargy, muscle weakness, muscle and joint pain. hypoactive bowel sounds
What is Hypercalcemia?
Administer 0.25% normal saline 125 mL/hr.
What is a dangerous order as the patient's sodium level may drop rapidly, causing complications?
What is a serious complication of IV fluid administration, especially in the elderly and small children?
What is fluid overload?
Administration of IV insulin and Dextrose is used for severe instances of this electrolyte imbalance
What is hyperkalemia?
Your patient is receiving IV fluids, 0.9% normal saline @ 150 mL/hr, for dehydration. Your nursing actions include 3 interventions which are...
What is auscultation of lung sounds, monitoring blood pressure and oxygen saturation?
Flushed skin and fever, restless, irritable, confused increase BP, edema, decreased urine output
What is Hypernatremia?
Administer 80mg potassium in 100 mL normal saline 200/mL/hr
What is a dangerous order as potassium should not be administered faster than 10 mg over one hour?