fluids
describe what assessment you would do to observe fluid status
blood pressure & pulse
look at client's tongue
lung sounds
urine (color, amount, specific gravity)
assess for edema
assess for skin turgor
what are some of the neuromuscular effects of hypovolemia?
dizziness
syncope
confusion
weakness
seizures
what type of acid-base imbalance would you expect when the client has opioid overdose?
resp acidosis
what are some of the complications of IV therapy?
fluid overload
phlebitis
infiltration
harm to red blood cells (inappropriate use of hypertonic IVF)
you have order for IV fluids 2000 ml LR to infuse over 24 hours. you hang the first 1000 ml bag at 0600. What time do you anticipate changing the bag?
1. calculate hourly rate: 83.3 ml/hr
2. calculate how many hours a 1000 ml bag will be infusing: 12 hrs
3. calculate what time you have to change the bag: 6 pm
what are S/S fluid overload?
crackles in the lungs
JVD
edema
bounding pulses
weight gain
what do you anticipate to do when client has hypovolemia?
start IV
give fluid bolus to rehydrate
NS or LR
monitor UO
whay type of acide-base imbalance would you expect when the client has NG tube suction intermittently?
met alkalosis
what are some of the diagnostic procedures when client has fluid overload?
x ray
lab draw
auscultate lung sounds
you are giving IV fluid for a child who weighs 34 lbs for dehydration.
the order is: give 3 ml/kg/hr of the fluid.
what is your hourly rate?
1. convert lb to kg; 15.4 kg
2. calculate hourly rate: 46.4 ml/hr
which client has a high risk for hypokalemia?
client with NG suction
client with vomiting
client with diarrhea
your client's lab just came back and
K 3.2 mEq/L
Na 128 mEq/L
what is your priority action next?
notify the provider, they are both low
patient needs K and fluid restriction
What is the interpretation of the following:
pH 7.32
CO2 47
HCO3 24
resp acidosis
what are the parameters for an IV fluid order?
type of fluid
amount of fluid
route
speed of administration
your patient has potassium ordered IV 2mEq/kg. He weighs 175lbs.
what is the dose?
1. convert lb to kg: 79.5 kg
2. calculate the dose: 159 mEq
which foods contain high potassium?
bananas
oranges
spinach
potatos
Which fluid is hypertonic?
0.9% NaCL
0.45% NaCL
3% NaCL
3% NaCL
what is the interpretation of the following:
pH 7.28
CO2 42
HCO3 18
metabolic acidosis
you have the following order:
Give 1200 ml 0.9% NaCL over 5 hours IV.
What is your hourly rate?
240ml/hr
You are calculating the intake and output for your client for the past 12 hours.
Intake: LR 80ml/hr, Vancomycin 250 ml X2, Platelets 60ml, PRBC 350 ml, protonix 50 ml X2.
How much intake the client had over the past 12 hours?
960
500
60
350
100
1970 ml
what are S/S of fluid volume deficit?
poor skin turgor
flat neck veins
hypotension
tachycardia
weak, thready pulses
Which fluid is hypotonic?
0.9% NaCL
0.45% NaCL
3% NaCL
0.45% NaCL
what is the interpretation for the following:
pH 7.47
CO2 36
HCO3 28
metabolic alkalosis
you have the following order:
Give Amphtericin B IV BID
Amphotericin B comes in 150 ml bag and infused over 30 minutes (NOT actual numbers)
what is your hourly rate?
300 ml/hr
Your calculating intake of your client, here is what he had in 12 hours
16 oz of bowel prep before CT scan
IV LR is running at 50 ml/hr 0600-1100
IV NS running at 80 ml/hr 1100-1800
4 oz of juice after CT scan
what is the intake?
480 + 250 + 560 +120 = 1410 ml