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IV tubing needs to be changed every...
96 Hours
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Intermittent infusion needs to be changed every...
24 hours
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Blood tubing needs to be changed every...
4 hours
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IV dressings need to be changed every...
- Gauze- 48 hours
- transparent- 96 hours
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Symptoms of overhydration
- Edema
- shortness of breath
- hemoptysis (blood in sputum)
- JVD
- cough
- crackles on auscultation
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symptoms of dehydration
- increasing thirst
- dry mouth
- darkening of the urine
- decrease in urination
- lower BP
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infiltration and symtpoms of
The leakage of IV drugs from the vein into the surrounding tissue
- Symptoms:
- skin around site is blanched, cool to touch, may be painful.
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Phlebitis and symptoms of
inflammation of inner layer of the vein
- symptoms:
- redness, tenderness, pain, warmth along course of vein.
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The 3 basic types of solutions
- Isotonic
- Hypotonic
- Hypertonic
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Isotonic solution
- possesses about the same osmolarity as serum and other body fluids
- stays where you put it
- expands this compartment w/o pulling fluid from other compartments
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Examples of isotonic solution
- normal saline (0.9NS)
- lactated ringers (LR or RL)
- 5% dextrose in water (D5W)- pts receiving D5W are susceptible to water intoxication. Once introduced into the circulatory system, glucose is metabolized leaving behind water
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Hypotonic Solution
- osmolarity lower than that of serum
- body fluid and electrolytes shift out of the blood vessels and into the cells and interstitial space
- hydrates cells while depleting the circulatory system
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Examples of hypotonic solution
- 0.45% sodium chloride
- 0.33% sodium chloride
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Hypertonic Solution
- Higher osmolarity than serum
- fluid and electrolytes are pulled from the intracellular and interstitial compartments into the intravascular compartments
- used for edema
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examples of hypertonic solutions
- combinations
- 3-5% NS
- 5% dextrose in 0.45% Saline (D5W.45NS)
- Dextrose in normal saline (D5WNS of D5.9NS)
- 5% dextrose in lactated ringers (D5WLR or D5LR)
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electrolyte
- an element or compound that, when dissolved or dissociated in water or another solvent, seperates into ions that are electrically charged.*measured in mEq/L
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Na+
Normal 135-145 mEq/L
- Hyponatremia: GI losses, diuretics, burns
- Hypernatremia: large amt. of salt solutions, diabetes isipidus, water depravation
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Na+ signs and symptoms (hyponatremia)
- apprehension
- hypotension
- dizziness
- abdominal cramping
- nausea and vomiting
- diarrhea
- tachycardia
- dry mucous membranes
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Na+ signs and symptoms (hypernatremia)
- extreme thirst
- dry and flushed
- dry and sticky tongue
- postural hypotension
- fever
- agitation
- convulsions
- restlessness
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K+
Normal 3.5-5.0 mEq/L
- hypokalemia: GI losses, diuretics, polyuria
- hyperkalemia: Burns or trauma, rapid infusion of blood, K+ substitutes, fluid volume deficit
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k+ signs and symptoms (hypokalemia)
- weakness
- fatigue, nausea and vomiting
- decreased bowel sounds
- irregular pulse
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k+ signs and symptoms (hyperkalemia)
- anxiety
- dysrhythmias
- weakness
- diarrhea
- cardiac arrest
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Ca+
normal 9.0-10.5 mEq/L
- hypocalcemia: pancreatitis, chronic renal failure, Vit D deficiency
- hypercalcemia: osteoporosis, Paget's disease, Osteometastasis
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Ca+ signs and symptoms (hypocalcemia)
- tingling of fingers and mouth
- hyperactive reflexes
- positive Trousseaus' sign
- chvostek's sign
- muscle cramps
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Ca+ signs and symptoms (hypercalcemia)
- Anorexia
- nause and vomiting
- weakness
- lethargy
- cardiac arrest
- kidney stones
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Mg++
normal: 1.3-2.1mEq/L
hypomagnesemia: alcoholism, GI loss, thiazide diuretics
hypermagnesemia: Renal failure, excessive oral or parenteral intake
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Mg++ signs and symptoms (hypomagnesemia)
- muscle tremors
- confusion and disorientation
- tachycardia
- hypertension
- + C&T signs
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Mg++ signs and symptoms (hypermagnesemia)
- decreased depth and rate of respiration
- hypotension
- flushing
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Cl+
96-106 mEq/L
- hypochloremia: vomiting, diuretics
- hyperchloremia: serum HCO3 levels fall, sodium levels rise
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Microdrip
delivers a little fluid over a long period of time
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Macrodrip
delivers a lot of fluid over a short period of time
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