JOHN TYLER COMMUNITY COLLEGE NURSING NSG
170 -FLUID AND ELECTROLYTES QUESTIONS WITH
COMPLETE SOLUTIONS
Whole Blood
Same as for PRBCs, except that whole blood is more beneficial
in cases of extreme (greater than 25%) loss of blood volume
because whole blood also contains plasma
Contains plasma proteins, which help draw fluid back into blood
vessels from surrounding tissues
Adverse Effects of Blood Products
Incompatibility with recipient's immune system
Crossmatch testing
Transfusion reaction
Anaphylaxis
Transmission of pathogens to recipient (hepatitis, HIV
Principal ECF electrolytes
sodium cations (NA+), chloride anions (Cl-)
Principal ICF electrolyte
Potassium (K+)
Most abundant positively charged electrolyte inside cells
Adverse effects of Potassium
Oral preparations
- Diarrhea, nausea, vomiting, GI bleeding, ulceration
,IV administration
-Pain at injection site
-Phlebitis
Excessive administration
- Hyperkalemia, toxic effects
A patient is hypokalemic and will be receiving intravenous
potassium. The patient is not on a heart monitor. How should the
nurse administer the potassium replacement?
A. IV push
B. No more than 10 mEq/hr
C. No more than 20 mEq/hr
D. 40 mEq/hr
B
If IV potassium is administered too rapidly, cardiac arrest may
occur. IV potassium should be given no faster than 10 mEq/hr to
patients who are not on cardiac monitors. For critically ill
patients on cardiac monitors, rates of 20 mEq/hr or more may be
used.
Oral forms of potassium must be
Must be diluted in water or fruit juice to minimize GI distress or
irritation
,Monitor for complaints of nausea, vomiting, GI pain, or GI
bleeding
Which solution should the nurse administer with packed red
blood cells?
A. Lactated Ringer's
B. 0.9% sodium chloride
C. D5W
D. 0.45% sodium chloride
B
Blood products must be given only with normal saline (0.9%
sodium chloride), because the solution of D5W results in
hemolysis (rupture or destruction) of red blood cells.
Types of intravenous solutions
Crystalloids
Colloids
Blood and blood products
Isotonic IV solutions
1. Normal saline (0.9%)
2. Lactated ringer (LR)
3. 5% Dextrose in water (D5W)**
4. 5% Dextrose in .225% Saline
Used to INCREASE EFV; dehydration, blood loss, surgery, etc.
Hypotonic IV solutions
, 1. 0.45% Saline
2. 0.22% Saline
3. 0.33% Saline
-Cause cell lyses (rupture or break)
-Deplete circulatory systems fluids (Hypovolemic)
-These solutions HYDRATE the cell
-Don't use in patients with an increase in intracranial pressure
(shift fluid into brain tissue, swelling), burns, trauma bc pt is
already hypovolemic
Hypertonic IV solutions
1. 3% saline
2. 5% Saline
3. 10% Dextrose in Water
4. 5% Dextrose in 0.9% Saline
5. 5% Dextrose in 0.45% Saline
6. 5% Dextrose in LR
- Usually given in central line, hard on veins and can cause
phlebitis
-Causes the cell to shrink, fluid overload w/pulmonary edema
-Give to patients with cerebral edema (reduces pressure),
hyponatremia (pulls sodium back into the intravascular system)
Electronic infusion devices (EIDs)
also called IV pumps or infusion pumps, deliver an accurate
hourly IV infusion rate.
Gravity Infusion Device
170 -FLUID AND ELECTROLYTES QUESTIONS WITH
COMPLETE SOLUTIONS
Whole Blood
Same as for PRBCs, except that whole blood is more beneficial
in cases of extreme (greater than 25%) loss of blood volume
because whole blood also contains plasma
Contains plasma proteins, which help draw fluid back into blood
vessels from surrounding tissues
Adverse Effects of Blood Products
Incompatibility with recipient's immune system
Crossmatch testing
Transfusion reaction
Anaphylaxis
Transmission of pathogens to recipient (hepatitis, HIV
Principal ECF electrolytes
sodium cations (NA+), chloride anions (Cl-)
Principal ICF electrolyte
Potassium (K+)
Most abundant positively charged electrolyte inside cells
Adverse effects of Potassium
Oral preparations
- Diarrhea, nausea, vomiting, GI bleeding, ulceration
,IV administration
-Pain at injection site
-Phlebitis
Excessive administration
- Hyperkalemia, toxic effects
A patient is hypokalemic and will be receiving intravenous
potassium. The patient is not on a heart monitor. How should the
nurse administer the potassium replacement?
A. IV push
B. No more than 10 mEq/hr
C. No more than 20 mEq/hr
D. 40 mEq/hr
B
If IV potassium is administered too rapidly, cardiac arrest may
occur. IV potassium should be given no faster than 10 mEq/hr to
patients who are not on cardiac monitors. For critically ill
patients on cardiac monitors, rates of 20 mEq/hr or more may be
used.
Oral forms of potassium must be
Must be diluted in water or fruit juice to minimize GI distress or
irritation
,Monitor for complaints of nausea, vomiting, GI pain, or GI
bleeding
Which solution should the nurse administer with packed red
blood cells?
A. Lactated Ringer's
B. 0.9% sodium chloride
C. D5W
D. 0.45% sodium chloride
B
Blood products must be given only with normal saline (0.9%
sodium chloride), because the solution of D5W results in
hemolysis (rupture or destruction) of red blood cells.
Types of intravenous solutions
Crystalloids
Colloids
Blood and blood products
Isotonic IV solutions
1. Normal saline (0.9%)
2. Lactated ringer (LR)
3. 5% Dextrose in water (D5W)**
4. 5% Dextrose in .225% Saline
Used to INCREASE EFV; dehydration, blood loss, surgery, etc.
Hypotonic IV solutions
, 1. 0.45% Saline
2. 0.22% Saline
3. 0.33% Saline
-Cause cell lyses (rupture or break)
-Deplete circulatory systems fluids (Hypovolemic)
-These solutions HYDRATE the cell
-Don't use in patients with an increase in intracranial pressure
(shift fluid into brain tissue, swelling), burns, trauma bc pt is
already hypovolemic
Hypertonic IV solutions
1. 3% saline
2. 5% Saline
3. 10% Dextrose in Water
4. 5% Dextrose in 0.9% Saline
5. 5% Dextrose in 0.45% Saline
6. 5% Dextrose in LR
- Usually given in central line, hard on veins and can cause
phlebitis
-Causes the cell to shrink, fluid overload w/pulmonary edema
-Give to patients with cerebral edema (reduces pressure),
hyponatremia (pulls sodium back into the intravascular system)
Electronic infusion devices (EIDs)
also called IV pumps or infusion pumps, deliver an accurate
hourly IV infusion rate.
Gravity Infusion Device
