ANSWERS
Signs and Symptoms of Intravenous Fluid (IVF) fluid volume overload - ANS Increased Blood
Pressure and Central Venous Pressure
Moist crackles on auscultation
Cough
Restlessness
Distended Neck Veins
Edema
Weight Gain
Dyspnea (difficult labored breathing)
Rapid, Shallow Respirations
Complications from IVF - ANS -Rapid infusion can cause hepatic, cardiac, or renal disease
-Fluid Volume Overload*
-Air Embolism
-Infection
-Infiltration
-Extravasation
Infiltration Definition - ANS The unintentional administration of a nonvesicant [V solutions
and medication that do not cause ischemia (inadequate blood supply) or necrosis] solution or
medication into surrounding tissue. This can occur when the IV cannula dislodges or perforates
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the wall of the vein
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, Clinical Manifestations:
Redness and pain
Blood Return
Edema around the insertion site
Leakage of IV fluid from the insertion site
Discomfort and coolness in the area of infiltration
Significant decrease in the flow rate
When the solution is particularly irritating, sloughing (necrotic tissue that needs to be removed
from the wound for healing to take place) of tissue may result.
Extravasation - ANS The difference between an infiltration and extravasation is the type of
medicine or fluid that is leaked.
Infiltration - if the fluid is a non-vesicant (does not irritate tissue), it is called an infiltration
Extravasation - if the fluid is a vesicant (a fluid that irritates tissue), it is called an extravasation.
Isotonic Solution - ANS Osmolality close to ECF and do not cause RBC to shrink or swell.
Expands ECF volume.
Types of Isotonic Solutions - ANS .9% normal saline, Lactated Ringers
Considerations when using Isotonic Solution - ANS Lactated Ringers Contains Potassium and
can cause hyperkalemia
When used carefully monitor hypertensive and heart failure patients for fluid overload
Do not use in liver impaired patients (Cirrhosis, hepatits)
When do you use Isotonic solutions? - ANS Blood loss
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Dehydration (diarrhea, vomitting)
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, Blood transfusion
Surgery
Hypotonic Solution - ANS Makes cells swell
Contains lower concentration/osmolality of salt than ICF
Diluted fluid
Types of hypotonic solution - ANS .45%, .33%, .225% NaCl and 2.5% dextrose, D5W(isotonic
in bag, hypotonic in body)
When to use hypotonic solutions - ANS Used for conditions that cause cellular dehydration
Ex:
Hypernatrimia (Thirst)
Type 2 diabetes
DKA-diabetic ketoacidosis in type 1 diabetes
Nursing Considerations for hypotonic solutions - ANS Watch for hyporvolemia signs and
symptoms:
Tachycardia
Decreased BP
Cellular edema
Cell damage-lysis
Use cautiously for trauma, burns and liver diseas
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Hypertonic Solution - ANS Shrinks cells
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