Fluid Volume Deficit: Hypovolemia

What are examples of a hypertonic solution?

1. D10W 2. 3% NS and 5% NS 3. D5LR 4. D51/2 NS 5. D5 NS 6. TPN 7. Albumin

Examples of isotonic fluids =

1. D5W 2. LR 3. NS 4. D51/2 NS

What are the three causes?

1. Loss of fluid from anywhere (thoracentesis, paracentesis, vomiting, diarrhea, hemorrhage, etc.) 2. Third spacing - burns (fluid to tissues) ascites (fluid in abdominal cavity) 3. Diseases with polyuria - shock (PID - particle induced diureses)

Treatment

1. Prevent further lose of fluid 2. Replace volume 3. Safety Precautions

Signs and symptoms (11)

1. Weight decreased 2. Decreased skin tugor 3. Dry mucous membranes 4. Decreased urine output (kidneys either arent being profused or they are trying to hold on to fluid) 5. Blood pressure decreases 6. Pulse increases 7. Respirations increases 8. CVP decreases 9. Neck veins vasoconstrict 10. Cool extremities (peripherals vasoconstrict in an effort to shunt blood to vital organs) 11. Urine specific gravity increases - concentrated urine

What safety precautions are key

1. high risk for falls - fall precautions 2. monitor for overload when replacing fluids

What are examples of hypotonic fluids?

1/2 NS, 0.33% NS, D2.5W

What is an important thing to remember with using an isotonic solution (alert)

Do not use in clients with hypertension, cardiac disease or renal failure. It can cause FVE, worsen hypertension, and cause hypernatremia

Why are hypotonic fluids used?

For a client who has hypertension, renal or cardiac disease and needs flud replacement because of nausea, vomiting, burns, hemorrhage, etc. Also used for dilution when a client has hypernatremia and for cellular dehydration.

What solution is a colloid?

Hypertonic

What solution is a crystalloid?

Isotonic

What fluids will be used to replace the volume

Mild = PO fluids Severe = IV fluids

Why is a hypertonic solution used?

The client with hypernatremia or has shifted large amounts of vascular volume to a 3rd space or has severe edema, burns or ascites. This fluid returns the fluid volume to the vascular space

What is a hypotonic solution?

This fluid goes into the vascular space then shift out into the cells to replace cellular fluid. They rehydrate but dont cause HTN

What is an isotonic fluid?

This solution goes into the vascular space and stays there. This creates balance and equilibrium

What is a hypertonic solution?

Volume expanders that will draw fluid into the vascular space and the cells

What is an important thing to remember with using an hypertonic solution (alert)

Watch for cellular edema because this fluid is moving out to the cell which could lead to fluid volume deficit and decrease blood pressure

What is an important thing to remember with using an hypertonic solution (alert)

Watch for fluid volume excess. Monitor in an ICU setting with frequent monitoring of blood pressure, pulse, and CVP

What is hypovolemia?

When fluid isn't in the vascular space. decreased volume.

What is the use of isotonic fluids?

the client that has lost fluids through nausea, vomiting, burns, sweating and trauma. NS is the basic solution when administering blood