Fluids and electrolytes theraphy

Prepared by: Karen Andrea G. Salvador

BSN 4G, Group 4
Mr. Virata
 Types of IVF
 Crystalloids
Ex: isotonic, hypotonic, hypertonic

 Colloids
> Increase intravascular colloid osmotic pressure.
 Crystalloids
 Hypotonic fluid
 Isotonic fluid
 osmolality: 240-340 mOsm/L
 Ringers lactate, blood component
 Hypertonic fluids

> osmolality: 340 mOsm/L

 Colloids solution
 Not true solutions
 Blood products
 Stabilized human serum
 Human albumin
 Plasma protein factor
 Types of IVF
 Resucitation fluid
 Maintenance fluid
 Replacement fluid
 Total parental nutrition
 Types of IV
 Resucitation fluid
 Hypoxia, septicemia
 Stabilized human serum
 Fresh frozen plasma
 Ringers lactate
 Types of IV
 Maintenance fluid
 Supplies H2O and electrolytes
 Hypotonic solutions
 0.45 % NaCl
 5 % dextrose water
 0.2 % NaCl
 Types of IV
 Replacement fluid
 Correct fluids and electrolytes balance
 Contains 3x more Na than maintenance fluids

2 types:
 Half- strength Darrow’s
 Half- normal saline
 Types of IV
 Total parentaral nutrition
 Meet fluids electrolytes and nutritional
requirements
 Pt with NGT
 NSG consideration in hydration
therapy
 Mild dehydration
 thirsty, alert, restless
 Estimated fluid deficit: 4-5 ml or 40-50 kg
 Pinch retracts immediately
 NSG consideration in hydration
therapy
 Moderate dehydration
 thirsty, restless, lethargic, irritable to touch or
drowsy, hypotension
 6-9ml, 60-90 kg
 NSG consideration in hydration
therapy
 Severe dehydration:
 Drowsy, cold sweaty, cyanotic extremities;
maybe comatose
 Concious, apprehensive, wrinkled skin of fingers
and toes muscle cramps.
 Pinch retracts: very slowly approximately 72
secs.
 Abnormalities in fluids and
electrolytes
 Extracellular volume deficit
 Extracellular volume excess
 Na deficit
 Na excess
 K deficit
 K excess
 Ca deficit
 Ca excess
 Assessment: F&E imbalance
Finding Possible cause
skin
Poor skin turgor Fluid volume defici
Cold clammy skin Na deficit
Pitting edema Fluid volume excess
Flushed, dry skin Na excess
Pulse
Bouncing Fluid volume excess
Rapid, weak, thready pulse Na deficit
Weak, irregular, rapid pulse Severe K deficit
Weak, irregular, slow pulse Severe K excess
Blood pressure
Hypotension Fluid volume deficit, Na deficit
 Assessment: F&E imbalance
Hypertension Fluid volume excess,
Respiration
Deep, rapid breathing Matabolic acidosis
Shallow, slow irregular breathing Metabolic alkalosis
Shortness of breath, Moist crackles Fluid volume excess
skeletal muscle
Cramping of exercised muscle Ca deficit
Carpal spasm ( trousseau’s sign) Ca deficit
Flabby muscles K deficit
Positive Chvostek’s sign Ca deficit
Behavioral of mental
Picking at bedclothes K and mg deficit
Indifference Fluid volume deficit, Na deficit
 Assessment: F&E imbalance

Apprehension Shift of plasma to intersitial fluid

Extreme restlessness K excess, fluid volume deficit
Confusion K deficit, fluid volume excess