Thursday, January 8, 2009

Intravenous Fluids

Fluids & electrolytes are a dynamic process that is crucial for life. Disorders of fluids and electrolytes occurs in every setting, with every disorder and with a variety of changes that affect well people and those who are ill. Example...people engaging in strenious activity may result to an increase fluid and sodium loss.

If you are a nursing student, you need to understand the physiology of fluids & electrolyte balance as well as acid-base balances in order to anticipate, identify & respond to possible imbalance of each. For student nurses who will be exposed to clinical areas with patients attached to IV fluids, it is very important to know why such an IVF is indicated for a particular patient.

IVF or intravenous fluid therapy is a common practice today. It is an efficient and effective method of supplying fluids directly into the ECF compartment, specifically the venous
system.

Purposes of IV Fluids

1. to supply fluids when clients are unable to take in an adequate volume of fluids by mouth.

Example: patients who are vomiting, patients with altered level of consciousness, patients with disabilities or patients under certain conditions cannot take in fluids orally.

2. to provide salts needed to maintain electrolyte balance.

You have to understand that electrolytes in the body were placed in such a way that it should maintain cellular equilibrium to achieve normal body functioning. If there will be an imbalance to these electrolytes, it will result to a serious disorder or malfunctioning....that's why IVF may come in a form of prevention --- to prevent electrolyte imbalance to occur.

3. to provide glucose (dextrose), the main fuel for metablism.

Glucose is NOT an electrolyte. It is a form of sugar. When carbohydrate is metabolized, it turns into glucose which the cell absorbs for cellular energy production and consumption.

4. to provide water-solube vitamins and medications.

Patients who cannot take in medications or even vitamins orally, may still be given through intravenous route. Either incorporated in an intravenous fluid or as an IV bolus.

5. to promote a life line for rapidly needed medications.

In cases patients develop convulsions or life-threatening conditions, the intavenous line is a helpful medium to give medications for rapid effects.

Common Type of Intravenous Solutions

IV solutions may come in different forms:

1. Depending on its TONICITY (the ability of the solute to cause water movement from one compartment to another)

  • Isotonic Solutions

  • Hypotonic Solutions

  • Hypertonc solutions

2. May also come in a form of:

  • Nutrient solutions

  • Electrolyte solutions

  • Alkalyzing solution

  • Acidifying solutins

Isotonic Solutions

-solutions that have a concentration of dissolved particles or tonicity equal to that of ICF. Osmotic pressure is equal both in ICF & ECF.
- there is no water displacement, thus, no effect on the cell.

Examples of IVfluids:

  1. NSS (NOrmal Saline Solution/ 0.9% NaCl) - contains only electrolytes Na&Cl.

  2. D5W (5% dextrose in water) - contains no electrolytes

  3. Ringer's solution - &

  4. Lactated Ringer's Solution - contains Na, K, Ca, Cl & Lactate

Purpose:

  • used to maintain fluid intake and reestablish water volume because these fluids stays in the vascular compartment, therefore, it expands the vascular volume. Example...patients who are vomiting, patients with acute diarrhea and fever.

  • take note: D5W is an isotonic fluid on initial administration, but when glucose is metabolized, it produces free water.This water may expand both the ICF & ECF fluid volume, thus, acts as a hypotonic solution.

  • D5W when given in large amounts may cause hyperglycemia.

Hypotonic Solutions

Hypotonic solutions have lesser tonicity than that of the ICF because it has lesser solute concentration. ICF becomes more concentrated, it pulls water from the ECF, thus, makes the cell swell.
Examples of Hypotonic Fluids:

  1. 0.45% NaCl (half strength normal saline)

  2. 0.33% NaCl ( one third strength normal saline)

  3. 2.5% Dextrose in water

Purpose:

  • used to provide free water and treat cellular dehydration.

  • Note: Free water is desirable to aid the kidneys in elimination of solute via urine output.

Hypertonic Solutions

Hypertonic solutions have tonicity or solute concentration in ECF greater than that of the ICF. Therefore, it pulls fluids out of the ICF...... and the cell shrinks.

Examples of Hypertonic Fluids:

  1. D5NSS (5% Dextrose in normal saline solution)

  2. D5 in 0.45% NaCl ( 5% Dextrose in half strength normal saline)

  3. D5LR (5% Dextrose in Lactated Ringer's Solution)

  4. D10W ( 10% Dextrose in water)

  5. D50W50 (50% Dextrose in 50 ml of water)

Purpose:

  • Hypertonic solution draws fluids from the ICF causing cells to shrink and ECF to expand.
  • Given to patients with hyponatremias (Na deficits) with edema
  • Aside from being isotonic, hypotonic & hypertonic. IVF may also come in a form of nutrient solution, electrolyte solution, alkalyzing solution & acidifying solution....

    Nutrient Solution

    Nutrient solutions contain some form of carbohydrates and water. Water is supplied for fluid requirements and CHO for calories and energy requirement. Example... 1 liter of 5% Dextrose provides 170 of calories.

    Common Nutrient Solutions are:

    1. D5W (5% Dextrose in water)
    2. 3.3% Glucose in 0.3% NaCl (Glucose in saline)
    3. 5% Dextrose in 0.45% NaCl (Dextrose in half strength saline)

    Purpose:

    • Nutrient solutions are useful in preventing dehydration. However, it is a wrong notion to say that dextrose increases weight, or promotes normal growth in children or promotes wound healing or healing disorders. The calories it provide are not for such purposes but mainly for prevention of dehydration and ketosis.

    Electrolyte Solutions

    Electrolyte solutions are either NaCl (saline solutions) or multiple electrolyte solutions containing varying amounts of cations and anions.

    Commonly Used Solutions are:

    1. Normal Saline Solution (0.9% NaCl Solution) - contains electrolytes Na & Cl only
    2. Ringer's Solution - contains Na, Cl, K, Ca
    3. Lactated Ringer's Solution - contains Na, Cl, K, Ca & Lactate( a salt of lactic acid that is metabolized in the liver to form bicarbonate)

    NOte: Normal saline solutions are frequently used as initial hydrating solutions. Multiple electrolyte solutions are useful to prevent dehydration or to restore or correct fluid and electrolyte imbalances.

    Alkalyzing Solution

    Alkalyzing solutions are administered to counteract or prevent Metabolic Acidosis. Example....Lactated Ringer's Solution

    Acidifying Solution

    Acidifying slutions are administerd to counteract or prevent Metabolic Alkalosis. Example... 0.9% NaCl &/or D5NSS.


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      Great post Glen, I had obtained as far as utilizing the FV web optimization plugin for most of our shopper blogs but there are nonetheless a bunch of ideas in here which are new to me. Yes, backlinks are often the key to driving traffic to a web site, and from my experience guest posting has been the most efficient method to spend my time. I am already implementing all of the steps you shared in this submit. BUT THE PROBLEM IS EVEN THEN I AM NOT GETTING MUCH TRAFFIC.

      I told myself that I am going to learn one submit of yours a day till I even have read everything on Viper Chill. May be worth a publish on some disadvantages of WordPress e.g. site speed. database calls aren't optimised, although caching might help. https://www.reviewengin.com/5-simple-wordpress-seo-hacks-to-boost-your-google-ranking/

      ReplyDelete
    34. 3 four Derivatives As Rates Of Change

      Stop Focusig On Profitability And Go For Growth
      A chemicals firm deploying the same analytical approach was able to develop a business strategy that enabled it to develop at above-market rates. There was a focused effort to establish high-worth system enhancements based on the worth that was at stake.
      An Accelerated Approach To Turning Around Company Performance
      Since data was scattered across several systems, it took months for management to determine and reprice those items. By establishing and accessing a single supply of truth, made possible by the info lake, managers can now more quickly respond to adjustments in market and customer trends which may open up pricing opportunities. For instance, the mix of attitudinal buyer segmentation, complete account potential, and historical response curves from outbound-sales exercise can lead to an optimum gross sales-deployment model that aligns all activity towards the very best-potential accounts to maximize returns. Using this strategy, one B2B distributor was capable of determine more than $one hundred million in extra revenues while lowering gross sales-management head rely by about 15 percent.

      In addition, it held quick-term competitions amongst completely different areas to improve particular metrics on the margin levers (corresponding to how regularly freight prices have been passed on to prospects). The firm additionally provided staff with a “bonus calculator” that allowed them to shortly see the incremental bonuses they might earn by following the new enterprise rules. In pricing, the transformation office’s function and cadence can present a discussion board to resolve conflicts that come up from pricing decisions.

      Establishing frequent meetings ensures that the transformation proceeds on an accelerated timeline. Having a centralized information lake is important to maximizing value from pricing actions. For one global producer, modifications in tax buildings in Europe significantly affected the market. The gross sales groups responded by growing discounts on certain merchandise, which led to unfavorable margins.
      Earnings momentum can also be an investment strategy that attempts to invest in firms experiencing an increase in share worth because of constructive earnings momentum or growth in EPS. At a complicated electronics company, senior management carried out financial incentives for improving margins (the general goal of the company’s transformation).
      These conflicts typically contain commerce-offs between margins and volume and may require quick motion. Salespeople had been afraid to observe suggestions from the pricing staff, which had used a new methodology to identify ongoing customer gross sales negotiations that may warrant greater costs. https://www.reviewengin.com/tips-to-write-eye-catching-headline-for-blog/

      ReplyDelete

    35. When it draws a parallel to Ecommerce, even professionals haven't reached a consensus. They've been having a good time. It's been very frigid here. Evidently, I trust them as far as I can see them. This is how to develop a workable Gadgets blueprint. Things will just have to get better from here. Gadgets is quite horrible.


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      ReplyDelete
    36. We'll get eyeball to eyeball on Gadgets. I have extensive experience in Ecommerce and even if the store doesn't have the Ecommerce that you are looking for it doesn't hurt to talk to the proprietor.


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    37. With enough passion, you will learn to accurately gauge the market. If you are still getting good results, then you can choose to trade your system live on a REAL account. For example, you could make it a rule that if your indicators happen to reverse to a certain level, you would then exit out of the trade. For example, in the chart below, this trader’s entry was when the candle closed below the support line.

      This is a feature of how much historic data you can get your hands on, how often your strategy triggers a trade to forward-test and how much time you have to spare to test. Profit factor is an important tool when dealing with risk and money management.

      The first line in the sand to draw is where you would exit your position if the market goes against you. The repeated testing of your setups requires that you love what you are doing.

      Algorithmic trading is when a robot/program uses a set of rules that tell it when to buy or sell. In other words, a tick is a change in the Bid or Ask price for a currency pair.

      The material has not been prepared in accordance with legal requirements designed to promote the independence of investment research. Although we are not specifically prevented from dealing before providing this material, we do not seek to take advantage of the material prior to its dissemination. Monitoring the slightest price movements in search of profits can be an extremely intense activity. As scalping requires larger position sizes than other trading styles, traders need to be extremely disciplined. https://www.reviewengin.com/trade-command-center-review/

      ReplyDelete