Unit 4 - Blood expanders and derivatives Crystalloids...

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Blood expanders and derivativesCrystalloids – crystal clearoD5W (5% dextrose water)Not used long term because it is a hypertonic solution – can cause circulatory overload – do not use for more than 3 daysUsed for sugar replacement with fluidsoNSS (0.9% normal saline solution)Used for long term fluid replacement greater than 3 daysThe only one that can be given concurrently with blood productsUsed in a bolus to increase pressure in emergency situationsoLR (lactated ringers)Used for long term fluid replacement greater than 3 daysUsed perioperatively (before, during and after surgery)Used in a bolus to increase pressure in emergency situationsCan cause tissue swelling (edema) – assess extremities and lung sounds (crackles and rhonchi)Colloids – gooey messoAmino acids – TPN (total parental nutrition)Given to pts on a ventilator or who is NPO greater than 3 daysElectrolyte panel is taken – patient will be given what is neededBag can only hang for 24 hours and tubing needs to be replaced as well to decrease risks of infectionBlood and blood products oPacked red blood cells (PRBC)Given for low blood levels (H&H)Has to be administered within 4 hours or else the blood goes badoBloodGiven for excess blood loss (losing an arm)oAlbuminA type of bloodIf albumin is low excess edema is present – albumin pulls fluidCompatible with PRBC and needs to be administered as quickly as possibleGive to patients with a low albumin level, hypokalemic (low volume), burn patients, adult respiratory distress syndrome and nephrosisNumber 1 priority of hypokalemic patient is to restore circulating fluidoMonitor for reaction when blood is givenReactions: itching, rash, back pain, increased temperatureWhen symptoms present, stop and consult doctorLipidsoFat emulsion solutionGiven when at patient cannot eat or drink for greater than 7 daysCan supplement up to 30% of caloric intakeCompatible with TPN – can be given simultaneouslyFluid volume deficit - Dehydration
oIf someone is dehydrated patient will have low BP and high pulseoSigns: decreased I&O, poor skin turgor, dry mucous membranesoCauses: blood loss, diarrhea, vomiting, dysphagia, excess diuretic useFluid volume excesso

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