What classification and types of solutions are crystalloid?
Classifications: isotonic hypotonic hypertonic Types: -dextrose -sodium chloride -electrolyte solutions
What makes up a crystalloid solution?
water carbs (glucose) protein vitamins electrolytes
What are the indications and risks of a crystalloid dextrose solution?
Indications:
-diluent for meds
-emergency tx for hypoglycemia
-adjunct tx of hyperkalemia
Risks:
-infuse slowly as to not cause dehydration
-never mix dextrose with blood (causes hemolysis)
What are the indications and risks of a crystalloid NaCl solution?
Indications:
-ECF replacement if chloride loss is greater than or equal to sodium loss (nasogastric suctioning)
-0.9% NaCl is only solution to be used with blood
-used as a flush for VAD
Risks:
-can cause hypernatremia and acidosis (due to excess sodium and chloride provided)
-can cause hypokalemia
-fluid overload
Why are Ringer’s solutions dn Lactated Ringer’s solution considered a balanced solution (or isotonic)?
they are similar to plasma
What is in Ringer’s solution (injection) and what is it used for?
- KCl, CaCl, Na, Bicarb
- used for dehydration with low electrolytes
What is important to remember when giving Ringer’s solution?
- incompatible with some meds
- can’t give to a pt with dialysis or kidney failure
What is different about Lactated Ringer’s?
- added lactate
- incompatible with some meds
- contraindicated for hepatic disease
What are colloidal solutions?
- plasma or volume expanders
- increases intravascular volume
Because colloidal solutions are volume expanders what does this put the pt at risk for?
risk for circulatory overload.
What are 4 examples of colloidal solutions?
- Albumin (considered blood product, 25% albumin is hypertonic)
- Dextran (seen in ICU)
- Hydroxyethyl starches
- Mannitol (used for glaucoma)
What are the signs of circulatory overload?
JVD
crackles
bounding pulse
increased respirations and shortness of breath
