Always IV (Can be straight or diluted with NSS or DW, Rate of infusion depends on situation)
How do we give 25% Albumin?
Rapid increase in blood pressure
What effect can albumin have?
What type of solution is most adequate for most situations?
0.9% saline does not diffuse/change across compartments
Does 0.9% saline diffuse across compartments?
0.45% saline will behave; half like water and half like saline
Does half saline diffuse across compartments?
What is another word for extravascular fluid?
Albumin Solution(5%) is yellow, given 100-250cc, and stays in the intravascular space. Salpore Albumin is used to make sure there is no saline in that bag.
What should I know about albumin?
A volume expanding drug or infusion
What is albumin considered to be?
People who initially lost volume will not receive it. The first step is usually to get blood work back and to administer saline. Will NOT see it during the recitation phase of the initial emergency care phase.
When will the patient receive albumin?
It is fluid that has been sequestered in a body compartment that is not in equilibrium with the ECF.
What is third spacing?
A truly devastating injury that causes several problems within the body. It can cause respiratory problems. It can cause swelling in the extremities because fluid cannot come back.
What can burns cause?
Fever, perspiration, acid base balance play a role but the big factor would be humidity in the air. The moisture in the air would determine how much you would sweat off and also affect respiratory rate.
What would be a variable for a person to lose more or less fluid?
It is Total Parental Nutrition which is given through one of the large veins. Each bag is based on the patient's blood work during the bag before it. They are constantly adjusting to each of the electrolytes. This is an expensive procedure. (Central Line Only)
What is TPN?
It is a 1000cc bag or 500cc of normal IV fluid. It contains lactase ions, potassium, bicarbonate, magnesium, calcium.
What is ringer's lactate?
It can cause life threatening hyperkalemia very fast.
What happens if you give ringer's lactate to someone with renal failure?
It would cause hypoatremia.
What happens if you give hypotonic IV solutions (Half saline or quarter saline) to someone who had volume depletion (Example: Fresh post-op or bleed during an accident) ?
What are protein containing solutions?
What is used to reverse metabolic acidosis in burns?
It is used to expand blood volume in people.
What is dextran (low molecular weight) used for?
Normal saline has no calories and it is typical given with blood products
Does normal saline have calories?
Normal saline (NEVER use Dextrose to flush blood)
What is used to flush blood?
It is good for fluid replacement and low sodium situations.
What is saline good for?
Patients with CHF and pulmonary edema because the sodium in the saline would hold onto the water in the body. Keep listening to the patients lungs and check for edema.
Which patients should not receive saline?
If you infuse a liter of 0.9% saline into someone who is volume depleted and only 250cc will stay in the intravascular space and the rest will be excreted. To have the patient retain a total of 1000cc, the nurse must infuse 4L of that saline.
If you infuse a liter of 0.9% saline into someone who is volume depleted, how many liters will you need if only 250 is absorbed?
What is it called if you give someone 8L of saline to resuscitate (non-protein containing solutions)?
It depletes all the body compartments equally. Some common examples include diabetes insipidus, salt and water loss together (isotonic), burns, ascites, cholera.