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- Jun 26, '09 by NurseHotFlashConfused about something. If a patient has ICP, and we use a hyperosmotic diuretic like Manitol, or a hypertonic solution with saline, I understand that it will pull fluid from the tissue and decrease ICP, but doesn't all that fluid in the vein increase BP as well, which in turn increases ICP again?
- Sep 16, '09 by StefanieJoHypotonic solutions will hydrate the cells, pull fluid from the vascular space into the cell.
Isotonic solutions will hydrate the extracellular compartment; replaces fluid vol without disrupting the intracellular and interstial voulumes
Hypertonic Solutions will drae fluid out of intracellular space, leading to increased extracellular volume both in vascular and interstial space.
- Sep 19, '09 by joyouterQuote from Esperanza1hypertonic saline is given usually in cases of severe cramps with patient on hemodialysis where cramps occur directly as a result of osmosis and filtration, where sodium chloride levels have been reduced, usually in patientw with fluid overload. Today that is rarer as hemodialysis methods have significantly improved to allow for ultrafiltration (fluid removal) and hemodialysis to lower waste products, ie. BUN ( blood urea nitrogen) and electrolytes especially serum K levels.Also,.could you give a hypertonic solution to someone with cerebral edema, or maybe to reduce edema at a wound site? The D5W solution trips me up sometimes because although it is technically a hypertonic solution its affects are like those of a hypotonic solution. Since the dextrose is is absorbed so quickly you are left with free water that hydrates the cells. My brain is mush!! Thank you again for your help!
Hypertonic Dextrose is applied in acute cases of diabtes where BS levels are controlled by insulin infusion. Specifically, high risk pregnant diabtetic mothers are induced close to term and dext. 10% and insultin infusions are given by iv infusor with Hrly BS measurements.
Isotonic infusions especially in Brain injuries are usually closely monitored and cases of suspected cerebral edema or other ICP's are given low doses of iv. isotonic fluids.
- Jun 30, '10 by noellepage2000Hi,
Can you tell me from a clinical instructors perspective what a day in medical surgical ward constitute with student nurses? I will be teaching for the first time and I will be bringing 10 students to their 2nd Med surg rotation in the hospital. The school does not really give any orientation and so I am on my own. Can you tell me how the day goes in the hospital? I understand that the students will be going to the ward the night before and get their patients and do their nursing care plan to be reported the following day w/ the class . I on the other hand will be meeting the students in the morning, give a little rundown of the plan for the day and send them to their respective wards/units. I will stay with the students in the base ward w/c is med surg and visit the others in the other units . Are the students allowed to give medications? What time do I have them leave so we can discuss the day and they can report their nurse care plan? How do I grade them? I have to read and study the grading system at my place and what criteria you grade. But a little advice from the experts would mean a lot. What do I do with the students that did not do their homework? Some instructors told me they have them leave. Can you tell me some proven techniques to deal with challenges in this area?
Thanks a lot,
- Aug 31, '11 by fmeu6038hi need more understanding..if d5% becomes hypotonic or free water as soon as its infused (VickyRN), then why can't we just infuse bottled or mineral water??
- Sep 1, '11 by xtxrnQuote from WDWpixieRNHourly rate x 0.75-- 3/4 of hourly rate......3/4 of an hourOne question I keep getting confused about is when something is administered in less than 60 minutes...for instance, I saw one question that said administering over 45 minutes...I can figure a 30 minute admin (X 2), but a 15- or 45-minute admin confuses me a bit...any tips for figuring those out?
- Sep 1, '11 by xtxrnQuote from fmeu6038they're hypotonic as well- besides being for oral use and not sterile.... too much free water puts the patient at risk for cerebral edema, CHF, and other excess fluid issues.hi need more understanding..if d5% becomes hypotonic or free water as soon as its infused (VickyRN), then why can't we just infuse bottled or mineral water??
- Mar 2, '12 by ELIZABETH KUSII am very happy to join this learning network
- Mar 2, '12 by ELIZABETH KUSII am confused of how excessive administration of d5w can cause increased intracranial pressure
- Sep 15, '12 by choralguyI am in A&P and have a question...A woman is passing blod clots. Her hemoglobin level is 10.4 and she has been diagnosed as slightly anemic. Admissions orders include starting an IV solution of dextrose 5% and lactated Ringer's solution.
Do you expect the IV solution to be hypertonic, hypotonic, or isotonic? Why?
A. Hypertonic - to decrease the size of the red blood cell
B. Isotonic - becacuse this solution does not change the size of the red blood cell
C. Hypotonic - to increase the size of the red blood cell and thus enable it to carry more oxygen
D. Hypertonic - to cause fluid shifts from the intracellular space to the extra-cellular space and thus replace the blood lost by the patient from the uterine bleeding.
I do not see how A could help. B would make sense for most IV fluids from what I can tell. C would be helpful if it is true that a larger cell carries more oxygen. I do not understand how D would cause the added water content to turn to blood.
I really desire to learn this stuff, so if you could explain why one of these is the best answer, I would greatly appreciate it.