IV therapy relies upon knowing the iso, hypo, hypertonic solutions. Get a good firm grip of how these solutions work. This was taught near the end of 1st semester and you'll have another lecture or two on it during your first week of 2nd semester so really pay attention and study it.
An example question: A patient comes into the ER with a BP of 82/50, P120, urine output of 10ml/hr, , and is weak and lethargic. What kind of IV solution would you give? To answer this you need to analyze first what's happening by the S/S's and secondly diagnose the problem. The patient is showing classic signs of dehydration. By knowing these facts, the question may ask:
What type of IV solution would you give to this patient? D5W, Ringer's solution, D5 1/2 NS, or 0.45%NaCl.
In order to answer this, you have to know what the solutions are and the effects of osmaolarity. D5W and Ringer's are isotonic. D5 1/2 NS is hypertonic and 0.45%NaCl is hypotonic.
Answer: Give 0.45%NaCl (hypotonic) bc it depletes the intravascular space by causing a fluid shift into the cells which will cause the BP to rise. You will have to watch his I&O and electrolytes when giving this solution bc they can easily go into overload. Isotonic and hypertonic solutions expands the intravascular space and will cause the BP to drop.
The first two tests comes from tons of new material that took a whole lot of my time studying it. You also need to know and understand the acids and basis and how to interpret them. If you have get the book, "Fluids and Electroylytes Made Incredibly Easy", this will help with everything I mentioned above. Plus, there are great links on this board that will help you TONS! Look for plenty of resourses here by doing search for whatever it is your stuck on.
2nd semester comes on strong and doesn't stop until the end. You've already learned the foundation of nursing in basics, now you will apply that with patient scenerios along with what you'll learn in Nac 1. 2nd semester tests takes more time to think out and the answers will all sound good if you don't know the information well.
Don't be fearful and just stay strong, focused and plan lots of study time.
I will unfortunately be repeating Nac1 bc my average was a 76.5. I missed passing by 2 (1pt.) questions on the final but I'd rather have to repeat again to get a stronger foundation than to just get by and struggle the rest of the way through my semesters.
I'm still a student myself and I'm learning so if anyone reads this and finds a discrepancy please let me know.