SUR 126 - fluids/chemo agents

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SUR 126 - fluids/chemo agents
2012-12-03 00:42:58
fluids chemo agents

fluids/chemo agents
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  1. major electrolytes
    • sodium
    • chloride
    • potassium
    • calcium
    • phosphate
    • magnesium
  2. electrolytes' 3 main purposes in homeostasis
    • controlling volume of body water by osmotic pressure, maintaining acid-base balance
    • serving as essential minerals
  3. most abundant anion in extracellular fluid and helps regulate osmotic pressure between intra- and extracellular spaces
  4. most abundant mineral in the body and necessary for formation and function of bones and teeth
  5. normal calcium levels
    4.5 to 5.5 mEq/L
  6. electrolyte associated with cardiac arrhythmias
  7. normal potassium levels
    3.5 to 5 mEq/L
  8. IV fluid that contains 0.9% sodium chloride
    normal saline
  9. most commonly used IV fluids in surgical setting
  10. when is sodium chloride used?
    • when chloride loss is greater than or equal to sodium loss
    • for treatment of metabolic acidosis in presence of fluid loss
    • to replenish lost sodium
  11. IV fluid used when transfusing blood products
    sodium chloride
  12. why is dextrose in water used in surgical patient?
    • hydrate patient
    • spare body protein
    • enhance liver function
  13. physiologic salt solution used to replenish patient's electrolytes and for rehydration to stimulate renal activity
    lactated Ringer solution
  14. primary IV tubing
    contains drip chamber, injection port, and roller clamp
  15. secondary IV tubing
    • contains drip chamber and roller clamp
    • hung higher than primary IV tubing so secondary med infuses first (antibiotics)
  16. functions of blood
    • transports oxygen, nutrients, wastes, hormones, enzymes throughout body
    • maintains acid-base balance, temp and water content
  17. amount of circulating blood volume in average adult
    approx. 70 mL/kg of body mass
  18. normal hemoglobin level
    • adult females - 12-16 g/100 mL of blood
    • adult males - 14-18 g/100 mL of blood
  19. volume of erythrocytes in a given volume of blood
  20. normal hematocrit levels
    35% to 52%
  21. average blood volume to body mass ratio
  22. 3 formed elements of blood
    • erythrocytes (RBCs)
    • leukocytes (WBCs)
    • platelets
  23. mediate clotting process
  24. what does below-normal hemoglobin level indicate?
    reduced oxygen-carrying capacity
  25. test performed to determine compatibility between donor and recipient
    blood cross-match
  26. what happens if unmatched blood is given?
    agglutination occurs
  27. most common indication for blood replacement in surgery
    hypovolemia (low circulating blood volume)
  28. other indications for blood replacement
    • anemia
    • maintain clotting properties (hemophilia)
  29. use of donor blood
    homologous donation
  30. patient donating own blood prior to surgery
    autologous donation
  31. patient's own blood collected and used during or after surgery
  32. risk associated with transfusion of donor blood
    transmission of blood-borne pathogens (hep B, C and HIV)
  33. when is whole blood transfusion indicated?
    only in cases of acute, massive blood loss that requires oxygen-carrying properties of RBCs and volume expansion of plasma
  34. most blood transfusions
    packed RBCs with synthetic volume expander (proven to be as effective as whole blood)
  35. how are packed cells obtained?
    removing approximately 200 mL of plasma and most of the platelets from 1 unit of whole blood
  36. when is plasma administered?
    when clotting factors are needed in addition to circulating volume
  37. how long after thawing does fresh frozen plasma need to be used?
    within 6 hours of thawing
  38. why are platelets infused?
    • to restore a more normal clotting process
    • to help repair damaged blood vessels
    • prophylactically in patients with low platelet counts (chemotherapy, leukemia)
  39. what must be done to platelets at room temp?
    must be continually gently agitated to prevent clumping
  40. plasma component used in the treatment of bleeding caused by hemophilia A, von Willebrand disease, DIC, and lack of factor XIII
  41. when is cryoprecipitate given in surgery?
    when coagulation has been compromised
  42. how is autotransfusion performed?
    • blood collected in suction-type device or via bloody sponges drained into a sterile basin of saline, then aspirated into the machine
    • blood is collected into sterile blood collection and suction canister, washed in red cell washer, and reinfused
  43. what type of blood cannot be used for autotransfusion?
    blood exposed to collagen hemostatic agents and some medications - clotting in the machine may occur
  44. why are volume expanders used?
    to increase total volume of body fluid when hypovolemia occurs
  45. volume expander categories
    • crystalloids
    • colloids
  46. why are albumin and PPF volume expanders used?
    • to provide volume expansion when crystalloid solutions are not adequate (massive hemorrhage)
    • treatment of hypovolemic shock (burn patients)
  47. what does Dextran do?
    expands plasma volume by drawing fluid from interstitial space to intravascular fluid space
  48. what is Dextran 40 used for?
    used prophylactically for thrombosis and embolism
  49. what is Dextran 70 or 75 used for?
    to expand plasma volume in impending hypovolemic shock
  50. what is Hetastarch used for?
    • needed to circulate RBCs, which carry oxygen to tissues
    • acts as albumin in management of shock
  51. names of oxygen therapeutics
    • Hemopure
    • Oxygent
    • PolyHeme
    • Hemospan
  52. irrigation solution that can be used for TURB but not for TURP
    sterile water
  53. balanced electrolyte solution used as sterile irrigant for wounds, washing and rinsing purposes, and as irrigant for body joints
  54. used as irrigating fluid for urinary bladder because it provides a high degree of visibility without conducting heat and current
  55. what is Sorbitol sometimes used in combination with?
    Purisole for transurethral procedures and hysteroscopy
  56. sterile, nonconducting fluid used to irrigate body cavities
    Glycine 1.5%
  57. 32% solution of dextran 70 suspended in glucose
    Hyskon - used to distend uterus during hysteroscopy and to irrigate blood and tissue debris
  58. irrigant for joints during arthroscopic surgeries and synovial fluid substitute
  59. most commonly used irrigator in open procedures
    Asepto syringe
  60. abnormal growth/tumor
  61. agents that fight cancer
    antineoplastic agents
  62. for what are antineoplastic agents used?
    remission, palliative effects, and/or to prolong life
  63. this means to harm normal cells as well as malignant cells
  64. abatement of symptoms and possible cure
  65. relief of symptoms without a cure
  66. antineoplastic agent categories
    • alkylating agents
    • antimetabolites
    • mitotic inhibitors
    • antineoplastic antibiotics
    • hormones
    • hormone antagonists
  67. largest group of anticancer agents that are toxic to tissues that grow rapidly
    alkylating agents
  68. first antineoplastic drug
    nitrogen mustard
  69. how do alkylating agents work?
    kills by directly damaging DNA strands and keeping cancer cells from reproducing
  70. examples of alkylating agents
    • Cytoxan
    • Paraplatin
    • Temodar
    • BiCNU
  71. how do antimetabolites work?
    disrupt cells' metabolic processes by interfering with DNA and RNA growth
  72. examples of antimetabolites
    • Folex/Mexate
    • 5-FU
  73. how do mitotic inhibitors work?
    block cell division by preventing chromosomes from dividing and migrating to the ends of the cells
  74. examples of mitotic inhibitors
    • Taxol
    • Taxotere
    • Velban
    • Oncovin
    • Toposar
  75. anti-tumor antibiotic used to prevent recurrence of pterygium
  76. corticosteroids primarily used for treatment of cancers of breast, endometrium and prostate
    • Lupron
    • tamoxifen
  77. main functions of biologic response modifiers
    • enhance body's immunologic function
    • destroys or interferes with tumor activities
    • inhibit protein and RNA synthesis
  78. 2 BRM agents used to treat chemo side effects by stimulating RBC production
    • erythropoietin (Epogen)
    • filgrastim (Neupogen)
  79. science that studies factors that determine and influence frequency, distribution, and cause of disease, and seeking to find a cure
  80. leading sites of fatal cancers in women
    lung, breast, colon, and rectum
  81. cause of disease
  82. most important known carcinogen in the US
  83. area of science and technology that focuses on atomic- and molecular-scale structures
  84. 7 warning signs of cancer
    • C - change in bowel or bladder habits
    • A - a sore that will not heal
    • U - unusual bleeding or discharge
    • T - thickening or lump in breast or elsewhere
    • I - indigestion or difficulty swallowing
    • O - obvious change in wart or mole
    • N - nagging cough or hoarseness
  85. ABCs for detecting skin cancer
    • A - asymmetry
    • B - border - jagged, blurry or irregular
    • C - color changes
    • D - diameter - greater than 1/4 inch
    • E - elevation