Beg Med Surg Iv Therapy

Front 1

Purpose of Intravenous Therapy (IV)

Back 1

administer fluids
electrolyte balance
medications
chemotherapeutic agents
transfuse blood and blood products
deliver parenteral nutrients and nutritional supplements
use for when people cannot take oral route
more accurate dosing of medications
immediate effect

Front 2

Risks of IV therapy

Back 2

Bleeding
blood vessel damage
fluid overload
infiltration
Infection
Overdose
too fast or too slow
incompatibility of drugs and solutions
allergic responses to substances
mobility issues

Front 3

Hemostasis is

Back 3

the body’s way of maintaining normal fluid volume and composition.

A balance of fluid between the intercellular space and the extracellular space

Front 4

Human body is composed of mostly fluid. In an adult about __% is fluid in a infant about __%.

Back 4

60%

80%

Front 5

______ adults also have less total body water than ______ adults.

Back 5

Elderly

younger

Front 6

ECF

Back 6

extracellular fluid- outside the cell 1/3 of our total water

Front 7

ECF is composed of

Back 7

plasma volume and interstitial space

Front 8

Interstitial space

Back 8

around the cell- also called 3rd space- made up of lymph, blood (intravascular), bone, connective tissue water and transcellular fluids (cerebrosopinal fluid, synovial fluid, peritoneal fluid and pleural fluid

Front 9

ICF

Back 9

Intracellular Fluid- Fluid within the cell- 2/3 total body water

Front 10

Body fluids are made up of _____ (a solvent) and dissolved _____ (solutes) like ______ (Na, K) and ___ ________ (proteins)

Back 10

water
substances
electrolytes
non electrolytes

Front 11

Isotonic

Back 11

2 solutions have the same osmolarity as your blood- will not change

Front 12

Avg adult daily fluid intake and output

Back 12

2,400-3,200 ml

Front 13

Where do we get our fluids for intake?

Back 13

1- Liquids 1,400-1,800ml

2- Water in foods 700- 1,000 ml

3- Water of oxidation (from respiratory system) 300-400 ml

Front 14

How do we produce fluid output?

Back 14

Lungs 600-800ml
Skin (Perspiration) 300-500 ml
Kidneys 1,400- 1,800
Intestines 100 ml

Front 15

How do we regulate our fluids??

Back 15

Hormones and thirst mechanism

Front 16

What hormones help to regulate our fluid volume?

Back 16

Antidiurectic hormone (ADH) and aldosterone

Front 17

How is the thirst mechanism for an elderly patient?

Back 17

Not as effective as younger patients

Front 18

signs and symptoms of fluid deficits

Back 18

Weight loss
HR up, BP down
Skin tugor poor, sunken eyes, pale cool skin,
Poor capillary refill, thirst, dry mouth, cracked lips,
Changes in mental status, weakness
Decresed urine output, Increased HCT, electrolyes,BUN, serum osmolarity

Front 19

signs and symptoms of fluid overload

Back 19

Weight gain
BP up, bounding pulse, JVD, Increased resp rate
Crackles or rhonchi,
Edema, puffy eyelids,
Slow emptying of had veins when arm lifted
Decreased HCT, electrolytes, BUN, serum osmolarity

Front 20

IV Fluids are used to regulate __________

Back 20

Electrolytes

Front 21

__________ are chemical compounds that dissociate in solution into electrically charged particles or ions. They work like wires that conduct electrical currents. We use them for normal cell function

Back 21

Electrolytes

Front 22

List the six electrolytes (lytes)

Back 22

Sodium
Potassium
Calcium
Chloride
Phosphorus
Magnesium

Front 23

Potassium normal values

Back 23

3.5 - 5.0 mEq/L

Front 24

Calcium normal values

Back 24

8.4 - 10.2 mEq/dl

Front 25

Sodium normal values

Back 25

135-145 mEq/L

Front 26

Omosis

Back 26

Movement of water from a higher concentration to a lower

Front 27

Osmolarity (concentration)Normal

Back 27

270-300

Front 28

The effect of an IV solution depends on the solutions ______

Back 28

osmolarity

Front 29

Isotonic

Back 29

(same osmolarity or tonicity) as serum, stays intravascular.

Front 30

Hypotonic

Back 30

(less than 270) shift fluids from blood to cells.

Front 31

Hypertonic

Back 31

(over 300) Pulls fluids from cells to blood.

Front 32

Examples of Isotonic IV fluids

Back 32

NS, D5W or LR

Front 33

Examples of hypotonic IV fluids

Back 33

½ NS

Front 34

Examples of hypertonic IV fluids

Back 34

D5 ½ NS, D5LR, 25% albumin

Front 35

Primary/Continuous Infusion

Back 35

Continuous, can give large volumes, over a prolonger period. Constant drug dose

Front 36

What type of infusion is parenteral nutrition on?

Back 36

continuous infusion pump

Front 37

Intermittent or Secondary Infusion

Back 37

Used to add a second infusion to a primary line. Over a specific time. Like antibiotics

Front 38

Direct Injection

Back 38

Sometimes called IV push (IVP). To deliver a single dose (bolus)

Front 39

Bolus

Back 39

a single dose

Front 40

Saline Lock

Back 40

Used with intermittent IV therapy or IVP. 


Front 41

Macrodrip

Back 41

10, 15 or 20 gtt/ml

Front 42

Microdrip

Back 42

60 gtt/ml

Front 43

What to document when starting an IV

Back 43

Device used, Date & Time, Location, type of dressing, cond. Of site, type of solution, rate, flow controller, patients response, number of attempts, patient teaching and understanding

Front 44

What to document when maintaining an IV

Back 44

Site cond, site care, dressing changes, tubing and solution change, teaching

Front 45

What to document when d/c an IV

Back 45

time, date, reason for DC, assesment of site before and after DC, pt. reaction, integrity of device, dressing

Front 46

pt teaching for IV

Back 46

procedure and why it’s needed, solution and time of infusion, activity restrictions, potential discomfort, may use pamphlets, videotapes, iv equipment demo.

Front 47

Which type of solution raises serum osmolarity and pulls fluids and electrolytes from the intracellular and interstitial compartment into the intravascular compartment?

Back 47

Hypertonic

Front 48

Intravascular infections can be prevented by which of the following precautions?
Securing the venous access device with gauze
Changing insertion sites according to facility policy
Applying the tourniquet 6-8” above the insertion site
Washing your hands after insertion

Back 48

B. Changing insertion sites according to facility policy

Front 49

Signs of speed Shock include...

Back 49

Light headedness, chest tightness, flushed face, irregular pulse

Front 50

Signs of catheter embolism include...

Back 50

Decreased blood pressure, pain along the vein, weak rapid pulse

Front 51

Infiltration

Back 51

catheter is no longer in vein- sipped out

Front 52

Signs of Infiltration include...

Back 52

pale, swollen at or above insertion site, tight skin, coolness, tenderness, fluid leaking from puncture site

Front 53

Signs of phlegitis include...

Back 53

Pain at site, vein red and inflamed, vein may be hard and cordlike

Front 54

Stacy has just come on shift when a client rings the bell to say that her IV is leaking all over the bed. Which action should Stacy do first?
A. Check the rate of infusion.
B. Assess vital signs.
C. Tape any tubing with a hole.
D. Assess the insertion site.

Back 54

D. Assess the insertion site.

Front 55

Who is at risk for fluid overload?

Back 55

CHF and renal pts
kids, babies, elderly

Front 56

How often to check and document on IV site?

Back 56

Q 2 hrs

Front 57

How to prevent hematoma when D/C IV?

Back 57

Put pressure on location for 2-3 minutes

Front 58

S/S of infected IV site?

Back 58

red, warm, swollen, painful
fever, high WBC, purulent drainage

Front 59

What should an MD order for an IV contain?

Back 59

amount, solution name + any additives and amounts of adds
rate (ml/hr), frequency (continuous) and start and end time/date

Front 60

What 2 places do we document IV?

Back 60

MAR and I&O