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285 Cards in this Set
- Front
- Back
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What an LPN cannot do
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Initiate or add antineoplastic drugs components
Initiate or add Blood components Access implanted port devices Administer drugs via manual IV push except when life threatening circumstances necessitate such action |
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with "additional" education, lpn may perform these
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participate in IV therapy for neonates
Obtain blood samples, hang IV fluids, change tubings from multilumen central venous lines hang IV fluids, give piggy back or access port devices administer premixed medications to PCA devices |
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CBC tube
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lavender
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PTT tube
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blue
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ammonia tube
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green
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iron tube
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red speckled stopper
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calcium tube
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red stoppered
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blood culture tube
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yellow
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equipment needed for phlebotomy
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tube, tube holder, needle, gloves, cleansing agent
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best vein for phlebotomy
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median cubital vein
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complications of phlebotomy
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Excessive bleeding : especially if on anticoagulant therapy
Hematoma: from improperly placed needle that allows blood to collect under skin petechiae- may result if torniquet is too tight or left too long short draw/no blood- occurs if suction was too great and vessel collapses syncope- usually due to psychological causes related to sight of blood or needles nerve trauma- poor technique, excessive angle or probing of vein. |
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four technical problems that may result in specimen being rejected
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hemolysis ( from vigorous shaking) , hemoconcentration ( torniqet left too long)
clots occur in expired tubes, clerical discrepancies ( name on tube and requisition do not match. |
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tasks lpn can perform in blood transfusions
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just monitoring
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vital nursing consideration when infusing TPN
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aseptic technique, do not use same site for other IV therapy, initiate TPN slowly, maintain a constant flow rate, decrease infusions gradually, use electronic infusion device, standard filter is 0.22 u filter, the 3-in-1 filter is 1.2 u- filter, change the set every 24 hours and it should coincide with hanging new fluid, patient should be flat in bed and instructed to perform valsaver maneuver when catheter is open to air, check finger stick q 6 hours, daily weight, daily i/o, vitals q 6 hours, assess for f/e balance, assess for s/s of infection.
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Immediate nursing actions for hemolytic reaction
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stop the transfusion, KVO with normal saline with a new tube set, notify physician, notify blood bank/transfusion services
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complications of phlebotomy
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bleeding, hematoma, petechiae, short draw/no blood, syncope, nerve trauma.
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tasks lpn can perform
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calculate rate of infusions
administer parenteral solutions through existing patent peripheral lines change iv tubings and dressings initiate IV fluid peripherally only with devices that do not exceed 3" in length administer premixed medications through existing patent lines maintain the patency of peripheral or central lines with saline or heparin solutions administer precalculated systems containing diluent and drug. |
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tasks lpn cannot perform
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neonates, blood, IV piggy back, premixed pain medications via PCA pump, administer premixed medications via mechanical devices.
access implanted port devices mix or add medications to existing solutions Administer drugs via IV push unless where life threatening circumstances neccessitate it. |
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supplies
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needles 21 or 23 guage
butterfly used for small hand veins tube holders- vacutainer holders and adapters torniquet- to increase resistance making veins easier to locate gloves, goggles, cleansing agent, gauze, cottonball, tape |
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basic process
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was hands, gather supplies, introduce self, explain procedure, check for allegies, set up supplies, perform puncture, label specimen, chart procedure.
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potential complications of phlebotomy
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Excessive bleedind
Hematoma Petechiae Syncope Short draw/no blood Nerve trauma |
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four technical problems
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hemolysis ( too mixed/over heated)
hemoconcentration ( from T too long) clots ( not well mixed) clerical discrepancies |
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The purpose of venous modalities
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LPNs to perform limited IV fluid treatment therapy
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the venous access and IV Modalities is in accordance with the guidelines enacted
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MIssouri Rule 4 CSR 200.6010
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what is the regulatory agency for venous access Modalities
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Missouri State Board of Nursing
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During the provision of Iv fluid procedures, universal precautions, universal precautions are federally mandated by which organization
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Occupational safety and Heath Administration ( OSHA)
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actions that could result in successful malpractice litigation
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coercion of rational adult patient to insert iv, failure to obtain allergy hx, continued use of defective equipment, failure to monitor iv fluid, performing iv procedures w/o proper education, failure to adhere to aseptic technique, failure to respond when patient shows s/s of adverse event
inadequate or absence of documentation. |
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maintenance of IV therapy certification in Missouri
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Rule 4 CSR 200.6010 does not require recertification
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intravenous therapy that may be delegated to LPN
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initiating peripheral access, converting IV cannula to a "locked" cannula, monitoring blood transfusions
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IV certified LPN is restricted/ barred from performing which task
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Adding vitamins to TPN solution in a home care setting
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a private wrong that can result in a civil action
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tort
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failure to act in a a reasonable and prudent manner
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negligence
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every person is liable for his or her tortious conduct
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Rule of personal Liability
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Coercion of a rational adult to establish IV
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Assault/battery
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Performance of IV therapy not allowed by Missouri Rule 4
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Malpractice
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Failure to employ universal precautions
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negligent action
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The likelihood of being charged with IV therapy-related malpractice is greatly diminished by
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establishing a good rapport with the patient and patient's family
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define documentation
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A written or printed recording of original, official or legal information
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List the five W of appropriate documentaion
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who- performed procedure
what - was done when - it was done where - it was done why - it was done |
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the threefold purpose of documentaion
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to create a legal record, to obtain reimbursement, communicating patient status
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a private wrong that can result in a civil action
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tort
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failure to act in a a reasonable and prudent manner
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negligence
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every person is liable for his or her tortious conduct
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Rule of personal Liability
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Coercion of a rational adult to establish IV
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Assault/battery
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Performance of IV therapy not allowed by Missouri Rule 4
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Malpractice
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Failure to employ universal precautions
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negligent action
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The likelihood of being charged with IV therapy-related malpractice is greatly diminished by
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establishing a good rapport with the patient and patient's family
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define documentation
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A written or printed recording of original, official or legal information
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a private wrong that can result in a civil action
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tort
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List the five W of appropriate documentaion
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who- performed procedure
what - was done when - it was done where - it was done why - it was done |
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failure to act in a a reasonable and prudent manner
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negligence
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the threefold purpose of documentaion
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to create a legal record, to obtain reimbursement, communicating patient status
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every person is liable for his or her tortious conduct
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Rule of personal Liability
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Coercion of a rational adult to establish IV
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Assault/battery
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Performance of IV therapy not allowed by Missouri Rule 4
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Malpractice
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Failure to employ universal precautions
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negligent action
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The likelihood of being charged with IV therapy-related malpractice is greatly diminished by
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establishing a good rapport with the patient and patient's family
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define documentation
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A written or printed recording of original, official or legal information
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List the five W of appropriate documentaion
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who- performed procedure
what - was done when - it was done where - it was done why - it was done |
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the threefold purpose of documentation
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to create a legal record, to obtain reimbursement, communicating patient status
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what form of documentation is composed of a story format
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narrative
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focus charting
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a method of organizing documentation to include data for each identified concern or focus
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PIE
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problem, intervention, evaluation
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SOAPIE
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subjective- what patient says
objective- what you observe assessment plan intervention evaluation |
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which form is used to document IV therapy procedures
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Nurses notes
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why should the word unit be written out and not abbreviated as U
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if abbreviated , it might accently be read as zero.
also never abbreviate drug names, and avoid using the word KVO unless approved by facility KVO= usually 5-10 cc/hr |
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which example is a subjective statement that is considered a common documentation error
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IV is dripping well
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which charting format tends to lead to greater opportunities for subjective rather than objective entries
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Narrative
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The purpose of an unusual occurrence or variance report, also known as incident report is to
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provide factual, non-judgemental accounts of unusual situations and their consequences
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The essential component of an unusual occurrence or variance report include
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factual description of event, physician notification and outcome
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Functions of the skin
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Protection, temperature regulation, sensation, covers body
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Structure of skin comprises of
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Dermis, Epidermis, superficial fascia ( *area where superficial veins are located)
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Uppermost layer of skin
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Epidermis
thickest: in the palms of hands and soles of feet thinnest: inner surface of limbs age: thinner in elderly |
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Highly sensitive vascular layer of skin
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Dermis
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The skin layer that connects the dermis to the underlying tissue and contains majority of veins in the administration of IV
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Subcutaneous Tissue
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Vessel carrying oxygenated blood from heart to tissues
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Arteries ( color is right scarlet red due to oxygenation)
2 major: pulmonary artery: from RV to lungs Systemic: LV to body |
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Microscopic vessels between arterioles and venules
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Capillaries
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More numerous than arteries
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Veins
carry blood to the heart, do not pulsate, has a superfial and deep layer, color is dark red |
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Connects arteries and capillaries
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Arterioles
A-A-C-V-V ( Tissues 02-artery, arteriole, capillary, venule, vein- heart) supply capillaries with oxygenated blood |
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connects capillaries and veins
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venules
smallest blood vessels, drain CO2 and waste products |
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characteristic of veins
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do not pulsate, more numerous than arterys , carries deoxy blood to heart, color is dark red
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characteristics of arteries
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compromised circulation to the tissue area it supplies resultant of injury, scarlet bright red.
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structural component common to both veins and arteries
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tunica intima, tunica media, tunica adventitia
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true statement regarding valves
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prevents back flow of blood
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which form of stimulation CANNOT generate vasoconstriction and subsequent spasm
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infusion of an infusate that has been warmed by controlled warming device
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three factors that could predispose patient to vasovagal reaction
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fear of needles or IV therapy itself, traumatic experience with previous IV therapy itself, lack of adequate patient preparation
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illustration of veins
1. by wrist prone toward little finger is called = 2. by wrist prone toward thumb= 3. on top middle of hand= 4. median of arm supine toward body= 5. median of arm supine away from body |
1. basilic
2. cephalic 3. dorsal venous arch 4. median cubital vein 5. accesory cephaic vein |
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any contrivance or arrangement that regulates amount and direction of flow of liquid, gas, vapor, or loose material
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valve
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abnormal accumulation of fluid in tissues
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edema
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function of heart
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to pump blood into arterial system
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which IV factor can cause variations in heart function and respiratory rates
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Fluid and electrolyte imbalance
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Which IV factor can cause variation in respiratory RATE
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electrolyte imbalance, emboli, medication, pH of medication, tempRATURE of transfused blood, fluid overload.
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function of pulmonary system
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exchange of gases between organism and environment
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Which IV factor can cause variation in respiratory FUNCTION
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f/e imbalances, medications, fluid overload, speed shock, SEPTICEMIA, emboli, VASOVAGAL reaction
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deficiency of Hgb in blood
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Anemia
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Fluid portion of blood
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Plasma
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study of blood
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hematology
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approximate number of liters of blood in an adult
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5 liters ( 7 % of body weight)
blood clots in 2-6 minutes |
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blood aids in regulating body
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temperature
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function of blood essential to homeostasis
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maintaining acid-base balance
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Trace the flow of blood through the heart
superior vena cava - RA- 1 - RV- 2 - 3 - LUNGS - LA - 4 -LV-5-6-BODY |
superior vena cava- right atrium- tricuspid valve- right ventricle- pulmonary semi lunar valve- pulmonary arteries- lungs-left atrium- mitral (bicuspid) valve- left ventricle- aortic semilunar valve- aorta- rest of body
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blood is formed in the
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red bone marrow and lymphatic tissue
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2 factors that can alter normal blood clotting
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certain disease processes, and medications
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erythrocytes function
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aids in transporting oxygen and c02
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leukocytes function
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protects body against infection
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thrombocytes
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clotting
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The steps in blood clotting in order
PQRSST -platelet form plug, release seratonin, spasm of blood, thmboplastin, then the thrombin produces fibrin |
1. Platelets form a white thrombus or platelet plug
2. platelets release seratonin blood vessel goes into spasm to decrease blood loss. 4. platelets release thromboplastin 5. thrombin works with fibrinogen to produce fibrin to form meshwork that traps erythrocytes |
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extravasation
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inadvertent administration of vesicant /drug into the tissue
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hematoma
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a localized mass of blood causing a hard painful lump
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cellulitis
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inflammation of cellular or connective tissue
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embolism
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obstruction of blood vessel by a thrombus or foreign material
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infiltration
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inadventent administration of a NON-VESICANT solution /drug into the tissue
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occluded cannula
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cannula is occluded with blood or drug precipitate
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infection at site
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bacterial invasion at venipuncture site resulting in infectious disease process
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septicemia
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systemic disease caused by presence of pathogenic microrganisms in the body
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circulatory overload
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condition pecipitated by presence of more fluid than the circultory system can handle.
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phlebitis
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inflammation of the intima of a vein
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thrombus
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blood clot
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vesicant
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any agent capable of producing blisters or tissue damage e.g. sodium bicarb, phernegan, radiology medium, amphotericin B, calcuim, norepinephrine, dopamine HCL, pottasium chloride in high doses
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thrombophlebitis
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inflammation of a vein in conjunction with a thrombus
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local complications of iv therapy
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Phlebitis, infiltration, extravasation
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which IV therapy complication has been reported to have 40-50% mortality rate
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air embolism
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discoloration and formation of a hard painful lump adjacent to the venipuncture site are 2 s/s of what condition
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hematoma
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2 characteristics of thrombophlebitis
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inflammation and thrombosis characteristic of
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engorged neck veins, hypertension, severe dyspnea, moist rales are indicators of
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circulatory overload s/s
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fever chills, general malaise, headache , nausea, vomiting , vascular collapse, and shock are signs and symptoms of what condition
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septicemia s/s
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pleuritic pain, dyspnea, hemoptysis, and cyanosis are s/s of what condition
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pulmonary embolism s/s
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swelling, coolness, altered flow rate are s/s
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infiltration s/s
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sterile/chemical, mechanical, and septic are subclassifications of which complication
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phlebitis ( inflammation of intima of a vein) subclassifications
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weeping of tissue may or may not develop in a patient who has which complication
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cellulitis
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Local complication
Ecchymosis( caused by unskilled personnel, anticoagulant, long term steroid, aged vessels) s/s nursing interveention |
s/s: swelling, discoloration
nx trt: remove cannula, apply light pressure |
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local complication
hemotoma s/s trt |
s/s: dc, development of hard painful lump
nx trt: d/c iv site, apply direct pressure, elevate extremity, apply cold compressess |
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infiltration
s/s trt: |
s/s: increased swelling of tissue adjacent to IV site, poor or no blood return at IV cannula, Adjacent skin is cool to touch, skin is taut, blanching of skin, pain c/o discomfort or pain
nx: d/c IV site immediately, elevate extremity, apply warm compresses |
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extravasation
s/s trt |
s/s- pain or burning at site, progressing erythema and edema, formation of blisters
nx trt- follow policy, report to physician for evaluation, continue monitoring the blisters |
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phlebitis- types include sterile/chemical, mechanical, bacterial
s/s trt |
tenderness, area warm to touch, redness, induration, swelling, possible temperature elevation, progressive alteration in flow
nx- d/c site, elevate extremity, apply warm compressess, notify physician |
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thrombophlebitis
inflammation and thrombus formation s/s trt |
s/s - vein becomes hard and tortous, extremely painful to touch, arching of entire extremity
trt- d/c site, elevate extremity, caution patient not to rub or massage, notify physician complications- septicemia and embolism |
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infection at venipuncture site
usually situated at cannula entry point s/s nx |
s/s- pain , redness, swelling, temperature elevation
trt- d/c site notify physician, continue monitoring |
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cellulitis
s/s trt |
s/s- same as infection plus INDURATION
trt- same as infection |
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nerve irritation
s/s trt |
tingling of extremity, numbness of extremity, sharp hot painful sensation radiating down, claw-like involuntary drawing of hand/fingers
nx- cease venipuncture attempt, remove armboard, use a different site if armboard related |
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occluded cannula
s/s trt |
slowing of infusion rate, resistance met when attempting to flush
nx- never forcibly flush a cannula, remove peripheral cannila, if central venous cannula- contact physician or RN to remove |
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septicemia****
staph may be staph or strep s/s trt |
s/s- chills, temperature elevation, malaise, confusion , HA, increased pulse rate, n/v, hypotension, vascular collapse, shock
nx- stop infusion but aseptically maintain equipment for lab evaluation, reestablish new site with a new set, obtain v/s, |
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air embolism****
s/s trt |
s/s- sudden onset of pallor, cyanosis, weak rapid pulse, dyspnea, chest pain, hypotension, generalized seizures, cardiac arrest
nx- correct source of air intake, place patient on left side in steep trandelburg |
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thrombophlebitis intervention
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d/c site, caution patient not to rub site, notify physician
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air embolism
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correct source of air intake, place pt on left side in trandelburg position
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phlebitis
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d/c site, elevate, warm compresses, notify physician
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circulatory overload
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slow infusion rate to rate that just keep patient patent, place in high fowlers, warmth, notify physician
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pulmonary embolism
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place in semi fowlers, assess v/s, notify physician
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infection
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d/c site, culture tip and drainage, , notify physician
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septicemia
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stop infusion, aseptically reserve assembled system for future testing, reestablish new site, obtain v/s
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nerve irritation
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cease venipuncture attempt, remove armboard, relocate IV
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extravasation
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stop drug administration, follow procedure and policy
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hematoma
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d/c iv immediately, apply direct pressure, elevate extremity, apply cold compresses.
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main sources of bacteria responsible for IV associated infections
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Air, blood, skin
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what factors influence bacterial survival
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presence of specific organism, number of organisms, and resistance of host
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intrinsic contamination may occur during
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manufacturing process
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what type of contamination can result from compromised integrity of the venipuncture site dressing
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extrinsic
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what governmental agency issued the bloodborne pathogen standard
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OSHA
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which statement applies to bloodborne pathogens
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gloves should be worn when touching blood and certain body fluids
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which intravenous procedure has high risk for blood contact
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peripheral venipuncture
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factors associated with IV related contamination
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inappropriate handwashing, use of TSM dressings, and cannula-associated contamination
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essential component of the patient IV therapy teaching plan should include
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limitations or restrictions imposed as a consequence of the therapy
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what factor could directly escalate the degree of anxiety a patient experiences when receiving IV
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misguided concept that IV is only administered to critically ill patients
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patients psychological resources
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previous experiences, family relationships, relationship with healthcare team
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s/s of vasovagal reaction
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vasoconstriction, syncope, diaphoresis
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regressive behavior is often a consequence of what
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psychological stress
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gauge
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diameter size of vascular access device opening
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Hub
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female connection point of vascular device
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length
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length of vascular access device
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lumen
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space within vascular access device
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winged-infusion needle
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short, small gauge needle with one or two plastic side arms or wings
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over the needle (ONC)
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catheter mounted on needle, needle removed once catheter is inserted.
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midline catheter
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catheter terminates in the upper aspect of the arm
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intermittent infusion device
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has a permanently attached injection port
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multilumen central venous catheter
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catheter containing three internal lumens for patients requiring multiple therapies
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tunneled central venous catheter
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commonly referred to as a hickman or broviac catheter
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implanted central venous catheter
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consists of implanted long term venous port device composed of a catheter and self sealing reservior
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PICC
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site of vein is adjacent to antecubital fossa
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Groshong
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hasa rounded blunt venous catheter closed tip
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microdrip primary standard set
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delivers 60 gtt/ml
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pressure sensitive check-valve sets
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allows primary infusion to cease during IVPB delivery
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secondary administration set
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used for drug delivery with pressure sensitive sets
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precision volume controlled sets
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contains a calibrated chamber
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macrodrip primary standard set
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drops per ml vary among manufacturers
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Y set
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used for administration of blood/blood components
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nonpolyvinyl chloride sets
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used to prevent absoption of certain infusates into tubing``
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factors to be considered when selecting a peripheral vascular access device
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ordered therapy, patients clinical status, patients age
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characteristics of parenteral fluid glass containers
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may be vented or non vented designs, and contains a vacuum
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disadvantage of using plastic containers
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it may be difficult to acertain the volume of fluid remaing in container
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important nursing consideration when using resealable injection ports
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integrity may be compromised due to numerous penetrations
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disadvantage of using transparent semipermeable membrane dressings
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cost of dressing
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needle protective systems are designed to
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reduce the risk of needle stick injuries
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most vital nursing consideration when using non electronic rate minder
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it does not negate the need for a nurse to monitor infusion rate
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a microbe extension tube set
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often used as adjuvant to a PICC
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what is the setting in which elastometric infusion devices are predominantly used
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home care setting
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the purpose of an IV site protrector is to prevent
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dislodgement of cannula
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PCA pump
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has a remote control for patient activated bolus dosing
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syringe pump
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used with standard disposable syringes
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ambulatory pump
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light weight compact battery driven
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3 common reasons for pediatric IV fluid therapy
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maintenance of f/e balance
medication administration/chemotherapy/TPN transfusion of RBC, platelets, plasma therapy |
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adolescent
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13-18 years
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infant
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4 weeks - 1 year
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neonate
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0-4 weeks
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preschool
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3-5 years
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school age
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6-12 years
avoid baby talk |
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toddler
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1-3 years
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adolescents
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may have concern about body image
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primary consideration in fluid and electrolyte imbalance
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the younger the child the greater the risk of f/e imbalance, fluid overload, CHF
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when venipuncture is to be performed on a child, parent or guardian should be
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provided with an explanation of what the procedure entails
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what kind of IV cannula is most frequently used for pediatric vascular access
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ONC
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the IV catheter gauge most commonly used for all pediatric age groupings
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24 gauge
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when using a volume-control set to provide infusion therapy for an infant it should:
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contain no more than one third of the infants daily fluid requirement at any given time
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where is the ideal place to perform venipuncture on a child
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in a treatment room
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|
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using scalp veins for venipuncture can cause
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psychological stress for the childs parent
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to ensure the accurate infusion flow rate in a pediatric patient, the flow rate should be adjusted when the child is
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resting
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the intake and output of pediatric IV should be computed and recorded for accurate monitoring every
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hour
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absecnce of tears when crying in an infant is a sign of
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FVD
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|
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variables that affect how often flow rates must be monitored include
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age of child, clinical status, mode of delivery
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what products are transfused during exchange blood transfusions
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fresh RBC and plasma
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the preservative sodium benzonate in the form of benzyl alchohol is toxic to which group
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Neonates and infants
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|
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When can an umblical cord be used
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Birth to 4 days
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|
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immune system changes
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causes patient to be hyporesponsive to foreign antigens
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diminished pulmonary function
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predisposes patient to C02 retention and respiratory acidosis
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altered renal function
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causes difficulty in eliminating heavy solute loads
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|
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cardiovascular system changes
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decrease size of capillary beds
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diminished hepatic function
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decreases ability to metabolise drugs
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decrease in body water
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approximately 6% reduction in body water
|
|
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a cardiovascular change secondary to the aging process
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fragility of veins
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impaired homeostasis can often be attributed to
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diminished thirst sensation
|
|
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when selecting a cannula for venipuncture in a geriatric patient , if available use a
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a winged hub catheter
|
|
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increased oncotic pressure negates the use of
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areas of bruising for venipuncture
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|
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to dilate the vein of a geriatric patient
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apply torniquet lightly
|
|
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intravenous catheter insertion in an elderly patient
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insertion angle is 5-15 angle and also apply skin traction below projected insertion site
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type of dressing to stabilize cannula and minimize injuryto fragile skin in elderly patients
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transparent dressing
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6 monitoring factors essential to IV therapy assessment in elderly
|
f/e, fluid volume, I/O, assess therapeutic response, assess puncture site
|
|
|
initial remedial action in occluded cannula is
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gentle aspiration
|
|
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concentration of heparin generally used in peripheral insertion
|
10 units per ml
|
|
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routine scheduled change of administration system
|
depends on facility policy
|
|
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thrombophlebitis, cellulitis or IV related sepsis
|
neccessitate change of entire system
|
|
|
time limit for blood administration set
|
4 hours
|
|
|
volume of fluid infused
|
included in i/o tabulations
|
|
|
peripheral site rotation
|
to minimize risk of potential phlebitis
|
|
|
homeostasis
|
maintenance of constant conditions in the internal environment
water balance is necessary for maintenance of homeostasis |
|
|
concentration of heparin generally used in peripheral insertion
|
10 units per ml
|
|
|
percentage of body water in full term newborns
|
70-80%
|
|
|
routine scheduled change of administration system
|
depends on facility policy
|
|
|
percentage of body water in 65 year old woman
|
46%
|
|
|
thrombophlebitis, cellulitis or IV related sepsis
|
neccessitate change of entire system
|
|
|
functions of water
|
providing for ionization of electrolytes, regulating body temperature, acts as a solvent for a variety of substances
|
|
|
time limit for blood administration set
|
4 hours
|
|
|
volume of fluid infused
|
included in i/o tabulations
|
|
|
concentration of heparin generally used in peripheral insertion
|
10 units per ml
|
|
|
peripheral site rotation
|
to minimize risk of potential phlebitis
|
|
|
routine scheduled change of administration system
|
depends on facility policy
|
|
|
homeostasis
|
maintenance of constant conditions in the internal environment
water balance is necessary for maintenance of homeostasis |
|
|
thrombophlebitis, cellulitis or IV related sepsis
|
neccessitate change of entire system
|
|
|
time limit for blood administration set
|
4 hours
|
|
|
percentage of body water in full term newborns
|
70-80%
|
|
|
volume of fluid infused
|
included in i/o tabulations
|
|
|
percentage of body water in 65 year old woman
|
46%
|
|
|
functions of water
|
providing for ionization of electrolytes, regulating body temperature, acts as a solvent for a variety of substances
|
|
|
peripheral site rotation
|
to minimize risk of potential phlebitis
|
|
|
homeostasis
|
maintenance of constant conditions in the internal environment
water balance is necessary for maintenance of homeostasis |
|
|
percentage of body water in full term newborns
|
70-80%
|
|
|
percentage of body water in 65 year old woman
|
46%
|
|
|
functions of water
|
providing for ionization of electrolytes, regulating body temperature, acts as a solvent for a variety of substances
|
|
|
which body fluid has the smallest volume of fluid at any given time
|
intravascular
|
|
|
four major organs involved in homeostasis
|
heart lungs kidneys adrenal glands
|
|
|
osmotic pressure is proportional to the
|
total number of particles in the fluid
|
|
|
anions
|
chloride, bicarb, phosphate,
|
|
|
cations
|
sodium, potassium, magnesium, calcium
|
|
|
non electrolyte
|
dextrose, urea, creatinine
|
|
|
what condition may GI sunctioning cause
|
hypokalemia
|
|
|
condition characterized by dry, sticky mucous membranes
|
hypernatremia
|
|
|
vague muscle weakness, gi hyperactivity , and paresthesia of face, tongue, feet , hands are s/s
|
hyperkalemia
|
|
|
postural hypotension, altered sensorium, slow filling hand veins are s/s
|
FVD
|
|
|
two objectives of parenteral fluid administration
|
maintenance therapy
replacement therapy |
|
|
rationale for fluid replacement
|
restoration of preexisting fluid losses
restoration of present fluid losses |
|
|
hypertonic fluid
|
increases osmotic pressure by drawing fluid from cells
|
|
|
hypotonic fluid
|
decreases osmotic pressure by forcing fluid into cells
|
|
|
tonicity of fluid
|
determined by osmolarity of normal blood plasma
|
|
|
isotonic fluid
|
expands extracellular fluid compartment
|
|
|
pH
|
indicator of hydrogen ion concentration of free acid activity
|
|
|
method an LPN may use to administer an IV push drug ( in ER)
|
using a safety syringe and needle to inject directly into the vein or into the injection port of an intermittent infusion set
|
|
|
goals of chemotherapy
|
cure, control, palliation
cytotoxic drugs intefere with cell division and growth LPN only monitors chemotherapy for evidence of side effects such as leukopenia and thrombocytopenia maintain a high fluid intake 0f 3-4 L/day to prevent hemorrhagic cystitis |
|
|
six right
|
right drug, right form of drug, right dose, right time, right right, right patient
|
