I.v. Therapy

Front 1

What is an advantage of I.V. route?

Back 1

rapidly absorbed

Front 2

What is a disadvantage to I.V. therapy?

Back 2

limited to highly soluble drugs

drug distribution is limited by poor circulation.

Front 3

Several reasons for intravenous therapy.

Back 3

rapid effect is required
medications are too irritating to tissues by other routes
when i.v. line is already established, avoids discomfort of other parenteral routes

Front 4

What should the nurse assess before beginning an I.V. line?

Back 4

signs of infection, infiltration, or a dislocated catheter
inspect surrounding skin for redness, pallor or swelling
palpate for coldness edema
take vital signs
determine allergies
check compatibility of medications

Front 5

What is Phlebitis

Back 5

infection of a vein due to mechanical or chemical injury

Front 6

Clinical signs of phlebitis

Back 6

redness, warmth, swelling, at the intravenous site and burning and pain along the course of the vein.

Front 7

What is infiltration?

Back 7

when an I.V. needle becomes dislodged from the vein and fluid flows into the interstitial space causing swelling

Front 8

What are signs of infiltration?

Back 8

swelling, pallor, coolness, and discomfort, at the I.V. site.

Front 9

Large volume infusions.

Back 9

is the safest way to administer drug by I.V.
diluted in volumes of 1000ml-500ml.
normal saline and ringer's lactate often used.
commonly added drugs are potassium chloride and vitamins.

Front 10

The main danger when infusing large volumes of I.V. fluids.

Back 10

can cause circulatory overload=hypervolemia

Front 11

intermittent intravenous infusions

Back 11

medication mixed in small amount of solution 100mL - 50mL.
administer every 4 hours or regular intervals for short period of time.
setup by piggy back or tandem
can also be in a syringe, via mini infuser

Front 12

volume control infusion

Back 12

way to administer intermittent medications.
small fluid containers 100ml-150ml
attached below primary infusion into I.V. line
commonly used for children/older adults
volume must be carefully monitored.

Front 13

Intravenous push

Back 13

is an undiluted drug directly into the systemic circulation. used in an emergency or when a medication cannot be diluted. can be introduced directly into a vein by venipuncture or into an existing line w/in port or IV lock

Front 14

Two major disadvantages to intravenous push methods.

Back 14

errors cannot be corrected after drug is introduced

drug may cause irritation to the vein lining.

Front 15

intermittent injection port

Back 15

resealabel latex injection site for needle access or a port that allows a syringe or a needleless adapter to be connected for administering medications.

Front 16

Advantage to a intermittent infusion port

Back 16

allows a closed system to be maintained
long term use
can be implanted under the skin
eliminates repeated needle sticks

Front 17

Two secondary IV lines.

Back 17

piggyback
tandem

Front 18

Piggy back IV

Back 18

used solely for intermittent drug administration.
connected to the primary tubing at the upper port of the primary container

Front 19

tandem

Back 19

a second container is connected to the primary container at the lower, seconday port.

used with intermittently or simultaneously with the primary solution

Front 20

isotonic solutions

Back 20

same consentrations of solutes as the body.

restores and expands vascular volume

Front 21

Examples of Isotonic solution

Back 21

0.9% NaCL normal saline
lactate ringers
5% dextrose in H2O

Front 22

Client's on isotonic solutions should be assessed for ?

Back 22

hypervolemia

bounding pulse

SOB

Front 23

Why should 5% dextrose in H2O (D5W) be avoided in clients with intracranial pressure?

Back 23

can increase cerebral edema

Front 24

Hypertonic solutions

Back 24

> concentration of solute or higher osmolality than body fluids

draws fluid out of intercellular & interstitial spaces into the vascular compartments

Front 25

Examples of hypertonic solutions.

Back 25

5% dextrose in normal saline(DSNS)

5% dextrose in 0.45% NaCl(D51/2NS)

5% dextrose in lactated ringers (D5LR)

Front 26

Who should not receive hypertonic solutions ?

Back 26

clients w. heart disease
clients w. kidney disease
clients who are dehydrated

Front 27

With hypertonic solution a nurse should assess the client for ?

Back 27

hypervolemia

Front 28

Hypertonic solutions used to treat?

Back 28

< concentrations of solute or lower osmolality than body fluids.

provides free H2O and treats cellular dehydration

promotes waste elimination by the kidneys

Front 29

Examples of hypotonic solutions.

Back 29

0.45% NaCL (1/2 normal saline)
0.33% NaCL (1/3 normal saline)

Front 30

hypotonic solutions should not be used for clients DX with?

Back 30

IICP Increased Intracranial Pressure
or
third space shift

Front 31

location for
blood draws
IV push (bolus)
central catheter

Back 31

basilic and median cubital veins in the antecubital space

Front 32

locations for intermittent or continuous infusions

Back 32

hand, basilic, cephalic, metacarpal veins

Front 33

Sites used for long term IV therapy, parenteral nutrition, or medications that are damaging

Back 33

central venous catheters- inserted into subclavian or jugular vein w/ catheter superior to the vena cava.
PICC- inserted in the basilic or cephalic vein above or below the antecubital space of the RIGHT arm.

Front 34

What is the height of the IV pole to facilitate flow?

Back 34

about 1 m= 3 ft.

Front 35

Why is the tubing primed when beginning an IV?

Back 35

to prevent air from entering the client

Front 36

Unless contraindicated which arm should be used when starting an IV?

Back 36

the client's non dominate arm.

Front 37

Why is if necessary to dilate the veins before starting an IV?

Back 37

makes it easier to insert the needle properly.

Front 38

What should the nurse do or have the client do if it is difficult to dilate the vein?

Back 38

massage or stoke the vein
have client clench and unclench fist
lightly tap the vein
if these steps fail, remove tourniquet and apply heat to the entire extremity for 15 minutes

Front 39

If using a anti-infective solutions such as providone-iodine or betaine, what should the nurse assess for before applying the anti-infective to the skin?

Back 39

allergies to shell fish

Front 40

Why should the nurse pull the skin tight below the injection site when starting an IV?

Back 40

stabilizes the vein

makes the penetration less painful

Front 41

At what angle does the nurse use when beginning the IV?

Back 41

15 to 30 degree angle

almost parallel when you feel a lack of resistance

Front 42

Once blood appears in the lumen during IV insertion how much further should the nurse advance the needle?

Back 42

0.5 to 1 cm= 1/4 inch.

Front 43

What information is labeled on the IV site?

Back 43

date and time of insertion.

type and gauge of needle or catheter used.

and nurse's initials

Front 44

How far does the nurse advance the catheter when inserting an IV?

Back 44

until the hub is at the venipuncture site.

Front 45

The larger the gauge

Back 45

the smaller the needle

Front 46

IV insertion

#22 gauge

Back 46

used for frail, elderly

rarely last more than 1 or 2 infusions

Front 47

IV insertion

#20 gauge

Back 47

used for standard adult infusions

Front 48

IV insertion
#18 gauge

Back 48

used for standard infusions
some irritation
allows for higher rate of infusion than #20.

Front 49

IV insertion

#16 gauge

Back 49

used in surgical clients, major surgery of trauma

Front 50

IV insertion

#14 gauge

Back 50

wants to make sure blood stays whole.

Front 51

What is the best vein for IV insertion?

Back 51

distal of arm first
non-dominate arm
easily palpated
naturally splinted by bone
large enough for adequate circulation around catheter.

Front 52

What veins should be avoided when selecting an IV insertion site?

Back 52

areas of flexion
rolling veins
damaged by previous use
continually distended with blood or knotted or torturous.
in a compromised extremity

Front 53

How long should the nurse clean the injection site before insertion?

Back 53

30 sec.

Front 54

signs of hypervolemia

Back 54

dyspnea=rapid labored breathing
cough=crackles in the lung bases
tachycardia
bounding pulses

Front 55

Complications associated with hypervolemia.

Back 55

pulmonary edema
and
cardiac failure

Front 56

What does a rapid flow of solution into the drip chamber indicate ?

Back 56

a patency of the IV line.

Front 57

How often is IV tubing changed?

Back 57

every 48 to 96 hours

Front 58

Serum osmolatlity

Back 58

is a measure of solutes concentration of the blood. Values are used primarily to evaluate fluid balance

Front 59

normal osmolatlity values

Back 59

280-300mOsm/kg

Front 60

An increased serum osmolatlity indicates?

Back 60

fluid volume deficit

Front 61

a decrease in serum osmolatlity indicates?

Back 61

fluid volume excess

Front 62

isotonic solutions

Back 62

same concentration of solutes in the blood plasma. most i.v. solutions are isotonic

Front 63

hypotonic solutions

Back 63

lesser concentration of solute than plasma

Front 64

hypertonic solutions

Back 64

higher concentration of solute than plasma

Front 65

examples of isotonic solutions

Back 65

0.9% NaCl (normal saline)
Lactated Ringer's =a balanced electrolyte solution.
5% dextrose in water (D5W)

Front 66

examples of hypotonic solutions?

Back 66

0.45% NaCl (one- half normal saline)
0.33% NaCl ( one-third normal saline)

Front 67

examples of hypertonic solutions?

Back 67

5% dextrose in normal saline (D5NS)
5% dextrose in 0.45% NaCl (D5 1/2 NS)
5% dextrose in Lactated Ringer's (D5LR)

Front 68

Why does a nurse prime an I.V. tube before beginning IV therapy?

Back 68

to prevent air from entering the client.

Front 69

For tubing with air vents, the nurse knows ?

Back 69

she should not remove the cap, the fluid will stop as soon as liquid enters the cap.

Front 70

Intermittent or continuous infusion sites?

Back 70

metacarpal

basilic

cephalic

Front 71

What risk are associated with CENTRAL VENOUS CATHETER?

Back 71

pneumothorax on catheter insertion.

Front 72

The client with a CENTRAL VENOUS CATHETER should be closely monitored for?

Back 72

shortness of breath
chest pain
cough
hypotension
tachycardia
anxiety

Front 73

Reasons for a PICC

Back 73

reduced risk of pneumothorax
long term intravenous access when the client will be managing IV therapy at home.