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43 Cards in this Set

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What are three types of vascular access for IV's?
Peripheral access, midline peripheral access, central venous access
How long are peripheral access catheters and how often are they changed?
Usually < 3 inches and are changed every 72-96 hrs.
How long are midline peripheral catheters and what types of solutions should you NOT infuse through them?
>3 inches and do not infuse vesicants, hypersmolar or irritating solutions
What types of things should you check when selecting the correct solution to infuse?
Check to make sure it is the correct solution order, it is clear, intact and that the expiration date has not passed.
What are some responsibilities of the nurse when it comes to IV's?
selection of the correct solution, insertion of the IV, monitoring the rate, and discontinuing the IV when dr. determines necessary.
Why is it important to prime the IV tubing before infusion begins?
To remove all the air bubbles. If not done, the pt. will get a bolus of air which could be tragic.
What type of equipment is needed for insertion of an IV?
IV catheter, IV start kit, solution, tubing, clean gloves, short extension set, tape, tegaderm (or opsite) and a chux pad.
Name some different types of solutions used for IV's?
Isotonic, Hypotonic, & Hypertonic
True or False? Hypotonic solutions have a concentration of about the same as plasma.
False. Isotonic solutions have the same as plasma
Isotonic solutions remain in the __________ space.
intravascular
What are some examples of isotonic solutions?
D5W, NS, and Ringers Lactate
What concentration does Hypotonic solutions have compared to plasma?
They have a concentration that is less than that of plasma.
Since hypotonic solutions have a lower concentration then that of plasma what space do they move to?
They move from the intravascular space to the intracellular space
What effect will a hypotonic solution have on a cell?
It will cause it to swell
What are some examples of hypotonic solutions?
1/3 NS and 1/2 NS
What is the concentration of hypertonic solutions compared to plasma?
It has a higher concentration than plasma
What effect does a hypertonic solutions have on a cell?
It's higher osmolarity causes water to move out of the intracellular space into the intravascular space and cause the cell to shrink.
What are some examples of hypertonic solutions?
3% NaCl, D10W, D20W, D50W
What are some parts of the IV tubing?
spike, drip chamber, clamps, primary tubing, secondary tubing, etc.
What are volutrols?
They have a chamber that holds about 100cc which provides a safety function for neonates and peds. If the IV pump malfunctions the pt. will not get a huge bolus of solution
Where are some sites that you would not want to put an IV into?
Sites of burns, arm of pt. having had a mastectomy, axillary node dissection, arteriovenous fistula. also avoid pts. dominant arm if possible and antecubital vein, veins near joints, or on legs (unless other veins are inaccessible)
What are some other factors that the nurse will consider and assess when inserting an IV?
Condition of the vein: fragile or scared veins may make insertion difficult
Type of solution: hypertonic, viscous or irritating sol. are best infused in larger veins.
Length of time for infusion: If infusion is for a long time select a site that will minimally restrict movement
A physician orders 1L of D51/2NS to infuse over 10hrs. You do not have a pump available and need to infuse by gravity and convert the flow rate to a drip rate. The drop factor of your tubing is is 15qtt/cc what is your rate?
1000cc/10hr = 100cc/hr
15qtts/1cc X 100cc/60 minutes = 25qtt/min
Why is it important to monitor the IV infusion?
To make sure the rate has not changed. If an IV infuses too slow the fluid balance problem may not be corrected and if too fast could result in fluid overload or congestive heart failure. It is also important to check to make sure tubing is not kinked, that there is no air in the line, and that there is no redness, bleeding, swelling etc at the site.
What are some complications of IV's?
infiltration, phlebitis, sepsis, thrombus, fluid overload, air embolism, and speed shock.
What is inflitration and why does it occur?
Infiltration occurs when the catheter tip exits the vein and the solution infuses into the tissue around the vein. This will cause swelling around the site.
What is phlebitis and what are some symptoms?
inflammation of a vein
symptoms: erythema, slight swelling, warmth, red streak following course of vein.
What is sepsis and what are the symptoms?
when microorganisms enter the intravascular space
symptoms: redness, tenderness, pain, fever, and malaise.
What is a thrombus and what are the symptoms?
a clot in the catheter
symptoms: erythema, slight swelling, warmth, red streak following course of vein and flow rate may stop.
Fluid overload occurs when too much fluid infuses into the system. What are the symptoms?
dyspnea, increase in B/P, neck vein distension
What are the nursing actions if infiltration occurs?
Discontinue the IV and restart in a different site
What are the nursing actions if phlebitis occurs?
Discontinue IV and restart in a different site. A warm moist compress may help reduce pts discomfort.
What are the nursing actions if sepsis occurs?
notify the physician. If the IV is the cause it will need to be discontinued and restarted in a different site.
What are the nursing actions if a thrombus occurs?
Discontinue IV and restart in a different site. Do NOT massage area as this may dislodge clot.
What are the nursing actions if fluid overload occurs?
slow IV rate, notify the physician and monitor vital signs.
What is an air embolism and what are the symptoms?
when air enter the circulatory system
symptoms: dyspnea, tachycardia, cyanosis, decreased B/P, changes in LOC
What are the nursing actions if an air embolism occurs?
flow should be stopped and pt. should be placed on lf. side in Trendelenburg position, monitor vital signs and pulse ox, & notify physician. O2 may be needed
What is speed shock and what are the symptoms?
a reaction to a substance that is injected too quickly.
Symptoms: pounding headache, fainting, tachycardia, apprehension, chills, dyspnea, & back pain.
What are two methods of administering IV meds?
continuous administration and IV Piggyback
What is continuous administration of IV meds?
administration of med over a long period of time through an infusion pump.
What is an IV piggyback?
administration of med using secondary tubing to infuse over a specific period of time ranging from 30-60 min.
True or False? The nurse must flush before and after administering and IV piggyback through a saline or heparin lock.
True
How much saline or heparin is used to flush a lock?
1-3cc