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35 Cards in this Set

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2. What functions related to IV therapy may the LPN not provide for the patient? (Board of Nursing document related to the role of the LPN in IV Therapy)
• Administer IV bolus meds for sedation
• Administer investigative/cytotoxic IV meds
• D/C central line
4. Describe two benefits of IV therapy: (text, pp. 1 – 2)
• Accurate dosing because it begins to act almost immediately
• Good if unable to take oral medications
5. Identify 6 risks associated with IV therapy: (text, p. 2)
• bleeding
• blood vessel damage
• fluid overload
• infiltration
• infection
• overdose
• allergic reaction
• incompatibility when drugs/solution are mixed
6. What percentage of body weight do fluids contribute in an adult patient? In an infant? (text, p. 2)
• Adults: 60%
• Infants: 80%
7. Name four functions which body fluids provide: (text, p. 2)
• regulate body temperature
• transport nutrients and gases around body
• carry cellular wastes to excretion sites
8. Name three things which affect the body’s fluid balance: (text, p. 4)
• fluid volume
• distribution of fluids in the body
• concentration of solutes in the fluid
ADH and Aldosterone
ADH = water conserving hormone
Aldosterone = retain sodium + water; secreted if sodium is low, potassium high, circulating fluid volume decreases
9. Identify five symptoms that may indicate fluid deficit: (text, p. 5)
• weight loss
• fast and thready pulse, diminished BP
• poor capillary refill
• mental status changes
• increased hematocrit, BUN, serum electrolyte levels
10.Identify five symptoms that may indicate fluid overload: (text, p. 5)
• Weight gain
• increased BP, bounding pulse
• distended veins
• crackles in lungs
• edema
12.Why are fluids and electrolytes generally discussed in tandem? (text, pp. 8 -10)
• they are interdependent; one affects the other
• intracellular electrolytes: potassium, phosphorus
• extracellular electrolytes: sodium, chloride
• Extracellular fluid
o ISF/intravascular fluid
o identical electrolyte compositions
o different protein contents; no proteins in ISF
capillary solute movementb
 filtration: move substances from areas of high hydrostatic pressure to areas of lower hydrostatic pressure. Forces fluid and solutes into ISF.
 Reabsorption: albumin remains in capillaries, pulls water back in by osmosis (called colloid osmotic pressure/oncotic pressure; when higher than BP water and solutes return to capillaries; usually in second half of capillary)
13. Define “isotonic” solutions: (text, p. 11)
• Same osmolarity as serum and other body fluids; stays inside the blood vessel & expands the compartment
• treatment for hypotension due to hypovolemia
• lactated ringers/normal saline
14.Define “hypertonic” solutions: (text, p. 12)
• Osmolarity higher than serum osmolarity; pulls fluid into blood vessels
• post-op to decrease fluid shift & reduce edema, stabilize BP, regulate urine output
• do not give if impaired heart/kidney because too much extra fluid
• dextrose 5% in half normal saline, dextrose 5% in normal saline, dextrose 5% in lactated ringers. 3% sodium chloride, 25% albumin, 7.5% sodium chloride
15.Define “hypotonic” solutions: (text, p. 14)
• osmolarity lower than the serum osmolarity; shifts fluid into cells
• hydrates cells + reduces circulating fluid
• do not give if cerebal edema or ICF (don't need more water!)
• half normal saline
• dextrose 2.5% in water
• 0.33% NaCl
16.When would you expect to see isotonic solutions prescribed for your patient? (text, p. 11)
• hypotension due to hypovolemia
17.When would you expect to see hypertonic solutions prescribed for your patient? (text, pp. 12-13)
• post operatively
• reduce edema, stabilize BP, increase fluid output
18.When would you expect to see hypotonic solutions prescribed for your patient? (text, p. 14)
• If diuretic therapy dehydrates cells
• hyperglycemia (DKA)
19.List four reasons why IV therapy may be prescribed: (text, p. 14)
1. Administer drugs: rapid and effective route
2. Blood administration: restore circulatory volume, prevent cardiogenic shock, increase bloods O2 carryin capacity, maintain hemostasis
3. Parenteral Nutrition: meet energy and nutrient requirements; used if gut cannot absorb nutrients; not for long-term use (liver damage)
4. Also PPN: for up to 3 weeks, lipid emulsions, track changes in pancreatic enzymes
• Administration sets:
o vented/unvented (Some bottles have their own venting system)
o variety of tubing
22.How many drops per milliliter (gtts / ml) does a macrodrip infusion set deliver? (text, p. 23)
10,15, or 20 gtt/mL
23.How many drops per milliliter (gtts / ml) does a microdrip infusion set deliver? (text, p. 23)
60 gtt/mL
24.What is the formula for calculating flow rate? (text, p. 23)
(volume of infusion (mL))/(time of infusion (minutes))×drop factor (gtt per mL)=flow rate (gtt per minute)
25.Name the three mechanisms for regulating flow rates and describe how each works: (text, p. 24)
o IV clamps
 Slide - stops/start, can’t regulate
 Roller - standard fluid therapy
o Pumps
o Rate minder (like roller clamp); label infusion bag in mL/hour
 do not deliver at less than 5-10 mL/hour
 for adult/noncritical patients
26.How frequently should flow rates be monitored? (text, p. 24)
• fight fickle flow with frequent follow-up
• anytime you are in a patient's room/after each position change
• more frequently: critically ill, concerns about fluid overload, peds, elderly, drug that can cause tissue damage if infiltration occurs
• also check IV insertion site and ask patient how it feels
27.Name six issues that may cause lawsuits related to IV therapy: (text, p. 26)
• fight fickle flow with frequent follow-up
• anytime you are in a patient's room/after each position change
• more frequently: critically ill, concerns about fluid overload, peds, elderly, drug that can cause tissue damage if infiltration occurs
• also check IV insertion site and ask patient how it feels
27.Name six issues that may cause lawsuits related to IV therapy: (text, p. 26)
1. Wrong med dose
2. inappropriate placement of IV catheter
3. Failure to monitor for adverse reactions
4. Failure to monitor for infiltration
5. Dislodgement of IV
6. Wrong med (wrong solution, dose)
28.Name three regulatory documents which, if followed correctly by the nurse, may assist in reducing the number of lawsuits related to IV therapy: (text, pp. 27-29)
1. State nurse practice acts
2. Federal regulations
3. Facility policy
29.Name 11 items which must be documented on the patient’s record when initiating IV therapy: (text, pp. 30-32)
1. Size, length, type of device
2. Name of person who inserted the device
3. Date and time
4. Site location
5. Type of dressing used
6. Condition of the site
7. Type of solution
8. Any additives
9. Flow rate
10. use of electronic infusion device or other type of flow controller
11. complications, patient response, nursing intervention
12. Patient teaching and evidence of patient understanding
13. number of attempts (successful/unsuccessful)
30.Name six items which should be assessed and documented for IV therapy maintenance: (text, p. 30)
1. condition of the site
2. site care provided
3. dressing changes
4. tubing and solution changes
5. teaching and evidence of patient understanding
6. facility may have flow sheets/intake or output sheets
31.Name six items that must be documented when discontinuing IV therapy: (text, pp.31-32)
1. Time and date
2. Reason for d/c
3. Assessment of venipuncture site before and after
4. Complications, patient reactions, nursing interventions
5. Integrity of venous device on removal
6. Follow-up actions
7. Amount of IV fluid infused before d/c
32.What is the goal of patient / family education regarding IV therapy? (text, pp. 32-33)
Relax the patient and promote understanding of IV therapy
33.Define the three steps which patient / family education should include: (text, pp. 32-33)
1. Describe the procedure
2. Explain what the solution is
3. Tell patient how long therapy will continue
34.Define direct injection: (text, p. 319)
Administration of single dose (bolus) of drug or other substance; aka IV push
35.Define electrolyte balance: (text, p. 319)
concentration levels of extracellular and intracellular electrolytes, should be about equal