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37 Cards in this Set

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Why use the direct IV route?
1. Instant peak drug level
2. Rapid drug response
3. Predictable serum levels
4. Time & cost effective
5. Allows irritating, vesicant meds
6. Avoids discomfort of injections
Advers effects of the direct IV route are..
1. Immediate
2. Potentially serious
3. Unable to be recalled
4. Difficult to counteract
Toxicities of IV include..
1. Speed shock
2. Cardiac arrest
3. Respiratory arrest
4. Anaphylaxis
5. Incompatibility
How to reduce the risks of IV therapy
1. Verify drug order
2. Perform thorough drug research
3. Set clear criteria outcome
4. Plan for emergency interventions
Additional research required for IV therapy
1. Type of IV access
2. Dilution
3. Rate of administration
To treat phlebitis
1. Move the venipuncture site
2. Apply warm soaks to the inflamed site.
Name the 3 types of IV delivery methods
1. Direct injection
2. Intermittent infusion
3. Continuous infusion
When is direct injection(IV push)indicated?
nonirritating drug with a low risk of immediate adverse reactions if required for a pateint with no other IV needs
Name 2 advantages to direct injection (IV push)
1. Risk of complications from an indwelling access device is eliminated.
2. Eliminates the inconvenience of an indwelling device.
Disadvantages of direct injection (IV push)?
1. Can only be given by a doctor or specially trained certified nurse.
2. Requires venipuncture = patient anxiety.
3. Requires 2 syringes..1 for med, 1 for flush
4. Requires dilution of med prior to injection
5. Risks infiltration allowing the solution to enter the surrounding tissue from the steel needle
6. Makes it impossible to dilute the drug or interrupt delivery when irritation occurs
Indications for IV delivery through an existing infusion line
1. When the pt. requires immediate high blood levels of a medication (for example, regular insulin, dextros 50%, atropine, or antihistamines)
2. In emergencies, when the drug must be given quickly for immediate effect
Advantages of IV delivery through an existing infusion line (direct injection)
1. Does'nt require time or authorization to perform venipuncture because the vein is already accessed.
2. Doesnt require needle puncture, which can cause pt. anxiety
3. Allows the use of an IV solution to test the patency of the venous acces device before drug administration
4. Allows continued venour access in case of adverse reactions.
Disadvantages of IV delivery through an existing infusion line (direct injection)
1. Carries the same incoveniences and complication risks as an indwelling venous access device
Indications for piggyback method (intermittent infusion)
Commonly used with drugs given over short periods at varying intervals (for example, antibiotics and gastric secretion inhibitors)
Advantages of piggyback method (intermittent infusion)
1. Avoids multiple IM injections
2. Permits repeated administration of drugs through a single IV line
Provides high drug blood levels for short periods
Disadvantages of piggyback method (intermittent infusion)
1. May cause periods when the drug level becomes too low to be clinically effective (for example, when peak and trough times arent considered in the medication order)
Indications for a Saline lock (intermittent infusion)allows for maintenance of venous access
When the pateint requres constant venous access, but not continuous infusion
Advantages of a Saline lock (intermittent infusion)allows for maintenance of venous access
1. Provides venous access for patients with fluid restrictions
2. Allows better patient mobility between doses
3. Preserves veins by reducing frequent venipuncture
4. Lowers cost
Disadvantages of a Saline lock (intermittent infusion) allows for maintenance of venous access
1. Requires close monitoring during administration so the device can be flushed on completion
2. Most commonly used in adults with peripheral IV access devices
Indications for a volume-control set (intermittent infusion) which has a medication chamber that allows it to deliver small doses over an extended period
When the pt. requires a low volume of fluid
Advantages of a volume-control set (intermittent infusion) which has a medication chamber that allows it to deliver small doses over an extended period
Requires only one large-volume container and prevents fluid overload from runaway infusion
Disadvantages of a volume-control set (intermittent infusion) which has a medication chamber that allows it to deliver small doses over an extended period
1. May have a high equipment costs
2. Carries a high contamination risk.
3. Requires that the flow clamp be closed when the set empties, if set doesnt contain a membrane that blocks the air passage when its empty.
Indications for Continuous Infusion through a primary line.
1. When continous serum levels are needed.
2. When consistent fluid levels are needed.
Advantages of Continuous Infusion through a primary line.
1. Maintains steady serum levels
2. Lowers the risk of rapid shock and vein irritation from a large volume of fluid diluting the drug.
Disadvantes of Continuous Infusion through a primary line.
1. Increases the risk of incompatibility with drugs administered by piggyback infusion
2. Restricts pt. mobility when the pt. is connected to an IV system
3. Increases the risk of undetected infiltration because slow infusion makes it difficult to see swelling in the area of infiltration.
Indications for Continuous Infusion through a secondary line which is connected to a primary line.
1. When the pateint requires continuous infusion of two or more compatible ad-mixtures administered at different times.
2. When there is a moderate to high chance of abruptly stopping one admixture without infusing the drug remaining in the IV tubing.
Advantages of Continuous Infusion through a secondary line which is connected to a primary line.
1. Permits the primary infusion and each secondary infusion to be given at different rates.
2. Permits the primary line to be shut off and kept standing by to maintain venous access in case a secondary line must be abruptly stopped
Disavantages of Continuous Infusion through a secondary line which is connected to a primary line.
1. Eliminates the use of drugs with immediate incompatability
2. Increases the risk of phlebitis or vein irritation from an increased number of drugs.
3. Uses multiple IV systems (for example, primary lines with secondary lines attached), which can create physical barriers to pt. care and limit pt. mobility.
Causes of lawsuits related to IV therapy
1. Wrong sloution
2. Wrong route
3. Errors in infusion pump use
4. Failure to monitor for adverse reactions
5. Infiltraton
6. Dislodgment of IV equipment
Name the two broad categories of IV fluid replacement
1. Crystalloids (category of IV solutions which contain substances which can dissolve)
2. Colloids (Category of IV solutions which have molecules that do not dissolve)
Isotonic solution osmolality
250-300 mOsm/kg
Hypotonic fluid osmolality
Less than 250 mOsm/kg
Hpertonic fluid osmolality
Higher than 300 mOsm/kg
List 3 examples of isotonic solutions
1. Dextrose 5% in water
2. 0.9% sodium chloride (ns)
3. Lactated Ringers
Example of hypotonic solution
0.45% sodium chloride (half-normal saline solution)
List 3 examples of hypertonic solutions
1. Dextrose 5% in half-normal saline
2. Dextrose 5% in normal saline
3. Dextrose in 10% water
Uses of Dextrose %5 in water (isotonic) solution
1. Treatment of fluid loss and dehydration
2. Hypernatremia