Nur 205 Module 1

Front 1

Why use the direct IV route?

Back 1

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

Front 2

Advers effects of the direct IV route are..

Back 2

1. Immediate
2. Potentially serious
3. Unable to be recalled
4. Difficult to counteract

Front 3

Toxicities of IV include..

Back 3

1. Speed shock
2. Cardiac arrest
3. Respiratory arrest
4. Anaphylaxis
5. Incompatibility

Front 4

How to reduce the risks of IV therapy

Back 4

1. Verify drug order
2. Perform thorough drug research
3. Set clear criteria outcome
4. Plan for emergency interventions

Front 5

Additional research required for IV therapy

Back 5

1. Type of IV access
2. Dilution
3. Rate of administration

Front 6

To treat phlebitis

Back 6

1. Move the venipuncture site
2. Apply warm soaks to the inflamed site.

Front 7

Name the 3 types of IV delivery methods

Back 7

1. Direct injection
2. Intermittent infusion
3. Continuous infusion

Front 8

When is direct injection(IV push)indicated?

Back 8

nonirritating drug with a low risk of immediate adverse reactions if required for a pateint with no other IV needs

Front 9

Name 2 advantages to direct injection (IV push)

Back 9

1. Risk of complications from an indwelling access device is eliminated.
2. Eliminates the inconvenience of an indwelling device.

Front 10

Disadvantages of direct injection (IV push)?

Back 10

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

Front 11

Indications for IV delivery through an existing infusion line

Back 11

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

Front 12

Advantages of IV delivery through an existing infusion line (direct injection)

Back 12

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.

Front 13

Disadvantages of IV delivery through an existing infusion line (direct injection)

Back 13

1. Carries the same incoveniences and complication risks as an indwelling venous access device

Front 14

Indications for piggyback method (intermittent infusion)

Back 14

Commonly used with drugs given over short periods at varying intervals (for example, antibiotics and gastric secretion inhibitors)

Front 15

Advantages of piggyback method (intermittent infusion)

Back 15

1. Avoids multiple IM injections
2. Permits repeated administration of drugs through a single IV line
Provides high drug blood levels for short periods

Front 16

Disadvantages of piggyback method (intermittent infusion)

Back 16

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)

Front 17

Indications for a Saline lock (intermittent infusion)allows for maintenance of venous access

Back 17

When the pateint requres constant venous access, but not continuous infusion

Front 18

Advantages of a Saline lock (intermittent infusion)allows for maintenance of venous access

Back 18

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

Front 19

Disadvantages of a Saline lock (intermittent infusion) allows for maintenance of venous access

Back 19

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

Front 20

Indications for a volume-control set (intermittent infusion) which has a medication chamber that allows it to deliver small doses over an extended period

Back 20

When the pt. requires a low volume of fluid

Front 21

Advantages of a volume-control set (intermittent infusion) which has a medication chamber that allows it to deliver small doses over an extended period

Back 21

Requires only one large-volume container and prevents fluid overload from runaway infusion

Front 22

Disadvantages of a volume-control set (intermittent infusion) which has a medication chamber that allows it to deliver small doses over an extended period

Back 22

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.

Front 23

Indications for Continuous Infusion through a primary line.

Back 23

1. When continous serum levels are needed.
2. When consistent fluid levels are needed.

Front 24

Advantages of Continuous Infusion through a primary line.

Back 24

1. Maintains steady serum levels
2. Lowers the risk of rapid shock and vein irritation from a large volume of fluid diluting the drug.

Front 25

Disadvantes of Continuous Infusion through a primary line.

Back 25

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.

Front 26

Indications for Continuous Infusion through a secondary line which is connected to a primary line.

Back 26

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.

Front 27

Advantages of Continuous Infusion through a secondary line which is connected to a primary line.

Back 27

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

Front 28

Disavantages of Continuous Infusion through a secondary line which is connected to a primary line.

Back 28

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.

Front 29

Causes of lawsuits related to IV therapy

Back 29

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

Front 30

Name the two broad categories of IV fluid replacement

Back 30

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)

Front 31

Isotonic solution osmolality

Back 31

250-300 mOsm/kg

Front 32

Hypotonic fluid osmolality

Back 32

Less than 250 mOsm/kg

Front 33

Hpertonic fluid osmolality

Back 33

Higher than 300 mOsm/kg

Front 34

List 3 examples of isotonic solutions

Back 34

1. Dextrose 5% in water
2. 0.9% sodium chloride (ns)
3. Lactated Ringers

Front 35

Example of hypotonic solution

Back 35

0.45% sodium chloride (half-normal saline solution)

Front 36

List 3 examples of hypertonic solutions

Back 36

1. Dextrose 5% in half-normal saline
2. Dextrose 5% in normal saline
3. Dextrose in 10% water

Front 37

Uses of Dextrose %5 in water (isotonic) solution

Back 37

1. Treatment of fluid loss and dehydration
2. Hypernatremia