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57 Cards in this Set
- Front
- Back
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What are the 2 ways to administer meds through IV
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intermittent infusion, continuous infusion
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What is continuous infusion
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constantly infusing ml/hr or mg/hr or units/hr
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How can MD orders for continuous infusion be given
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volume/hr or dose/hr
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What are most IV pumps calibrated in
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mL/hr
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What do you use if an IV pump is unavailable
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micro drip tubing 60 gtt/mL
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What is usually used if the IV has meds in it
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pump
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What must you know in order to convert a dosage to an infusion rate
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the concentration of the solution
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What are IV meds always rounded to?
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at least one decimal
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What must you know as a nurse besides the infusion rate
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safe and therapeutic level
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What should you do if the patient is getting too much meds in the IV
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stop the meds (not the IV, you'll blow it) and call the doctor IMMEDIATELY
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What is a continuous IV dose of med which is increased or decreased thorughout the day according to the physiologic needs of the patient
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titration
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What is adjusting the IV dose upward or downward in response to a patients condition
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titration
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What does the MD order for titration require
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acceptable range of the med to be administered (high and low), clinical parameters for the dosages to be changed
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Can a titrated dose exceed the upper MD dose
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no
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When doing titrations, what do you set the pump at
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start at the lowest range
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What are key issues for nurses with titration
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know the effect of the drug, continue to assess the patient and adjust IV rate as needed, never exceed the max titration amount regardless of the value of the assessment
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What is 3 o clock in the morning in military time
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0300
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What is eleven o clock in the evening in military time
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2300
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Three things the nurse should assess on the patient in order to determine if the new infusion rate is feasible
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check BP (call MD if hypertensive)
lungs clear? (call if have crackles or other adventitious sounds) renal functions/ signs of fluid retention (call if not excreting much or have abnormal labs) |
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When doing Iv rate adjustment, would you need to call the MD to lower
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no
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What does infusion time tell you
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when the bag is completed and you need another one, how to label the bag to keep on schedule
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In order to know when to expect an IV to be completed, you must know the...
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infusion time (time require to complete IV), start time
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What is evening time in military time
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evening time + 12
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Does the nurse have the authority to change an IV rate if there is meds in it?
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no
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does the nurse have the authority to change an IV rate if there are no meds
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yes
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What should you consider when thinking of raising the fluid IV rate
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if the patient can handle more fluid: if not, call the doctor or if patient condition changed call MD
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What is heparin
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anticoagulant
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What is the usual dose of heparin
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20,000-40,000 units/day
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How many decimals do we leave when rounding heparin Iv
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one
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What are 3 issues with pediatric dosing
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medication injection doses, diluting IV meds, iron preparations
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What is the max volume IM to give in a child?
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2.5
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What is the average range of IM in peds
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0.5-2.5 depending on muscle size
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What do you usually use the vastus lateralis for in peds
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up to 3 years
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When can you use the dorsogluteal muscle in peds
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after the pt has been walking for a year (about 2? depending on pt)
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When should you use the deltoid muscle
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must have adequate mass, children may be much less than the 2 mL max for adults
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What is the max volume for SC injection in peds
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0.5
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How do you choose peds administration IM site
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must have adequate fat pads, SC tissue, sides of upper arm, stomach, thigh, buttocks fat pad, same area for insulin
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What are some special issues with peds IV
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the smaller the child, the narrower the range of tolerating hydration (easily over hydrated)
Smaller veins can be irriated more easily by concentrated drugs (easily blow the vein) Veins are fragile and smaller in infant/child (easy infiltrate) Electronic controllers are used to administer IV meds |
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How should you dilate a peds IV
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enough to keep drug from irritating vein but not too much to cause high fluid
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What ways can IV meds be administered in peds
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a calibrated burette (to an accuracy of 1 mL), syringe pump (as accurate as the size/callibrations), individual small IV bags
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What decimal does a 1 cc syringe measure
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2 decimals
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what decimal does a 3 cc syringe measure?
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tenths: one decimal
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What are individual small IV usually used for
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adults and larger toddlers and older children
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What is a measuring device that has been incorporated into a set of IV tubing
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buretrol
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What does a buretrol measure to
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1 cc
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What can a nurse do in the buretrol
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mix meds
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What is needed to ensure that peds meds gets into the child and is not left in tubing
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flush
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What is the total volume of IVPB in children/peds
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volume of drug plus volume of flush
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What is the volume of flush in peripheral peds lines
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15 cc
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What is the volume of flush in central peds lines
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20 cc
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When do you do the peds flush
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after the meds go in so it will push the med from tubing into patient
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When an MD writes an iron order, you determine safe and therapeutic levels according to...
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elemental value, NOT overall dose
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What do you calculate for MD iron order
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amount of elemental iron MD ordered and recommended amount of elemental iron
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What do you do if you're not given the elemental iron amount
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either look in a reference book: if don't have one, you can go no further
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What are 2 important differences between administration of adult and ped dosages
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peds have different med injection doses (2.5 mL MAX) AND peds need their IV meds diluted (flush)
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Why is a flush necessary
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to push the remaining medicine in the tubing into the child
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What must the nurse assess in a child in order to determine if the volume to be injected SC is safe?
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amount of fat pads/ SC tissue
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