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44 Cards in this Set
- Front
- Back
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What is the normal osmolarity value?
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275-295 mOsm
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Low Osmolarity causes what to the body?
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Fluid overload
Meaning: diluted intravascular fluid. |
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High Osmolarity causes what to the body?
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Dehydration
Meaning: hemoconcentration |
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As a nurse... if you don't have a serum osmolarity lab, you can use this other lab to figure out serum osmolarity?
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2 times the sodium= serum osmolarity.
(only works if the blood glucose is in the normal range.) |
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What is speed shock?
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Med given too quickly
S/S: dizziness, facial flushing, headache, chest tightness, hypotension, irregular pulse. |
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What is chemical phlebitis?
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Irritating or vesicant solutions
S/S: redness, localized swelling, palpable cord along vein, sluggish infusion rate, increased body temp. |
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Thrombophlebitis
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Hypertonic/acidic/alkaline solutions.
S/S: sluggish flow rate, limb edema, tender/cordlike vein, warm to the touch, visible red line above site. |
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Infiltration
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Seepage of nonvesicant solution into tissue.
S/S: cool, taught skin, dependent edema, absence of blood backflow. |
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Extravasation
(it can cause necrosis) |
Infiltration of vesicant medication.
S/S: complaints of pain/burning, skin tightness, blanching, edema, leaking. |
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What 3 important things must you check before giving an IV push or IVPB?
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1. Rate 2. compatibility 3. dilution.
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How many cc's must you pre flush and post flush with each time?
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10cc's each time
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What are the 3 IV routes of administration?
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Peripheral, midline, and central
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How long is IVPB tubing good for?
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24 hours
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How often should maintanence line tubing be changed?
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72 hours
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All central venous access devices (central lines) must be?
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radiopaque (must be seen on x-ray)
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Central lines- A distal lumen is used for what?
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to administer vesicant solutions
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Central lines- A proximal lumen is used for what?
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Used for blood withdrawals (this avoids contamination from solutions infusing at other lumens.
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Triple lumen catheter- a proximal lumen is what gauge and used for what?
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18, and used for blood sampling, meds, blood administration.
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Triple lumen catheter- a medial lumen is what gauge and used for what?
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18, and used exclusively for TPN.
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Triple Lumen Catheter- a distal lumen is what gauge and used for what?
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16 (The largest), and used for central venous pressure monitoring; high vol/viscous fluids, colloids, or meds.
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Percutaneous Catheters
Where does it start and end up? How long can it stay in? Type of dressing changes? |
*Starts subclavicular into subclavian vein and ends at superior vena cava.
*Days to weeks (only short term) *Requires sterile dressing changes. |
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PICC Lines-
Where do they start and end up? How long can they stay in? Type of dressing changes? |
*Inserted Peripherally in the basilic vein, tip ends at superior vena cava.
*Can stay in up to several months. *Sterile dressing changes. |
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What are midline and midclavicular catheters?
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*They are not central lines, they are long-term peripherally.
*They are inserted in basilic, cephalic, or medial antecubital vein. *Catheter is 6in long. *they can last up to 28 days *they are located between antecubital area & head of cclavical. |
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What is a central venous tunneled catheter (CVTC)?
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*Surgically inserted
*Proximal end is SQ tunneled to exit site on chest or upper abd. Distal end is in SVC. *Long term intermittent, continuous, or daily IV access for up to 3 years. |
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Implantable venous access ports? What are they?
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*Surgically implanted in SQ pocket.
*Self sealing septum-withstands 2000 needle punctures. *MUST ACCESS W/ HUBER NEEDLE (NONCORING NEEDLE) |
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Why must you NEVER use a 1-2 cc size syringe to irrigate a central line.
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Smaller the size diameter, the greater the pressure inside causing the catheter to burst.
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Parenteral Nutrition means?
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That it bypasses the gut
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Marasmus malnutrition is?
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Decrease intake of calories with adequate protein intake.
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Kwashiorkor malnutrition is?
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Adequate calories but decreased protein intake. (mostly a grain based diet)
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IV dextrose- D10 or less may be given where?
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Peripherally
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IV dextrose- D20 or greater must be given how?
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Through a central line into superior vena cava.
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Dextrose administered with lipids means?
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a decreased need for insulin and decrease respiratory demands.
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What are the S/S of EFAD Essential Fatty Acid Deficiency?
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desquamating dermatitis, alopecia, brittle nails, delayed wound healing, thrombocytopenia, decreased immunity, increased capillary fragility.
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When administering Lipids (TPN)... You must
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*start slow: 1mL/min for 15-30 min.
*Use a 1.2 micron filter. |
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When should you discard TPN?
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24 hours after hanging
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What size filter must you use with TPN?
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0.2 if no lipids are involved and 1.2 if lipids are involved.
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Can you IVPB a TPN?
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NO!!!!!!!! you must use a dedicated line for TPN's.
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What are the nursing considerations for TPN's? (7 of them)
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1. admin through central line
2. strict aseptic technique 3. discard after 24 hrs. 4. Start slow then increase 5. monitor vital signs and glucose q 4-6 hours. 6. Daily weights 7. Good hand hygiene |
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What is the most common complication of pediatric TPN?
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Cholestasis
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Test ????
Single dose...if you give x med over 5 min. how long would it take to give the dose? |
5 minutes (yes it's that easy)
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PCA is? and used for?
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Patient controlled analgesia and is used for patients suffering from moderate to severe pain.
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Who is allowed to push the PCA pump?
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ONLY THE PATIENT. Family members or medical personel may not push pump.
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As a nurse what should you be doing with a patient on a PCA pump?
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-still document ongoing pain assessments eventhough patient is not requesting pain meds.
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Intrathecal catheters are mostly used for?
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Long term cancer pain management or other drug delivery-ie:multiple sclerosis
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