Iv Therapy

Front 1

Purposes of IV therapy:

Back 1

1. Supply fluids - crystalloids
2. Administer blood products - colloids.
3. Attain/maintain electrolyte balance
4. Provide nutrition
5. Administer medication
6. Blood specimen collection

Front 2

Advantages of IV Therapy:

Back 2

Rapid acting, can be used in emergencies, better control over administration, better absorption of medications, prevents irritation and pain to SQ and muscle tissue.

Front 3

Crystalloid solutions include:

Back 3

Sodium fluids for hydration, dextrose fluids - calories for energy, electrolyte solutions, Lactated ringers

Front 4

Sodium fluids include:

Back 4

0.9 Normal Saline is isotonic
1/2 NSS (0.45) Hypotonic
1/4 NSS (0.225%) Hypertonic

Front 5

Dextrose fluids include:

Back 5

1 gram of Dextrose/100 ml, calories for energy, correct hypoglycemia

Front 6

Isotonic solution:

Back 6

240-340 mOsm/liter

Front 7

Hypotonic solution:

Back 7

<240 mOsm/liter
0.45% NS

Front 8

Hypertonic solution:

Back 8

>340 mOsm/liter
5% glucose with NS
Is irritating

Front 9

Osmolarity is:

Back 9

Amount of solutes our blood has in it. Normal is 280-300

Front 10

Colloid solutions include:

Back 10

Blood/blood products

Front 11

Nutrition includes:

Back 11

TPN, vitamins, lipids and glucose

Front 12

Nutrition provides:

Back 12

Higher concentration of glucose and other minerals, vitamins, electrolytes, additives. Lipids may be added or given separately. Monitor lab values, glucose regularly, long term can cause liver damage.

Front 13

Initiating IV therapy basic rules:

Back 13

Work distal to proximal, avoid areas of flexion, never start on side of mastectomy

Front 14

When choosing a site for phlebotomy:

Back 14

Select larger median cubital, basilic, or cephalic veins, samples may be drawn from the same arm as a continuous IV if it is drawn below the IV. Avoid same side as mastectomy.

Front 15

Feet and legs:

Back 15

Must have physician order to use this site in adults due to complication. Ok to use in children.

Front 16

Central venous lines in SVC are:

Back 16

Short term central lines, jugular or subclavian, done in angio, bedside or OR, inserted directly into SVC, single, double, triple lumen, dressing change weekly, removal by physician or IV team.

Front 17

Long term central lines:Longer than 2 weeks:

Back 17

Broviac/Hickman, Groshong, Implanted ports, PICC

Front 18

Broviac/Hickman and Groshong are:

Back 18

Tunneled under the skin into SVC, single to triple lumen, removed by surgeon as adipose tissue gets around catheter, dressing changed weekly.

Front 19

Implanted ports are:

Back 19

Port inserted under skin, threaded into SVC, inserted in OR, single or double barrels, access by specialized nurses or IV team, HUBER needle, dressing change weekly by IV team, when incision is healed, pt may shower and swim, requires monthly flush, no outside port.

Front 20

PICC are:

Back 20

Antecubital, threaded into SVC, done at bedside or angio, elaborate sterile procedure, weekly dressing changes by IV team, removed by IV team.

Front 21

Intraosseous are used:

Back 21

Emergency, no other access possible, into the bone marrow.

Front 22

Dialysis catheters are:

Back 22

Larger, red and blue caps. NEVER USE FOR ANY OTHER PURPOSE!

Front 23

Buretrols-volume control:

Back 23

Backup safety device, will only get 1 hours of fluid.

Front 24

Gravity IVs:

Back 24

Need to count the drips for 1 minute, rate can change when patient changes position, NEVER hang potassium on gravity or any medication that must be controlled, such as heparin, pitocin, insulin, mag sulfate.

Front 25

PCA: patient controlled analgesia:

Back 25

Self administered pain medication, valuable and dangerous, stable blood level, client controlled and not nurse controlled, loading dose, continous, intermittent, lockout amount

Front 26

Phlebitis is:

Back 26

pain along vein above insertion site, redness along vein, warm to touch, hard or cord like, slight swelling, sluggish infusion

Front 27

Causes of phlebitis: Mechanical irritation:

Back 27

Too large of a needle in the vein and catheter tip not securely taped

Front 28

Causes of phlebitis: Chemical irritation:

Back 28

Improper mixed or diluted medications, too rapid infusion of medications or irritating solutions.

Front 29

Treatment of phlebitis:

Back 29

D/C the IV, restart in opposite arm, warm, moist soaks to area.

Front 30

Infiltration is:

Back 30

Fluid running outside vein, running into tissue under the vein.

Front 31

Symptoms of infiltration includes:

Back 31

Coolness at site, swollen when compared to other extremity, taut skin, slowing or sluggish rate, discomfort at site.

Front 32

Causes of infiltration:

Back 32

Puncture of vein during venipuncture, dislodgement of catheter from vein, poorly secured catheter, high delivery rate or pressure, over manipulation of iv device

Front 33

Treatment of infiltration:

Back 33

D/c infusion, restart in opposite arm, elevate arm if swollen, warm, moist packs for comfort.

Front 34

Infection-local v/s systemic:

Back 34

Redness, pain, swelling, foul smelling discharge, fever, increased WBC

Front 35

Circulatory overload:

Back 35

Too much primary maintenance fluid, too fast. Body can't excrete as fast as it goes in.

Front 36

Circulatory overload symptoms:

Back 36

1. slow increase in HR
2. SOB
3. distended neck veins
4. crackles on auscultation
5. wet cough
6. increased RR with dyspnea on exertion
7. weight gain and swelling of extremities

Front 37

Prevention of circulatory overload:

Back 37

Monitor iv rate every hour, never play catch up with fluids unless ordered, monitor VS and breath sounds

Front 38

Calculating pediatric safe dose equation:

Back 38

100 x first 10 kg =
50 x second 10 kg =
20 x remaining kg =
Add up and calculate how much fluid can get in 24 hrs. Divide by 24 to get hourly rate.

Front 39

Treatment of circulatory overload:

Back 39

Keep vein open, slow IV rate, check the client and notify physician, monitor VS, keep client warm, diuretics may be ordered, strict I&O, weights

Front 40

Air embolism:

Back 40

Pt gets too much air through iv.

Front 41

Air embolism symptoms:

Back 41

Hypotension, cyanosis, tachycardia, weak and thready pulse, wheeze, cough, dyspnea, mental status change, substernal chest pain

Front 42

Prevention of air embolism:

Back 42

Remove air from tubing
Remove air from syringes that are administering medications to the client.

Front 43

Treatment of air embolism:

Back 43

Call for help
place in Trendeleberg position and on left side
Admin O2
Monitor VS

Front 44

Speed shock is:

Back 44

Getting medication too fast. Is caused from rapid infusion of substance, usually medication, into circulation

Front 45

Signs of speed shock are:

Back 45

Flushing, HA, chest pain, vital sign changes.

Front 46

Prevention of speed shock:

Back 46

Know infusion rates for medications

Front 47

Treatment of speed shock:

Back 47

Usually supportive until system recovers.

Front 48

Treatment of speed shock:

Back 48

Usually supportive until system recovers.

Front 49

Assess site every 4 hours, peds every hour, then:

Back 49

IV set up q 8 hr, client - at least q 4 hr, physician orders for flow rate, fluid type, sites for therapy.

Front 50

Asepsis includes:

Back 50

Handwashing
Tubing change q 72 hr
IV bag change - q 24 hr
Redressing site q 72 hr