Flashcards
IV Administration
Flashcards do conjunto (85)
- 1Peripheral InsertionResponsibility of the RN
In the peripheral extremities (Arm/leg) - 2Central PlacementIntravenous line in a central vein- direct to the heart( Jugular, femoral or subclavian vein) Responsibility of the physician or nurse practitioner.
- 3Whose responsibility is maintaining the IV Line?The RN
- 4Indications of IV placement1. Expand/reduce intravascular volume
2. To correct electrolyte imbalances.
3. To administer medications.
4. To administer blood/blood products.
5. Patient Status
6. Nutritional Support
7. Emergency access - 5CrystalloidsIV fluid containing various concentrations of electrolytes that may expand or reduce the intravascular volume
- 6Intravascular volumeVolume of blood in a patients system
- 7What determines whether or not an IV fluid expands or reduces intravascular volume?Osmolarity
- 8Isotonic Solution osmolarity?280-295
- 9Example of Isotonic solution?Normal Saline Solution
- 10Hypertonic Solution Osmolarity>280-295
- 11Example of hypertonic solution5% Dextrose and normal Saline solution
- 12Hypotonic osmolarity<280-295
- 13Examples of Hypotonic SolutionsHalf Normal Saline
- 14Why is 5% dextrose in water isotonic in the bag and hypotonic in the plasma? What is the clinical significance?the glucose (solute) dissolved in sterile water is metabolized rapidly by the body’s cells.
- 15ColloidsIV solutions that contain large protein molecules and stay in the vascular space (plasma volume expanders)
Increase osmotic pressure in vascular space - 16What is the major intracellular electrolyte?Potassium (K)
- 17What is the major extracellular electrolyte?Sodium (Na)
- 18What are the normal potassium levels?3.5-5.5 MEQ/L
- 19What are the normal Na levels?135-145 MEQ/L
- 20Why might an order for IV D5NSS with 20 MEQ KCL per liter be ordered?For a patient with a potassium level below 3.5
- 21Name the methods of IV administration1. Direct IV push
2. Via secondary line in a piggyback or miniinfuser
3. ADD-vantage containers - 22When administering a piggyback medication what should you ALWAYS check?The "compatibility" of the medication to the fluid in the primary IV tubing
- 23How should blood be administered?In a separate IV line, primed with 0.9 NSS ONLY
- 24What tubing is specifically for blood?The set Y tubing
- 25Total Parenteral Nutrition (TPN)Solution containing amino acids, electrolytes, glucose, and vitamins.
- 26How is a TPN administered?Via a central IV line
- 27Can you ever administer nutritional solutions peripherally?Yes but the solutions are made differently from TPN
- 28Why would patient status effect the need for IV fluids?Patients who are unconscious, or post-operative for example may need IV access for fluids, medications, and /or nutritional requirements to maintain homeostasis
- 29What is meant by emergency access as an indication for IV placement?Establishment of a worthwhile IV line. (It can be difficult to establish an iv line when a patient is in cardiac arrest for example)
- 30QSEN Infection control considerations-IV placement is invasive
-Maintain proper hand hygiene
-Chlorhexadineis preferable to alcohol and batadine - 31IV bagsStandard size- 1000 ml unbreakable- puncture-able bag
- 32IV bottlesglass and subject to breaking- need to be vented.
- 33When would an IV bottle be usedWhen using chemicals that have the potential to leech through the plastic
- 34Macrodrip10-20 gtts per ml
- 35Microdrip60 gtts per ml
- 36FilterStrain solution to remove contaminants
- 37Extension setsExtend tubing and add extra ports
- 38Peripheral locksPrevent IV from flowing out
- 39Transparent Semipermeable membranestabilize the cannula, offer protection and provide visualization of the site
- 40How often are dressing supposed to be changed?Every 2 days or PRN
- 41Pumpsmeasure in ml per hour
- 42Mini infuserControlled intermittent administration of IV fluid
- 43Patient Controlled Analgesia (PCA)is any method of allowing a person in pain to administer their own pain relief.
- 44PCA dosageamount administered with each dose
- 45PCA lockout periodtime between dosage
- 46Basal RateContinuous rate
- 47How often should you assess the IV site?Every 2 hours or whenever you enter the room
- 48How long are most IV fluids good for?24 hours in most institutions
- 49Occlusionloss of patency
- 50Causes for occlusions?1. kinked tubing
2. backflow of blood
3. Clot - 51How can you tell when an IV is occluded?Flow is sluggish
- 52Intervention for occlusionDiscontinue IV- Do not milk, aspirate, or irrigate
- 53InfiltrationSeepage of non vessicant IV fluid into the tissue when IV cath penetrates the vein.
- 54VessicantIrritating to the tissue
- 55Causes of InfiltrationDislodgment of catheter
Overmanipulation of the catheter
Failure to secure the catheter properly - 56Assessment of infiltrationPain, Edema, cool skin, decreased IV flow, damp dressing, no blood return at IV site.
- 57Intervention for infiltrationDiscontinue IV
Elevate extremity
Apply warm compress
insert IV in unaffected arm
Document - 58ExtravasationInfiltration of vessicant fluid into the tissues
- 59Indications for warm compress to treat extravasation?Vasodilation- increases drug distribution- and local concentration
- 60Indications for cold compress to treat extravasation?Vasoconstriction- allows for local removal
- 61Other interventions for extravasation?Direct injection by the physician can be necessary
- 62PhlebitisInflammation of inner layer of a vein
- 63Causes of phlebitisBacterial- poor asepsis
Chemical- irritating medications
Mechanical - poorly secured caheter, too large for vein - 64Assessment of phlebitisRedness, tenderness, pain, vein is often red hard and cordlike
- 65InterventionDiscontinue IV apply warm compress
restart IV in unaffected arm - 66Vascular Access Devicescatheters cannulas, or ports designed for repeated access to vascular system
- 67CatheterSoft flexible tube
- 68CannulasRequire a needle introducer,
- 69PortsImplanted under the skin
- 70Insertion sites for VADJugular, Subclavian, Cephalic, Femoral
- 71Indications for VADno peripheral vein access
Central venous pressure
Complex treatment regimes
Hyperosmolar Infusions
Vesicant drugs
Long term IV therapy - 72How would you confirm placement of a VAD?X-Ray
- 73How is dressing change on a VAD done?Aseptic sterile technique
- 74Types of cathter VADsSingle lumen
Multiple lumen
Triple Lumen Catheter (TLC) - 75Distal Port VAD16G best for viscous fluids, volume monitoring
- 76Proximal port VAD18G Best for drawing labs and medications
- 77Medial Port18G TPN
- 78TLC placementnot for longer than 6 weeks- not routinely replaced
Sterile dressing change
X-ray for placement - 79PICC LINE indicated primarily for?Long term antibiotics
- 80PICC placement pearlsSterile dressing change
May remain up to 6 months or longer
Never smaller than 10ml syringe
X-ray for placement - 81Midline cathetershorter than PICC - placed in peripheral vein- tip in distal part of vein- no x-ray necessary
may remain 8 weeks - 82Implanted porttip in subclavian or external jugular
implanted in sub q of chest wall
chemotherapy
need x-ray for placement - 83Huber needleNon-coring needle used to access an implanted port
- 84Normal WBC5000-10,000
- 85IV formulaGtts/min=(volume)(Set calibration)/Time in minutes
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- NCLEX NURSING 110 (Exam 2 ) FlashCards sobre IV Administration, criado por Gwen Paparone em 04-10-2016.
- Criado por
- Gwen Paparone
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