Infusion Therapy

Question 1

IV Hypotonic Fluid

Answer 1

<270mOsm/L
Moves water into cells
0.45% sodium chloride

Question 2

Isotonic IV fluid

Answer 2

270-300mOsm/L
Water neither moves in/out of the cell
- 0.9% NS
- D5W
- LR

Question 3

Hypertonic IV fluid

Answer 3

> 300 mOsm/L
Moves water out of cells
-D5LR
-D5NS
-TPN

Question 4

Short peripheral IV

Answer 4

Usually inserted into superficial veins of forearm
- intended for short term use (<6 days)

Question 5

Midline Catheter

Answer 5

Usually inserted into median antecubital vein
Catheter tip located in upper arm
Intended for vascular access >6 days

Question 6

Peripheral IV restriction

Answer 6

Cannot be used for high osmolarity infusates or vesicants

Question 7

Non tunneled CVAD

Answer 7

Inserted by provider, usually into subclavian vein in upper chest or jugular veins in neck
Usually inserted in emergent situations only

Question 8

Tunneled CVAD

Answer 8

Surgical insertion by provider
Portion of catheter lies in sub-q tunnel to prevent infection
Intended for frequent long term infusion therapy
Months to years

Question 9

PICC

Answer 9

Peripherally Inserted Central Catheter
Lengthy courses of antibiotics, chemotherapy, parenteral nutrition, vasopressors
Intended for months of vascular access or when peripheral site is not possible

Question 10

Port

Answer 10

Implanted port a cath
Inserted into subclavian or jugular vein with access port in SQ pocket in chest/upper extremity
Intended for vascular access >1 year

Question 11

Hemodialysis Cath

Answer 11

Used for Dialysis only
Very large lumens accomodate hemodialysis
DO NOT USE for admin of other fluids/meds

Question 12

Treatment of complications with PIV

Answer 12

Remove catheter for all complications!!!
Redness/inflammation: cool compress
Swollen: elevate
Cool to touch: warm compress
Extravasation: administer antidote
Bleeding: apply pressure
Infection: clean site, send catheter for culture

Question 13

Central line associated blood stream infection

Answer 13

Hand hygiene
Change tubing every 96 hours
Skin asepsis:
- daily chlorhexidine baths
- sterile dressing
- CHG impregnated patch dressing
- change dressing 24 hours after insertion
- change dressing on a scheduled basis
Daily review of necessity
Scrub the hub

Question 14

CVAD dislodgment

Answer 14

Prevention
- secure catheter properly
- advise the patient to avoid physical exertion
Treatment
- stop infusion
- advise provider

Question 15

CVAD occlusion

Answer 15

Prevention
- flush before, between, and after each med
- use positive pressure flush
Treatment
- may administer thrombotic enzymes

Question 16

Total Parenteral Nutrition

Answer 16

Daily nutrition given IV form if GI tract not functional
May include lipids, electrolytes, proteins, and dextrose
Must be given through CVAD
Side effects:
- fluid overload
- electrolyte imbalance
- infection
- blood glucose imbalance