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Flashcards in 2. IV, PN Deck (46):
1

Examples of Isotonic

.9NSS, D5W, Ringer’s Lactate, Normal Saline

2

Hypotonic def

(push fluid into cell) prevent fluid overload

3

Hypotonic examples

.45NSS (1/2 NSS) half strength saline

4

hypotonic complications

intravascular fluid depletion, decreased blood pressure, cellular edema, and cell damage

5

hypertonic def

(pull fluid out of cell) increase blood pressure

6

hypertonic examples

10% Dextrose in water, D5.45NSS, D5.9NSS, DSLR, 50% Dextrose in Water

7

hypertonic complications

extracellular volume excess and precipitate circulatory overload and dehydration

8

What size needle for blood?

18 or larger needle

9

Gauges of needle

14-24 (14 largest, 24 smallest)

10

What affects IV flow?

diameter (bigger than faster flow); height of bag (higher bag, faster flow)

11

When flush IV?

every 8 hours and before and after administration of meds

12

If using iodine for IV insertion ask pt?

if allergic to shell fish

13

How to know if IV inserted in artery?

if bright red blood and blood shooting out with each heart beat

14

How should vein feel once tourniquet is placed?

firm, elastic, engorged, and round; not hard, flat or bumpy

15

degree of angle of needle when inserting IV

10-30 with bevel up

16

What requires own IV site?

Heprin, blood, and TPN

17

change IV tubing and equipment every?

72-96 hours/site & tubing (thick liquids changed every 24 hours - TPN, blood, lipids/24 hours)

18

hematoma?

could be caused by inserting IV at the wrong angel, should be 5-30; results when blood leaks into tissues surrounding the IV insertion site (puncturing the back wall of the vessel)

19

infiltration?

leaking of fluid into interstitial space
- Regular infiltration – noncaustic type of fluids
- Extravasation – Caustic fluids
- Causes: ruptured vessel, dislodge cannula, occlusion
- Assessment: swelling, blanched, cool, pain, occlusion
• Tie tourniquet above IV site to determine if present (tight enough to restrict venous flow, if infusion continues to drip despite the venous obstruction, infiltration is present)
• Will not have blood return

20

level 4 infiltration?

compartment syndrome

21

phlebitis?

inflammation of a vein
- Causes: irritant solution, dehydration, infection
- Assessment: erythema, warmth, pain
• Site – red, warm to touch, painful, burns when touched (“burned the vein”), sometimes red streak
• Can get blood return

22

fluid overload

overloading the circulatory system with excessive IV fluids causes increased blood pressure and central venous pressure (so making the heart work too hard)
- Ex. Albumin (hypertonic) draws more fluid in because of concentrations)
- Causes: Rapid or large volume fluid administration, compromised cardiac function
- Assessment: SOB & crackles, tachycardia, agitation or anxiety
- Intervention: slow infusion, raise HOB to set patient up, monitor VS, notify provider

23

veins used for PN

Typically, a large, high-flow vein such as the subclavian vein or superior vena cava is the preferred site. femoral lines (last resort)

24

TPN

Total Parenteral Nutrition contains glucose, amino acids, vitamins, and minerals all mixed into 1 bag; Does not have fat (lipids), so sometimes have to give pt fat emulsions

25

PPN

Peripheral Parenteral Nutrition; “half dosing”, Can give through midline, Given for supplement, Individualized to the pt by pharm and orders written every 24hrs

26

TNA

Total Nutrient Admixture; Same as TPN but also has lipids

27

Important monitoring of PN

Blood sugar measured every 6-8 hours
Intake and Output – to make sure pt is excreting properly
Daily weight – make sure taken at the same time every day, good time is the morning; every L gain 2.2 lbs

28

complications of PN

Sepsis – because of glucose
Electrolyte imbalance
Hyperglycemia – think about how fast start rate
Hypoglycemia – if stop abruptly
Hypervolemia
Hepatic dysfunction – because of lipids
Hypercapnea – CO2 in the blood
Lipid intolerance

29

administering PN

Remove TPN and lipids from the refrigerator at least an hour before hanging. TPN solution should be clear, not cloudy.
Lipids will be white. Do not use the fluid if cracking or creaming of the fluid is present because it may indicate fluid separation.

30

Input and Output defined

Defined as the measurement and recording of all fluid intake and output during a 24 hour period

31

1 tablespoon (tbsp) = ___milliliters(ml)

15

32

___ teaspoons(tsp) = 15 milliliters(ml)‏

3

33

1 cup(C) = ___milliliters(ml)‏

240

34

8 ounces(oz) =___ milliliters(ml)‏

240

35

1 teaspoon(tsp) = __milliliters(ml)

5

36

1 cup(C) =__ounces(oz)‏

8

37

16 ounces(oz) = __pound(lb)‏

1

38

1 ounce (oz) = ___milliliters(ml)

30

39

Jello?

120 ml

40

Ice cream/sherbet

120 ml

41

4oz of juice

120 ml

42

1 ice cup

120 ml

43

16 oz milkshake

480 ml

44

popsicle

90 ml

45

120 oz soda

360 ml

46

pudding/yogurt

120 ml