Basic Intravenous Therapy- Test 2 Flashcards by Bailey Pontius

Purposes of IV therapy

Fluid and electrolyte therapy
medication administration
Blood products administration
TPN (total parental nutrition)

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What is IV therapy

Infusion of fluid directly into the circulation

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TPN

Total Parental Nutrition

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When would you use a butterfly needle

short term IV therapy

- vein that is difficult to start an IV

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What is a steel needle called

Butterfly

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Characteristics of a steel needle

Rigid, metal, with plastic wings

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Advantages/disadvantages of butterfly needle

Advantages
-easy to insert
Disadvantages
-not flexible, irritating

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What is the common IV access device ?

Characteristics?

Over the Needle Catheter

Flexible plastic catheter with guide needle for insertion

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How is Over the Needle Catheter inserted

Inserted using a steel guide needle for insertion and then after insertion the steel guide is removed and the flexible catheter is left behind

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Advantages/disadvantages of Over the Needle Catheter

Advantages
- flexible, can use near joints, less irritation
Disadvantages
- more difficult to insert

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What safety mechanism does a ONC have?

Autoguard
The needle springs back when barrel button is presses after catheter is inserted
**this prevents the nurse from having needle sticks when the steel guide needle is withdrawn

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What are the two options for tubing

Macrodrip

Microdrip

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What is drop factor

Size of drip itself

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Drop factor for macrodrip

10 to15 drops/ml

Used with adults

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Drop factor for microdrip

Used for?

60 drops/ml
Used for slow and accurate rates
Children and critical care

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Blood tubing has a special….

Filter

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What is a piggyback tubing used for

Secondary infusion of medications

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How should you handle IV fluids

As if they are prescribed meds

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What should you inspect a IV fluid bag for

Expiration date, additives present, clarity of solution, leaks

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How many times should you read a IV fluid bad label

3 times

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Abbreviations:
Dextrose=
Water=
Lactated Ringers=
Normal Saline=
5%=

Dextrose= D
Water= W
Lactated Ringers= LR
Normal Saline= NACL
5%= 5

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What’s another name for ONC

Angiocatheter

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What does D5 .2NaCl

5% Dextrose .2% sodium chloride

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What is a gravity drip influenced by

height of solution bag compared to patient
size and patency of IV catheter
position of extremity
are there kinks in the line

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What is timing tape used for

Used monitor amount infused hourly

What are the uses of a "Positional" gravity drip IV

General fluids-hydration | Emergency- start with gravity drip until IV infusion pump can be located

What is something that should be known about "positional" gravity drip IV

Rate varies greatly with movement

What must you do with a Infusion Pump

Continue site assessment & infusion rate | ** machines are not perfect

What machine accurately infuses solution at rate prescribed

Infusion pump

What is PCA

Patient Controlled Analgesia

What does a PCA do?

- Delivery of pain medicine through IV infusion - client medicated self for pain - machine is set to deliver specific individual dose of medication when pt presses a button - limit set - security lock to prevent setting changes

Does a patient on a PCA use more or less pain medicine than a patient who needs to ask nurse for medicine

Less

What are needle less systems used for

To prevent unnecessary exposure to contaminated needles

What is priming

Remove all of air from the tubing

When spiking a IV the equipment must be...

Sterile, closed system

Tubing should be changed every ___ hours

24 hours

What is timing tape used for

Along side of the bag with hourly markings

You should inspect the IV site every ____ hours

2 hours

What should you check the IV site for

Needle placement, redness, edema, color, temperature, presence of pain

You should change gauze dressings every ____ hours

48 hours

You should change transparent every ______ hours

48-72 hours

At the change of dressing what should you do

Clean skin carefully

IV rate calculation

Volume x drop factor / time (minutes) = drops per min

How should you count the drip rate

15 seconds Then 30 seconds Then 1 full minute

What are 4 things you should remember about timing tape?

- don't cover up the name of the solution - start at the top of IV bag and mark hourly - use ink, not felt marker because it will soak through the bag - inspect bag hourly to see if rate of infusion is "on time"

What does "on time" mean

+/- 10% of rate prescribed

Can you catch up the infusion rate if it is behind?

No! Must have a physicians order to alter infusion rate

What does KVO mean

Keep vein open rate | Slowest possible rate which will maintain patency of IV and not clot off

When do you use a KVO

When waiting on a physicians order

Why are KVO not used routinely

Can vary so much from patient to patient

Standards for IV therapy come from

CDC and INS | center for disease control and intravenous nursing standards

Can agency policies go beyond standards?

Yes | But they can never be less than standards

What should you remember about solutions

Read label carefully (including additives), inspect expiration date, clarity, leaks, change every 24 hours or when empty

What should you inspect when looking at tubing and when should it be changed?

Inspect for air in line and check drip chamber | Change every 48 hours (label with date and time)

What should you check with site dressing? When should it be changed?

Check securement | Change every 24 hours according to policy

What should you check when looking at an IV site? When should you change it?

Inspect for swelling, color, warmth, pain | Change site every 48 to 72 hours or when a complication occurs

When should you discontinue a IV

D/C IV if physician orders or if complication occurs

When you D/C a IV what should you do

Apply pressure 1-2 minutes continuously with gauze bad (not alcohol) and don't pull up gauze to look at it Apply band aid after bleeding stops DOCUMENT why IV was d/c

If a patient is on blood thinners and you D/C an IV how long should you apply pressure to site

5 minutes

When should you document?

Initial assessment at start of care shift Then every 2 hours And at end of care shift

You should asses for _____ to ________

Top to bottom | Bag to site

What is infiltration? | Cause?

Fluid infuses into subcutaneous tissue and is around vein instead of through vein Cause: catheter punctures vein wall

Signs and symptoms of infiltration

Swelling in area, pain, pale/cool to touch because circulation being compromised in that area

Nursing actions with infiltration

d/c IV | Depending on type of fluid that was in sub a tissue warm or cool compress to that area

What is phlebitis

Vein inflammation

What is thrombophlebitis

Inflammation of vein with clot formation

Causes of phlebitis/thrombophlebitis

Mechanical or chemical irritation

Signs and symptoms of phlebitis/thrombophlebitis

Warm to touch, red, very painful

Nursing actions with phlebitis/thrombophlebitis

D/c IV, apply warm compress to area

What is fluid overload? | Signs and symptoms ?

Too rapid of an infusion | SS: increased pulse, increased BP, fluid in lungs to auscultation

Nursing actions with fluid overload

Slow IV to a KVO rate do NOT d/c IV Notify physician May give IV diuretics

Basic Intravenous Therapy- Test 2 Flashcards

(71 cards)