Exam 2 - IVF

Question 1

purpose of IVF

Answer 1

maintenance
replacement
administer meds
administer blood products

Question 2

what are the 3 types of IVF

Answer 2

isotonic
hypotonic
hypertonic

Question 3

What is the rule of 300?

Answer 3

below = hypotonic
above = hypertonic

Question 4

will a cell change with isotonic solution?

Answer 4

no

Question 5

what occurs with isotonic solution?

Answer 5

the amount of water transported into the cell is equal to the amount of water transported out of the cell

Question 6

examples of isotonic solution

Answer 6

NS

LR (blood loss, truma)

Question 7

when would you give an isotonic solution?

Answer 7

when fluids need to be replaced

Question 8

when would you give NS?

Answer 8

fluid resuscitation
metabolic acidosis
hypercalemia
mild hyponatremia

Question 9

too much NS can cause which electrolyte imbalance?

Answer 9

hypernatremia

hyperchloremia

Question 10

LR contraindication

Answer 10

kidney injury

Question 11

when would you use LR?

Answer 11

maintenance in postop
hyponatremia
fluid loss

Question 12

Example of hypotonic solution

Answer 12

0.45 NS

Question 13

when would you administer a hypotonic solution?

Answer 13

remove waste

replace insensible fluid loss

Question 14

Can you bolus 1/2 NS?

Answer 14

No, rapid swelling will occur, cardiovascular collapse, or increased ICP

Question 15

what occurs with hypotonic solution?

Answer 15

water is transported into the cell making the solute concentration higher

Question 16

what occurs with hypertonic solutions?

Answer 16

water is pulled OUT of the cells making the solute concentration lower

Question 17

examples of hypertonic solution

Answer 17

3% NS
mannitol
PPN
colloids: dextran, albumin, D5NS, D5LR

Question 18

indication for 3% or 5% NaCl

Answer 18

critical hyponatremia

Question 19

what VS to monitor when administering 3% or 5% NaCl

Answer 19

BP

Question 20

how would you administer 3% or 5% NaCl

Answer 20

slowly; closely monitor

Question 21

what does administering albumin do?

Answer 21

pulls fluid into the vessels to be excreted

Question 22

What does Dextran do?

Answer 22

volume expander
-pulls fluid out of cells into vascular space
-reduces clotting ability
increases BP, circulatory volume

Question 23

when is dextran used?

Answer 23

hypovolemic shock

Question 24

peripheral parental nutrition (PPN) may be administered through

Answer 24

a large peripheral vein

Question 25

total parental nutrition (TPN) must be administered throguh

Answer 25

a central line

Question 26

what to monitor with PPN or TPN administration

Answer 26

glucose imbalance fluid, electrolyte imbalance fluid overload

Question 27

how soon to pull refrigerated IV meds

Answer 27

15-20 minutes to allow it to come to room temperature

Question 28

fluid overload nursing care

Answer 28

``` elevate HOB KVO at 10-21 mL/hr assess pt -VS, lung sounds, mental status, O2 SAT, edema administer diuretics ``` *contact HCP

Question 29

when air enters the R ventricle, lodges against pulmonic valve and stops the valve action/flow of blood

Answer 29

air embolism

Question 30

how to prevent an air embolism

Answer 30

use locking ports on tubing prime all tubing fill drip chamber half full IV pump air detection alarm

Question 31

air embolism s/sx

Answer 31

``` dyspnea palpitations coughing JVD wheezing chest, shoulder, low back pain shock -weak, rapid pulse; hypotension; decreased LOC ```

Question 32

air embolism txment

Answer 32

``` clamp the line place on L trendelenburg fix air leak administer O2 assess, tx according to orders ```

Question 33

infiltration or extravasation (damaged tissue) are used

Answer 33

interchangably both involve infusion of solution into the surrounding tissue instead of vein

Question 34

infiltration, extravasation s/sx

Answer 34

``` swelling around site coolness at site slowed rate leakage from site pump alarm indicating pressure ```

Question 35

how to prevent infiltration, extravasation

Answer 35

``` frequent site monitoring flush for patency prior avoid IV at areas of flexion secure IV to avoid movement give vesicant IV push meds through side port on IV tubing ```

Question 36

infiltration treatment

Answer 36

``` agency policy stop infusion, remove IV start new site above or opposite arm isotonic solution used: warm compress, elevation hypertonic solution used: cool compress ```

Question 37

extravasation treatment

Answer 37

agency protocol ``` common extravasation protocol: stop infusion assess, notify HCP administer antidote through existing cannula remove cannula ```

Question 38

common vesicants

Answer 38

``` vasopressors Ca K Dilantin phenegran vanc chemotherapy ```

Question 39

What is phlebitis?

Answer 39

inflammation of the vein *no clot

Question 40

phlebitis treatment

Answer 40

DC IV, restart above or other arm warm compress NSAIDS

Question 41

what is thrombophlebitis

Answer 41

clot with inflammation

Question 42

s/sx of thrombophlebitis

Answer 42

localized pain redness warmth edema

Question 43

thrombophlebitis treatment

Answer 43

DC IV, restart above or opposite arm cold compress FIRST warm compress, elevate LATER may culture drainage from catheter tip

Question 44

thrombophlebitis prevention

Answer 44

``` avoid trauma wash hands aseptic technique monitor hourly flush with saline prior to administering meds ```

Question 45

blood leakage into surrounding tissue

Answer 45

hematoma

Question 46

cause of hematoma r/t IV

Answer 46

cannula goes through the vein cannula is too big cannula slips out of vein -no secure adequately

Question 47

hematoma treatment

Answer 47

remove cannula apply pressure pressure dressing x24 hours elevate extremity

Question 48

how to prevent IV clotting/obstructions

Answer 48

do not let bag run dry do not let tubing kink maintain adequate flow flush as appropriate

Question 49

Bolus

Answer 49

give fluid fast 1 L/hour 500 mL/hour

Question 50

Maintenance drip

Answer 50

KVO | 75 mL/hr

Question 51

safest, easiest methods of administering IV medications

Answer 51

mixing in large volumes

Question 52

first step if you were to mix a medication with IVF

Answer 52

make sure they're compatible

Question 53

most dangerous method of medication administration

Answer 53

IVP | bolus

Question 54

IVP should be administered over less than __ minute

Answer 54

1

Question 55

how an order should be written if IV med is to be given over 1 minute

Answer 55

"IV over x minutes"

Question 56

IVP advantages

Answer 56

fluid sensitive pt rapid action only one stick for multiple doses

Question 57

IVP disadvantages and safety concerns

Answer 57

most dangerous acts instantly ALWAYS VERIFY with another nurse always check site for patency and placement FIRST

Question 58

volume-controlled infusions

Answer 58

50-100 mL fluid

Question 59

3 types of volume-controlled infusions

Answer 59

volume-control admin. set piggyback sets syringe pumps

Question 60

advantage of volume-controlled infusions

Answer 60

reduced risk of rapid-dose infusion (given over 30-60 minutes) admin. meds that are stable allows control of IV fluid intake

Question 61

Piggyback size and connection location

Answer 61

25-250mL UPPER Y-port

Question 62

syringe pump is ___ operated

Answer 62

battery

Question 63

syringe pump allows meds to be given in doses that range from __ to __ mL

Answer 63

5-60 mL

Question 64

syringe pump container volume

Answer 64

150 mL

Question 65

intermittent venous access is aka

Answer 65

saline or heparin lock

Question 66

SAS method

Answer 66

S - saline flush (patency) A - administer med S - saline flush (clear med)

Question 67

IV home therapy education begins when?

Answer 67

while in the hospital -s/sx of infection infusion pump maintain IV admin. equipment