FIRST EXAM REVIEW Flashcards
(116 cards)
1
Q
How many different types of IV solutions?
A
Crystalloid solutions
Colloid solutions
Solutions by tonicity
Oxygen-carrying solutions
2
Q
Name the three spaces?
A
intracellular space
Interstitial space
intravascular space
3
Q
What IV solution is defined as dissolved crystals in water?
A
crystalloid solutions
4
Q
can crystalloid solutions cross membranes and alter fluid levels?
A
yes
5
Q
what is the 3-1 replacement rule and what IV solution does this apply too?
A
3 mL of isotonic crystalloid solution is needed to replace 1 mL of blood
crystalloid solutions
6
Q
can crystalloid solutions carry oxygen?
A
no
7
Q
What are some examples of crystalloid solutions?
A
Normal Saline
Ringers Lactate
D5W-D51/2NS-D10
8
Q
This IV solution is defined as containing
molecules that are not dissolved and are too large to pass out of capillary membranes
A
colloid solutions
9
Q
What are some characteristics of colloid solutions?
A
molecules that remain in the vascular compartment
high osmolarity
could cause dramatic fluid shifts
short duration of action
10
Q
Examples of colloid solutions include:
A
Albumin
Plasmanate/Plasma-Lyte
Destran-Hespan
11
Q
Name the three types of solutions categorized by their tonicity:
A
isotonic
hypertonic
hypotonic
12
Q
this IV solution is defined as the same concentration of sodium as cell
A
isotonic IV solution
13
Q
this IV solution is defined as greater concentration of sodium
A
hypertonic IV solution
14
Q
this IV solution is defined as lower concentration of sodium
A
hypotonic IV solution
15
Q
examples of isotonic solutions include:
A
lactated ringer’s solution
D5W, 5% dextrose (only considered isotonic in the bag)
16
Q
Name a few examples of oxygen-carrying solutions
A
whole blood
PRBC’s
synthetic blood substitutes
17
Q
Equipment necessary for IV therapy:
A
elastic tourniquet cleaning wipes gauze tape/adhesive bandage IV catheter IV admin set
18
Q
IV solution usually come in these two types
A
normal saline
LR solution
19
Q
define Microdrip set
A
60 gtt/mL
20
Q
define Macrodrip set
A
15 gtt/mL or 10
21
Q
other examples administration sets include:
A
blood tubing: macro drip set
Volutrol: micro drip set
22
Q
in choosing an IV site you should consider three things:
A
avoid valves and bifurcations
look for a vein that looks straightest, firm, round, and springs
limit IV access to distal areas
23
Q
what are three types of IV catheters?
A
over the needle
butterfly
through the needle
24
Q
what is the over-the-needle catheter?
A
inserted over a hollow needle
25
what is a butterfly catheter?
hollow, stainless steel needle with two plastic wings
26
through-the-needle catheter?
inserted through a hollow needle
27
this catheter is inserted over a hollow needle?
over-the-needle catheter
28
this catheter is a hollow, stainless steel needle with two plastic wings
butterfly catheter
29
this catheter is inserted through a hollow needle
through-the-needle catheter
30
these catheters are most preferred and this diameter of catheter should be chosen for vein
over-the-needle; largest diameter catheter
31
the best gauges for over-the-needle catheters are _____ in treating peds patients. Though _____ are ideal
20-, 22-, 24-, 26-; butterfly catheters
32
IV locations for peds patients include?
hand veins, scalp veins
33
What are some considerations for IV therapy in geriatric patients?
use smaller catheters
tape may be damaging
be careful with macro drips
consider poor vein elasticity and avoid spidery/varicose veins
34
these factors affect IV flow rate
```
fluid
admin set
height of bag
catheter type
constricting band
```
35
name local IV site reactions and complications?
```
infiltration
occlusion
vein irritation
thrombophlebitis
hematoma
nerve, tendon, ligament damage
arterial puncture
```
36
escape of fluid into surround tissue
infiltration
37
Infiltration causes?
edema or necrosis
catheter passes through vein and out other side
patient moves excessively
tape becomes lose or dislodged
catheter is inserted at too shallow an angle
38
in the event infiltration occurs what should you do?
d/c the IV line
reestablish IV line in opposite extremity
apply direct pressure over the area
do not wrap tape around extremity
39
blockage of vein or catheter
occlusion
40
seeing a decrease drip rate or blood in the IV tubing is a sign of?
occlusion
41
occlusion may develop due to:
positioning of catheter
| patient's blood pressure overcoming the flow
42
this type of site reaction is caused by too-rapid infusion rate
vein irritation
43
the steps in handling vein irritation include:
d/c the line
save equipment for analysis
reestablish the IV line in the other extremity with new equipment
44
inflammation of the vein
thrombophlebitis
45
causes of thrombophlebitis?
| characterized and treated how?
aseptic technique
pain and tenderness along vein, redness, edema; appears after IV therapy. treat by discontinuing the infusion and IV
46
thrombophlebitis can be prevented how?
```
disinfecting skin
wearing gloves
not contaminating site
cover site with dressing
anchoring catheter and tubing
```
47
this is an accumulation of blood in the tissues surrounding an IV site?
hematoma
48
this site reaction, usually caused by vein perforation and improper catheter removal, is characterized as _____
hematoma
49
systematic complications include:
```
anaphylaxis
pyrogenic reactions
circulatory overload
air embolus
vasovagal reactions
catheter shear
```
50
how do you handle an allergic reaction?
```
d/c line and remove soln
leave catheter in place
attach saline lock
notify med control
maintain airway/VS
retain soln or medication for evaluation
```
51
foreign proteins that produce fever
pyrogenic reaction
52
steps in handling a pyrogenic fever
stop infusion
| *always inspect bag prior to admin
53
problems may occur in patients with cardiac, pulmonary, or renal dysfunction
circulatory overload
54
to treat circulatory overload, you should:
slow IV
raise patient's head
administer high flow O2
monitor VS and breathing adequacy
55
treating air embolus consists of:
placing patient on left side with head down
admin 100% oxygen
transport to facility
assist ventilations if needed
56
the brain is deprived of oxygen and fainting occurs is known as?
vasovagal reactions
57
to treat vasovagal reactions you should?
place patient in shock position
apply high flow oxygen
monitor VS
establish IV line
58
when the needle slices through catheter creating a free flowing segment
catheter shear
59
to treat a catheter shear you should:
surgical removal of the tip is often necessary, consider placing the patient in left lateral recumbent position and do not rethread catheter
60
define the seven R's
```
right patient
right med
right dose
right route
right time
right documentation
right to refuse
```
61
integrates comprehensive knowledge of pharmacology to formulate a treatment plan intended to mitigate emergencies and improve overall health of the patient
pharmacology
62
routes of administration
self-administer
peer-administer
assist/administer medications
63
predefined procedures performed before physician is contacted
standing orders
64
paramedics must contact medical directors prior to performing procedures
online medical control
65
procedures for adminsitering medication
- obtain order from medcontrol
- understand physician orders
- repeat any orders for verification
- ask about medication allergies
66
how many times should read the drug label
three times
in packaging
during prep
before admin
67
difference between antiseptic and disinfectant?
antiseptics are used before invasive procedure whereas disinfectants are toxic to living tissue and used on nonliving objects
68
used before invasive procedure?
antiseptic
69
chemicals toxic to the living tissue?
disinfectant
70
in preventing contamination of the patient, what are some aseptic techniques?
sterilize the equipment
antiseptic
disinfectant
71
intended for tissue cleaning
antiseptic
72
not intended for tissue cleansing, i.e. tissue damage
disinfectant
73
deconstruction of all living organisms using heat, gas, or chemicals
sterile technique
74
for a sterile field to exist you should have:
- sterile sleeves or a gown
- wear sterile gloves
- place sterile drapes around procedural area
75
cells are enclosed by a cell membrane, this is called?
semipermeable membrane
76
name small compounds that can pass easily through the cell membrane?
water, H+, CO2
77
what is unique about the phospholipid bilayer?
selective permeability
78
Total body water (TBW) is what percent of the adult weight?
60%
79
TBW can be divided into?
intracellular fluid
| extracellular fluid
80
intracellular fluid is what percent of the TBW?
45%
81
extracellular fluid is what percent of the TBW?
15%
82
The extracellular fluid can be divided into two
interstitial fluid
| intravascular fluid
83
the remaining 40% of the total body weight is comprised of?
solids
84
this ion plays a major role in neuromuscular function and the conversion of glucose into glycogen
potassium
85
this ion regulates distribution of water and major extracellular cation
sodium
86
major intracellular cation
potassium
87
this ion is important for bone growth
calcium
88
this ion metabolizes protein and carbohydrates
magnesium
89
this electrolyte determines metabolic acidosis and alkalosis, part of the buffer system in regulating acid/base balance
bicarbonate
90
regulates the pH of the stomach and major extracellular anion
chloride
91
important component in adenosine triphosphate (ATP), serves as the body's energy source
ATP
92
compounds concentrated on one side of a cell membrane move to an area of lower concentration
diffusion
93
name an example of diffusion
filtration as observed across the kidney
94
movement of water across a cell membrane and occurs when there are different concentrations on each side of a membrane
osmosis
95
a healthy person loses approx how many liters of fluid daily?
2-2.5 L
96
causes of overhydration ?
unmonitored IVs
kidney failure
water intoxication
hypoventilation
97
these types of medication are given through the digestive or intestinal tract and usually take how long to be absorbed?
enteral medications; 30-90 minutes
98
the purpose of a gastric tube?
decompress
gastric lavage
route admin
99
breakable sterile glass containers and carry one of medication
ampules
100
glass or plastic bottles with rubber stopper top and can contain single or multiple doses
vials
101
the two types of prefilled syringes?
glass cartridge and syringe, and preassembled prefilled syringes
102
common sites for SC injections
```
upper arms
anterior thighs
abdomen
*0.5-1 ml max volume
15-30 min absorption
```
103
common sites for IM injection
```
vastus lateralis
rectus femoris
gluteal area
- limited to 5 ml's
deltoid muscle
- listed to 2 ml's
*10-20 mins absorption
```
104
percutaneous medication administration takes how long for absorption to take place?
mins to hours
105
the absorption rate for sublingual medication administration?
3-5 min absorption, the area is highly vascular
106
buccal medication absorption rate
30-90 mins absorption
107
the purpose of ocular medication administration?
for pain relief, allergies, and infections, tetracaine takes 1-2 drops, no more
108
intranasal medication administration
3-5 min absorption
109
nebulizer and MDI takes how long to absorb?
2-3 mins absorption for patients with respiratory disorder
110
ET tube medication administration uses only 4 meds
lidocaine
epinephrine
atropine
nalozone (narcan)
111
Adult insertion sites for IO
right and left proximal humerus
right and left proximal tibia
right and left distal tibia
112
pediatric insertion sites for IO
right and left distal femur
right and left proximal humerus
the right and left proximal tibia
right and left distal tibia
113
Average flow rate achieved for IO via humeral site
5L/hr
114
indications for IO
any time vascular access is difficult to obtain in emergent, urgent or medically necessary situations for 24 hours
115
contraindications for IO
fracture of target bone
infection at area of insertion
inability to identify landmarks
IO or attempted IO access in target bone within previous 48 hours
prosthesis or orthopedic procedure near insertion site
116
IO sterile needle sets
```
15 gauge, 30 4stainless steel in 3 lengths:
15 mm (pink), 3-39 kg
25 mm (blue), 3 kg or >
45 mm (yellow), 40 kg or >
```
