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Flashcards in Intravenous Therapy 2 Deck (36):
1

Intravenous Access

Fluid & electrolyte replacement; Medication; Blood/blood products; Procedural contrasts; Blood specimen; Emergency access; Central vs. Peripheral

2

central line access more than _____ days

more than 14 days

3

central line is in

subclavian vena cava -> right atrium -> right ventricle -> out to circulation

4

central lines can handle

more volumes and more concentrated

5

tunnel catheters are used for

dialysis

6

would want central line if

large volumes, chemo, if medication is costic

7

Central Venous Access Reason for insertion:

Limited peripheral access, Long term therapy, High osmotic or caustic fluids or medications, Frequent blood /blood products, Hemodynamic monitoring, Hemodialysis

8

Central circulation:

Subclavian, Jugular

9

Types of central lines:

Non-tunneled, Tunneled, Implanted, Peripherally Inserted Central Catheter (PICC)

10

Non-tunneled

Short term; Directly in large vein- Subclavian, Jugular; Bedside insertion; Terms- C VL, Subclavian, Triple Lumen;; has wings that have to be sutured in place

11

Tunneled

Long term; Insert chest & tunnel under skin; Surgical insertion; Types- Hickman, Broviac, Groshong (Depends on tip);; see no wings so not sutured, have cuff that goes under skin and once skin heels holds it in place, inserted off floor and in special environment

12

Implanted Ports

Long Term; Reservoir under skin; Single or Dual; Non-coring needle (Huber);; subq port, placed during surgery, need special needle to access

13

What is the difference between tunneled
and non-tunneled?

A Hickman® or Broviac®are both examples of tunneled catheters. They are placed in the OR or in interventional radiology . Nurses do not remove these; When you look at a tunneled catheter, it doesn’t have the “wings” that are used for sutures. Also, you can feel a bump a inch or two away from where the catheter comes out. This is the cuff, a piece of material that grows into the tissue to keep microbes out.

14

Peripherally Inserted Central Catheter
(PICC)

Long term; Ante-cubital or above; Bedside insertion; RN-special training;; for 14 days, use chest xray to look at proper location, can be in superior vena cava or subclavian

15

Peripheral Venous Access

Short term; Catheter, cannula, butterfly needle

16

Peripheral Venous Access Uses

Continuous infusion; Keep Vein Open (KVO) or To Keep Open (TKO); Intermittent therapy (INT, Hep-lock)- Needs flush

17

Peripheral Venous Access can only be used ____ if inserted somewhere else

2 days

18

Peripheral Venous Access, KVO

running line at slow rate so want vein open, ex. PCA pump

19

Peripheral IV Nursing Procedures

Insertion, Maintenance, Discontinuation

20

IV Insertion, Verify Order

have to have order unless emergency

21

IV Insertion, Equipment:

Catheter gauge 24-14; Kit- tourniquet, dressing, skin prep, tape, label; Tubing- specific to pump; macro & micro; Extension with syringe flush

22

the larger the number then the

smaller the diameter of the catheter

23

blood has to be in a diameter of

20 or 18 because the diameter is bigger and blood has particles

24

flush extension tubing with

saline

25

if graft/fistula - can't

can't insert IV

26

after inserting an IV check site every

two hours

27

IV Insertion Site Selection

Hand or arm for adults, Distal & Non-dominant

28

IV Insertion Site Selection Patient consideration:

Mobility, Vein size & fragility, Previous access- including blood draws, Graft/fistula, Mastectomy, Other equipment

29

how can you tell if you insert IV into artery

there will be bright red blood, heart beat will shoot off blood with each beat

30

IV Maintenance Fluid delivery:

Rate/order- Pump & Controllers; Prepare next bag- Set pump & Have available

31

IV Maintenance Assessment:

At least every 2 hours; Rate, Patency, Site, Volume infused; Pt response

32

Medication Administration: Primary-

Electrolytes; Flush

33

Medication Administration: Secondary -

(Piggyback)- Antibiotics, Blood (has to be on own site), Narcotics

34

Medication Administration: V Push-

Port, Duration, Flush X 2

35

With IV medication check

Check Compatibility

36

some IVs have designated sites

heprin, TPA, blood products (have to have own rate on own site)