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IV Administation > IV therapy: > Flashcards

IV therapy: Flashcards

1
Q

Intravenous (IV)

A

administration of fluids, blood components, and medication into a vein

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2
Q

Intravenous fluids (IVF)

A

include electrolyte solutions, vitamins, nutrient preparations, and commercial blood “fractions” designed to be administered into a vein.

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3
Q

Colliod

A

solutions containing protein or starch molecules that remain uniformly distributed in fluid (DO NOT DISSOLVE) > fail to form a true solution
EX: Dextrame, Albumin

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4
Q

Crystalloid

A

non-colloid (salts), electrolyte solution (with potential to form crystals)> restore vascular volume
EX: NS, LR, D5W

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5
Q

Venipuncture

A

the insertion of a needle or catheter into a vein

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6
Q

Peripherally inserted central catheter (PICC)

A

entry into the vascular system via the insertion of a catheter into a peripheral vein threaded through to the superior vena cava (stay in 7days-6months)

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7
Q

Central venous catheter (CVC) aka central line

A

catheter inserted into a centrally located vein usually subclavian or jugular vein (stay in < 7 days)

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8
Q

Implanted port

A

aka port-a-cath, surgically placed under the skin and accesses vascular system internally. Single location to inject medications, fluids or take blood samples. (stay in >30 days)

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9
Q

Vascular access devices (VAD)

A

catheters, cannulas, or infusion ports usually designed for long term repeated access to the vascular system (CVC, PICC, Portacath)

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10
Q

Parenternal

A

by route other than GI into tissue

EX: IM, SQ, ID, IV

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11
Q

Total parenteral nutrition (TPN)

A

nutritionally adequate hypertonic solution - usually given via CVC (white/yellow 2000ML bag)

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12
Q

Extravasation (vesicant solution)

A

vesicant solution is administered into surrounding tissue; vesicants are solutions capable of causing tissue injury or destruction if they escape into surrounding tissue
EX: K, Cl, zosyn, Dilantin, chemo, pressor agents, dopamine

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13
Q

Infiltration (nonvesicant solution)

A

nonvesicant solution is administered into surrounding tissue

EX: puffy, cool, painful site

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14
Q

Delayed extravasation

A

symptoms occurring > 48 hrs after medication administration.

EX: more swelling, burning, soreness

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15
Q

Purpose of IV therapy:

A 
>rehydrate
>NPO 
>med. adm.
>nutrition
>trauma 
>immediate access
>rebalance fluids
>transfuse blood
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16
Q

Legal implications:

A 
>right drug, dose, patient, route, time (5Rs)
>check allergies
> educate 
> assess and reassess!!!
> documentation
> check MD order
> liable for med errors
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17
Q

ICF

A

intracellular fluids- 2/3 of body water weight is inside cells, protein keeps water in cells

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18
Q

ECF

A

extracellular- 1/3 of body water weight is outside cells.
>intravascular - inside BV (plasma), high amount of protein
>interstitial- fluid between surrounding cells
>transcellular- fluid in fluid with in small space
>lymph- tissue fluid

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19
Q

Osmosis

A

movement of water across cell membranes from the less concentrated solution to the more concentrated solution

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20
Q

Serum osmality

A

concentration of body fluids: normal range 280-300 mOsm/kg

21
Q

fluid intake and output

A

how much is intake 2300 ml/day;

output 2500 ml/day = 30-50ml/hr

22
Q

Fluid volume deficit (FVD)

A

> hypovolemia: intravascular compartment fluid loss (water & electrolytes)
third space syndrome: fluid accumulates w/in interstitial space, occationally peritoneal, pleural, and pericardial space (ISOTONIC)

23
Q

Fluid volume excess (FVE)

A

> body retains water and Na
hypervolemia: increased blood volume, secondary to increase in fluid Na increased
Edema: intravascular and interstitial spaces have increase water

24
Q

Dehydration

A

water lost from leaving patient with excessive Na levels

>check skin turgor, mm, happens in TF patients if fluid bolus is inadequate

25
Q

Overhydration

A

too much water in body and too little electrolytes.

>if Na levels are low, cells draw in more water, causing brain to swell

26
Q

Types of IVF

A

Isotonic, hypotonic, and hypertonic

27
Q

Isotonic

A

> same osmotic pressure as the cell.
fluid can increase ECF volume,
can result in circulatory overload.
EX: LR, NS, D5W

28
Q

Hypotonic

A

> lower osmotic pressure than the cell.
fluid may cause the cell to swell.
cant give to pt with brain injury or burns
EX: 0.45% NSS, 1/2 NSS

29
Q

Hypertonic

A

> higher osmotic pressure than the cell.
fluid may cause cells to shrink.
EX: D10W, D5LR, D5NSS, D5 1/2 NSS

30
Q

Common IVF

A

Dextrose injection, Saline, Dextrose in saline, and multiple electrolyte solutions

31
Q

Dextrose

A 
>isotonic
>used KVO (10 ml/hr)
>promotes Na diuresis
>supplies 170 calories/liter
*can cause hyponatremic encephalopathy = death from brain swelling*
32
Q

Lactated ringers

A

> isotonic
electrolyte concetrations similar to plasma levels
lactate for correction of metabolic acidosis
used to replace fluid losses due to bile drainage, diarrhea, and burns
fluid of choice for acute blood loss replacement
does not supply calories
avoid use in patients with liver disease

33
Q

5% Dextrose/LR (D5LR)

A

> hypertonic
used to replace gastric fluid losses
supplies 170 calories/liter
*avoid in patients with liver disease

34
Q

0.9% NaCl (NSS)

A

> isotonic
used to expand plasma volume
provides sodium and chloride in excess of plasma levels
given primarily with blood transfusions and
to replace large sodium losses from burns or GI fluid losses
used to treat metabolic alkalosis increase Cl > decrease bicarbonate
does not supply calories
use caution in patients with compromised cardiovascular status

35
Q

0.45% Na Cl (1/2 NSS)

A

> hypotonic
used to replace fluid and electrolytes
does not supply calories

36
Q

administration sets

A

> macrodrip = 10-20 gtt/ml (adults)
microdrip = 60 gtt/ml (children/infants)
components of a set = primary vs. secondary tubing

37
Q

how long is IV tubing good for?

A

96 hrs = 4 days

38
Q

How long is an IV bag good for?

A

> w/o meds = 48 hrs

>with meds = 24 hrs

39
Q

How often should the IV site be changed?

A

96 hrs = 4 days

40
Q

Assess IV site for and how often?

A

> erythema, pain, pallor, drainage, edema, and patency q 4 hrs

41
Q

When should the jelco be flushed?

A

> q8hrs with 3ml if locked

>before and after infusing medicine via NS flush of 3 ml

42
Q

Flare

A

local allergic reaction w/o pain or swelling.
>red blotches or streaks along the vein
>subside w/in 30-90 minutes

43
Q

Phlebitis

A

inflammation of the vein (local inflammatory process)

44
Q

Thrombophlebitis

A

clot formation with phlebitis
>due to mechanical movement of the catheter
>chemical reaction to infusing solution
>microbial agent

45
Q

Air embolism

A

air inadvertently enters the venous system more common in CVC
> S/S: CP, SOB, cyanosis, low back pain, hypotension, weak/tready pulse, loss of consciousness, loud churning murmur over precordium
>TX: Place on left side, with HOB flat, 100% O2, and cardiocentesis

46
Q

Catheter embolism

A

portion of the catheter breaks off and flows into the vascular system biggest risk is during insertion of IV cath
>TX: apply tourniquet to most proximal joint of the torso, further tx depends on pt clinical status
>prevention: Never restylet over the needle catheter, withdraw through the needle catheters through the introducer needle, and use sissors during drsg change or removal of IV

47
Q

Speed shock

A

rapid introduction of a medication into the circulatory system
>S/S: flush face, HA, severe shock to death
>Tx: depends on clinical status
>Prevention: reconstitute all drugs, adding of drugs to an IV solution already hanging, and hemodilution of all drugs given IV

48
Q

Circulatory overload

A

decompensation of the circulatory system due to excessive volume of fluid (CHF, AFIB, crackles,)
>S/S: crackles, dyspnea, productive cough, cyanosis, and JVD
>TX: reduce infusion rate to a keep open rate, place patient in high fowlers, obs vs and ABG results, adm oxygen and diuretics according to the MD plan of care
>prevention: monitor IV flow rate, assess pt fluid and electrolyte balance, use of intermittent infusion or mechanical devices

IV Administation (3 decks)

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