IV Therapy Flashcards by Keegan Williams

What is the equation for normotension in peds patients

Age x 2 + 90

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What is the equation for hypotension in peds?

Age x 2 + 70

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What are the 2 indications for IV Therapy

Potential med administration
and the need for fluid therapy

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What is the use of a secondary set in medication administration in the context of IV

It allows for a slow administration of drugs

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Define Macrodrip

comes in (10/15/20 Drops per mL) sets, runs drips faster
10 drops=1ml of fluid

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Define Microdrip

Microdrip 60 drops per ml of fluid
Runs drips slower
Allows more control
Recommended for Peds (2-12)

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Define Crystalloid solution

Homogenous
Dilution of mineralized salts

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What are 3 examples of a Crystalloid solution that we use as PCPs

Ringers Lactate
Saline
D-10

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Define Colloid solution

Heterogenous and Difficult to store

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What is an example of a colloid solution?

Blood

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Define Hypotonic Solution

A solution that has a higher osmotic pressure external of the vasculature which causes fluid to fill the cells

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Define Isotonic solution

It doesn’t draw fluid in or out, just provides body with extra volume
Ex - Saline

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Define Hypertonic solution

Draw more fluid from the cells in to vasculature
These solutions are Used for cerebral Edema
and Used in partner with hyperventilation

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What is TKVO on a 10-set macro drip typically in adults?

1 drop every 6-12 seconds or 5 drops per minute or 30-60ml/hr

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What is TKVO on a Microdrip for Peds?

1 drop every 4 seconds with Microdrip

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When cannulating what should you avoid?

Fracture
Hematomas
AV graft/fistula
history of mastectomy
Infection/swelling
decreased sensation
sclerosed or thrombosed veins

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What are 2 indications for the use of a Buretrol?

Pediatrics
D10W
or other slow admin of meds

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When would you use a pressure infuser?

rapid delivery of fluid is required

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Some local complications of IV administration

pain and irritation
infiltration and extravasation
hematoma formation
venous spasm or vessel collapse
Phlebitis
thrombosis and thrombophlebitis
cellulitis
nerve, tendon, ligament and limb damage

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What are 3 causes of Infiltration?

Dislodgement of catheter or needle cannula during venipuncture
Puncture of vein wall during venipuncture
High delivery rate or pressure

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What are the signs and symptoms of infiltration

cool site around the IV
Swelling at IV site
Sluggish or absent flow
infusion flows when pressure is applied to vein above tip of cannula
no backflow of blood into IV tubing when clamp is fully opened, and solution container is lowered below IV site

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What are 4 systemic complications that can occur

sepsis (infection)
Hypersensitivity reactions
Pulmonary Edema
Emboli

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Signs and Symptoms of Air Embolism

hypotension
Cyanosis
weak rapid pulse
loss of consciousness

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How to manage an Air embolism

close the tubing
transport pt semi-prone on left side (keep head down)
Check tubing for leaks
administer high concentration O2
notify medical direction
CPR if needed

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Paramedics are permitted to transport pts on these 4 types of IV therapy without an escort

- Peripheral IV - TKVO or prescribed rate no greater than 2ml/kg/hr to max of 200ml/hr - drugs within your certification level - normal saline, D5W, Ringers, Thiamine, multivitamins * Pt has to be 18+ to be transported with KCL

What percentage of total body weight is interstitial fluid

40-60%

What is an example of Intravascular fluid

Blood Plasma

What is an example of interstitial fluid

CSF

What % of total body weight is body fluids in an infant

80%

What % of total body weight is body fluids in a child

60-65%

What % of total body weight is body fluids in an adult

50-60%

What % of total body weight is body fluids in an infant Obese/Elderly

40%

Define Edema

Fluid that accumulates in interstitial spaces

4 things that interstitial space fluid depends on

1. capillary hydrostatic pressure 2. Oncototic pressure by blood plasma proteins (pulls fluid back into capillaries) 3. Capillary permeability 4. Lymphatic channels (collects fluid forced from capillaries by blood hydrostatic pressure and returns it into circulation)

What are the 2 type of clinical manifestations of edema +?

Localized, and generalized

What are some characteristics of a gernalized edema

- more widespread - dependant on the body part - pitting - symptom from undelying illness

What is a way to check for dehydration?

Tenting of the skin

3 classes of dehydration and definitionso

Isotonic - excessive loss of sodium and water in equal amounts Hypernatrermia - loss of water in excess of sodium Hyponatremic - loss of sodium in excess of water

How often do you reassess when running a fluid bolas

every 250 ml of fluid

What are signs and symptoms of fluid overload

Crackle in the lungs, and localized edema

What is the chief cation in ICF?

Potassium

What is the chief anion in ICF

Phosphate

What is the chief cation of ECF?

Sodium

What is the chief anion of ECF?

Chloride

Where would you find large amounts of Bicarb ions? In ICF or ECF?

ECF

What is the role of sodium in the body

- helps maintain water balance - helps with transmission in muscles and nerve fibres

What organ is key in regulating sodium?

The renal system and the kidneys

What are the 2 hormones that regulate sodium levels and helps maintain the balance of water and sodium in the body

Aldosterone and ADH

When would aldosterone be secreted

If ECF Na was decreased, the aldosterone would cause an increase in sodium

Why would you see an increase in ADH in the body?

to help secrete water and NA

What would cause sodium loss in the body that would result in excess water?

- Medications - Diarrhea - Renal, liver, or hear disease (CHF)

What would cause water gain in excess of sodium

- Hypotonic fluid excess - Compulsive Water Drinking May also be adrenal insufficiency (low aldosterone)

What would cause excess sodium in the body in relation to water

- diet - Hypertonic saline IV solutions

What would cause excessive water loss

- extensive burns - hyperglycemia - diabetes insipidus

What is potassium vital for in the body

- regulating the normal electricity of the heart - nerve and skeletal function and metabolic processes

Sodium and Potassium work in ________________ of each other

oppostie

When aldosterone is released, the kidneys may.....

eliminate more potassium, and not recognize the fact that there may already be a lack of potassium in the body

Acidosis = hyper or hypokalemia

Hyperkalemia

Alkalosis = hyper or hypokalemia

hypokalemia

True or False - the body reatians potassium well

False

- Muscle Dysfunction (decreased reflexes) - Muscle weakness - Malaise - Constipation - decreased myocardial muscle contraction (hypotension) - Conduction problems - Vomitting These are symptoms of what?

Hypokalemia

Causes of Hyperkalemia

- cell injury - Acidosis - poor elimination - excess intake

What is Calcium essential for in the body

- neuromuscular transmission - cell membrane permeability - contraction of cardiac, smooth and skeletal muscles - hormone secretion - formation and structure of teeth and bones - blood clotting process

How is calcium regulated by the GI tract

- absorbed by the GI tract - Requires vitamin D

How is calcium regulated by the Renal system

- filtered by the glomerulus and reabsorbed in the tubules - stone formation can occur

How is calcium regulated by the Endocrine system

- parathyroid releases PTH to increase calcium concentration - Calcitonin acts to move calcium from plasma to bone (decreases blood calcium levels)

What are some causes of hypocalcemia

- decreased intake or increased excretion - parathyroid problem - vitamin d deficency - inadequate exposure to UV light - Hydrofluoric (HF) burn

Signs and symptoms of Hypocalcemia - What does "CATS" go numb mean?

C – Convulsions (seizures) A – Arrhythmias (irregular heartbeats) T – Tetany (muscle cramps, spasms, or twitching) S – Stridor and spasms (laryngospasm or bronchospasm) The "go numb" refers to paresthesia (numbness and tingling), which often occurs in the lips, fingers, and toes due to increased neuromuscular excitability.

Causes of Hypercalcemia

- Excessive intake or absorption - increased vitamin D - Altered GI metabolism - Medications - Metabolic - Hyperparathyroid and bone tumours

Bones, groans, stones and mental ovetones - Bone pain - abnormal bone growth - decreased peristalsis - GI Symptoms - Renal Stones - Personality changes confusion, altered LOC, Lethargic, psychosis, depression, memory loss - Cardiac dysrhytmias, short QT, heartblock, bradycardia What are all these symptoms of?

Hypercalemia

IV Therapy Flashcards

(70 cards)