IV Therapy Flashcards

Question

What are the factors that cause you to produce ADH?

Answer 1

* Stressors * Drugs (diuretics) * Smoking * Cancer * Steroids (aldosterone) * Kidneys , Edema, Too much K, Impacts the heart, too much phosphorus, Acidosis

Answer 2

o Maintain blood volume o Helps to regulate temperature (Dehydration=Fever) o Transports materials to and from cells o Medium for cell metabolism o Assists in food digestion thru hydrolysis o Solvent in which solutes are available for cell function o Medium for excreting waste

Answer 3

Intracellular | Extracellular: Intravascular, Interstitial, Transcellular

Answer 4

Hydrostatic pressure: Pressure exerted on the walls of blood vessels Osmotic pressure: Pressure exerted by the protein in the plasma

Answer 5

the differences of hydrostatic and osmotic pressure

Answer 6

Osmosis: Fluid moves from low solute to high solute Diffusion: Fluid moves from an area of high solute to low solute Filtration: Hold on to some particles and let go of others

Answer 7

Physiologic pump moves from lower concentrations to one of higher concentration. Moves against the concentration gradient. Requires ATP for energy Against the concentration gradient: Sodium potassium pump maintains the higher concentration of extracellular sodium and intracellular potassium

Answer 8

``` ♣ Sodium ♣ Potassium ♣ Calcium ♣ Magnesium ♣ Hydrogen ions ```

Answer 9

Urination and bowel movements

Answer 10

* Skin= 500mL/day (Temperature?) * Bowels= 100-200mL/day (diarrhea? C.Diff?) * Lungs= 300-500mL/day (Hyperventilates?) Altogether, we lost between 500-1,000mL per day through insensible loss

Answer 11

Normal distribution of fluids within the body

Answer 12

Abnormal accumulation in interstitial tissue Easily exchanges with extracellular fluid Example: on your feet all day, lay down and swelling goes away

Answer 13

Fluid accumulation in body not easily exchanged with ECF Examples: fluid in the lungs, severe burn, peritonitis, fistula. Pancreatitis, bowel extension, OR exposure (extensive) S/S: Hypovolemia Treat: • Slowly administer fluids to avoid hypervolemia • Look at electrolytes and urine concentration • Replace electrolytes and fluid if need be • Look for protein in the blood stream (Low protein- edemitis)

Answer 14

Reduced homeostatic mechanisms (Cardiac, renal, respiratory) o Decreased body fluid percentage o Medication use o Hormone: decrease in ADH o Dehydrated more easily o Lost subcut tissue o Dry skin o Do not feel thirsty as often as younger individuals o *Should be weighed everyday (Best way to measure fluid balance) o *Will collect fluid in lungs faster than younger pateints, which leads to pulmonary edema o *Do not depend on tenting to tell you if the patient is older

Answer 15

Medical diagnosis: Hypovolemia Definition: Losing fluid and electrolytes in the same proportion ***Different from dehydration: losing fluids only Can be recovered by administering NS or Ringer’s Lactate If hemorrhage: administer NS ``` Causes: • Vomiting • Diarrhea • GI suctioning • Sweating • Decreased intake • Inability to gain access to fluid ``` ``` Risk factors: • Diabetes insipidus • Adrenal insufficiency • Osmotic diuresis • Hemorrhage • Coma • Third space shifts ``` ``` S/S • Rapid weight loss • Decreased skin turgor • Oliguria • Concentratied urine • Postural hypotension • Rapid and weak pulse • Increased temperature • Cool and clammy skin due to vasoconstriction ``` *PC: hypovolemic shock

Answer 16

Medical diagnosis: hypervolemia Definition: Fluid overload or diminished omeostatic mechanisms Risk factors: • Heart failure • Renal failure • Chirrhosis of the liver ``` S/S • Edema • Distended neck veins • Abnormal lung sounds (wheezing) • Tachycardia • Increased BP • Pulse pressure • CVP • Increased weight • Increased UO • SOB • Wheezing ``` Treatment: • Directed at the cause • Restriction of fluids and sodium • Administration of diuretics *PC: pulmonary edema, HTN, electrolyte imbalance, hypoxemia, respiratory alkalosis

Answer 17

Mainly for those who are NPO and/or stressed Give: 1500 mL fluid/sq meter of body surface Should include: glucose, sodium, potassium and water • Supplies calories • Spares protein • Minimizes ketone formation (Helps put the patient into ketosis)

Answer 18

Given when the body cannot maintain requirements Usually d/c in 48 hours Check renal function before administration ``` Given for: • Diarrhea • GI surgery • N&V • Loss of electrolytes • Wound infection ```

Answer 19

Used for restoration on ongoing basis - greater than 48 hours Given for: • Burns • Wound draining • Fistula draining Similar to replacement except you need - Strict I & O - Daily labs - Type of fluid depends of type lost

Answer 20

Peripheral 3-8” long Can stay in 6 days – 4 weeks without causing a problem

Answer 21

Peripheral Specially trained nurses can insert them ***Remove in slow short pulls o Don’t put pressure on the needle until you see blood because there could be a clot. Given in the Basilic vein most often • Sometimes given in the cephalic vein or subclavian vein Can’t us turnicut so put in Trendelenburg Ends in the superior vena cava of the heart

Answer 22

Short term non-tunneled • 10 days • Placed in the jugular or subclavian ``` Long term tunneled • ***Must be removed by doctor • Hickman • Broviac • Groshong • Implanted port (Portacath) ``` Given for: Long term therapy, TPN, Glucose therapy, Chemo, Kidney failure

Answer 23

Hypotonic, Isotonic, and Hypertonic solutions Solutes are totally dissolved and can freely move in and out of membranes. Takes 3-4X of these to do the same job as Colloids (expanders) Ringer’s lactate=most balanced solution • If pt. is allergic to lactose, don’t give lactate • There is a plain solution for these patients *Look for kidney failure because potassium is added to many solutions

Answer 24

Solutes don’t dissolve Need more osmotic pressure Hypertonic Can be substitutes for blood transfusions Types • Albumin: Plasma protein, 500 mL of blood, Low albumin=edema, High protein=weight loss • Dextran: 20-40mL/minute, Given for hypovolemia, Substitute for blood transfusion • Hespan: Heta-starch, Not a blood product, LESS TOXIC THAN THE OTHERS, Substitute for blood transfusion • Mannitol: EXPANDER USED FOR BRAIN INJURY. It does not cause the brain to swell *Medications should not be given with or added to these solutions PC: ALWAYS OVERLOAD

Answer 25

(2 x Na) + (glucose÷18) +(BUN ÷2.8)

Answer 26

Diastole+Diastole+Systole/3 *should be above 60!

Answer 27

Gloves Wait until you see blood and then put pressure Observe catheter for problems - If part of the catheter is gone, put turnicut on and call physician

Answer 28

- Per agency policy - ***Patient in Trendelenburg - ***Have patient bear down so blood will come out to prevent air from going in - Inspect the integrity of the catheter - Document - Take precautions to prevent air embolus and catheter breakage

Answer 29

stop the blood immediately, take all of the blood and saline administered with blood away keep the IV in with the piggy-backed saline.

Answer 30

An infection that was already in the patient prior to care.

Answer 31

An infection that we caused through care

Answer 32

- Wash hands before doing anything with the site - Good skin prep and technique with start - Change tubing/bags/site at proper times - Label all above - If no label consider expired - Inspect and palpate site daily, change if necessary - Dressing are to be left intact until catheter is removed or it becomes damp, loose, soiled - Wear gloves for dressing changes if needed - Universal precautions - Care with flushes, needless systems, additives ``` Site assessment: o Redness o Swelling o Tenderness o Coolness o Warmth o Inflitration- pain, coolness, pallor o Phlebitis- pain, redness, warmth, red streak ``` ``` Monitor: o Length of time hanging o Tubing o Flow rates o Pumps o Dressing o Site o Patient response o Documentation o Write down patient name and flow rate on the bag so that everyone knows ```

Answer 33

Local PC * Skin is cool and tight * Take IV out * Place warm compress * Graded from 0-4

Answer 34

Local PC * Red, warm, swelling, red streak * Take IV out * Place either cold or warm compress * Inform physician and possibly infection control

Answer 35

Local PC • Edema, tender, vein feels like a cord

Answer 36

Local PC * Bruise and swelling, burning pain, discolored * Take IV out * Apply pressure * Elevate * Ice

Answer 37

Local PC • IV too fast or the solution is cold (blood)

Answer 38

Local PC * Infiltration of medicine * Burning * Try to suck it back out with a syringe * Notify, take a picture, elevate, warm or cold compress, incident report, sometimes they even have to have surgery

Answer 39

Systemic PC S/S: Restless, Headache, High pulse, Gain >2 pounds in one day, Cough, fluid in the lungs, Edema, Hypoxia, O2 Sat<90 , Wide difference between I&O Treat: Report, Give diuretics, Keep HOB up, Daily weight, I&O monitoring, Do not take IV out, Turn down to keep the vein open, Keep patient warm

Answer 40

Systemic PC S/S: Palpitations, Confused, Coma, SOB, Tachycardia, Murmurs, Shock Treat: Call for help, Clamp the line, ***Trendelenburg on left side to prevent it from moving into the lungs, ***Oxygen, Vasopressors, Fluids, Could go into cardiac arrest

Answer 41

Systemic PC * Chills * Fever * Tachycardia * N&V * Pain * Elevated white count * Could go into septic shock

Answer 42

Systemic PC * Med too fast * Could go into cardiac arrest

Answer 43

Systemic PC Apply tourniquet and notify provider

Answer 44

Systemic PC Find a specialist immediately

IV Therapy Flashcards

(73 cards)