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P&A II midterm > IV therapy fluid > Flashcards

IV therapy fluid Flashcards

(59 cards)

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1
Q

Where is most fluid located?

A

Inside the cells

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2
Q

What is diffusion?

A

Movement of particles from high concentration to low concentration

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3
Q

What is osmosis?

A

The movement of water through a semipermeable membrane

Low particle concentration -> high particle concentration

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4
Q

What is osmotic pressure?

A

The pressure exerted on a semipermeable membrane by osmosis

Pressure necessary to create equilibrium

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5
Q

What is filtration?

A

Movement of fluid and small particles due to hydrostatic pressure

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6
Q

Where does filtration happen?

A

Kidney/capillary level

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7
Q

What is active transport?

A

Movement of particles from an area of LOW concentration to an area of HIGH concentration
Requires ATP

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8
Q

What are the 2 types of solutions?

A

Crystalloid

Colloid

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9
Q

What is a crystalloid solution?

A

Clear solution
Isotonic fluids
Hypotonic fluids
Hypertonic fluids

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10
Q

What is a colloid solution?

A

Proteins/starch
Blood products
Parenteral nutrition

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11
Q

When do you use an isotonic fluid?

A

Low BP

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12
Q

When do you use a hypotonic solution?

A

When cells needs fluid and are dehydrated

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13
Q

When do you use a hypertonic solution?

A

In people with edema

To pull fluid from cells into vasculature

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14
Q

What is insensible fluid loss?

A

Losing fluid that cannot be measured (sweating during a hot day - diaphoresis, respiration)

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15
Q

What is sensible fluid loss?

A

Fluid loss that can be measured

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16
Q

When is 3% fluid usually used?

A

For brain swelling because the swelling has no where to go

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17
Q

How do you treat a dehydrated pt?

A

Give 0.9% NS to increase fluids, THEN hypotonic

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18
Q

What is fluid osmolality?

A

The number of dissolved particles per unit of water

We refer to solutions in relation to plasma

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19
Q

What is a hypotonic solution?

A

Less concentrated (more dilute) than plasma

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20
Q

What is a hypertonic solution?

A

More concentrated than plasma

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21
Q

What is IV therapy?

A

Infusion of a fluid into a vein to prevent or to treat fluid or electrolyte imbalance or to deliver medications, nutrition, or blood products

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22
Q

What are types of venous access devices?

A 
Peripheral insertion devices
Midline infusion devices
Peripheral inserted central venous access devices
Tunneled central venous access devices 
Implanted vascular access devices
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23
Q

What is a peripheral insertion device?

A

Over-the-needle intravenous catheters

Winged infusion or small vein needles

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24
Q

What are advantages of a peripheral insertion device?

Study These Flashcards
A

Choice of sites
Ease of insertion and removal
Decreased infection rates

25
What are disadvantages of a peripheral insertion device?
Short term (72 hours) Infiltration/phlebitis Inability for hyperosmolar solutions Inability to draw blood
26
What is infiltration?
When the catheter is dislodged from the vessel and you have fluid leaking into the tissue
27
What are symptoms of infiltration?
Cool to touch, swelling, discomfort and no blood return
28
What is phlebitis?
Inflammation of the vessel
29
What are symptoms of phlebitis?
Pain, warmth, redness at site, edema
30
Can you draw blood off of peripheral IVs?
No
31
What is a midline infusion device?
Similar to a PICC line
32
What are advantages of a midline infusion device?
Ease of insertion and removal Intermediate use Decreased infection rates TPN and blood draws
33
What are disadvantages of a midline infusion device?
Infiltration/phlebitis/air embolism more common than peripheral line
34
Why is an air embolism more common in midline infusion devices?
It’s a wider bore - concern for air getting inside the catheter
35
Where are midline infusion devices usually placed?
Basilic, cephalic, or brachial veins 3-8 inches
36
How long are midline infusion devices usually good for?
6-8 weeks
37
What is a peripheral inserted central venous access device?
A PICC line | Considered a central line because it feeds into the heart even though it's peripheral
38
What are advantages of a peripheral inserted central venous access device?
Ease of insertion and removal Long term & home use Decreased infection rates May infuse all solutions and blood draws
39
What are disadvantages of a peripheral inserted central venous access device?
High thrombosis rate Small Diameter Higher malposition risk *CLAB/CRBSI*
40
How long is a a peripheral inserted central venous access device good for?
1 year
41
What veins could a a peripheral inserted central venous access device be put into?
Basilic, cephalic, or brachial veins (end near right atrium)
42
What is an implanted vascular access device?
Port | Central line
43
When are implanted vascular access devices used?
Oncology or people with long term autoimmune disease that requires lots of medication over time
44
What are advantages of implanted vascular access devices?
Long term & home use No external catheter Low maintenance, swim/shower/bath, cosmetic Decreased infection rates than tunneled
45
What are disadvantages of implanted vascular access devices?
Surgical insertion and removal | Need to access - port is under skin
46
What is a central venous access device?
Central line | Can have a triple-lumen catheter
47
What are advantages of central venous access devices?
Ease of insertion and removal Intermediate term May infuse all solutions and blood draws *TPN line has to remain specifically for that
48
What are disadvantages of central venous access devices?
CLAB/CRBSI
49
What are guidelines for peripheral site selection?
Determine type and duration of therapy Inspect the patient’s veins Place a tourniquet 4 to 6 inches above venipuncture site Lower extremity below the level of the heart. Ask the patient to open and close fist several times Warm soaks x 5 minutes before venipuncture: vasodilates selected vessel
50
Where is the best place to put an IV?
Antecubital because the veins are big there
51
What factors affect flow rate?
``` Height of the solution container Position of the extremity Tubing obstruction Position of the IV access IV patency ```
52
What are nursing functions in IV therapy?
``` Initiating Maintaining Assessing Discontinuing Administering ```
53
How does the nurse initiate IV therapy?
``` Preparing the patient Selecting the site Preparing the site Performing the venipuncture Securing the venipuncture device ```
54
How does the nurse maintain IV therapy?
Monitoring and documentation Dressing changes (72 hours) Changing IV solutions and tubing Intermittent flushing of an infusion lock Disconnect as little as possible to decrease risk for infection
55
How does the nurse assess for complications in IV therapy?
``` Check for: Infiltration Phlebitis Infection Fluid overload Air embolism Pneumothorax (think in relation to central lines) Catheter breakage or damage ```
56
What are S&S of infected IV site?
Local - redness, warmth, purple to drainage | Systemic - fever, wbc, chills, malaise
57
How does the nurse discontinue IV therapy?
When all ordered fluids have infused or when complications develop Inspect the integrity of the catheter after removal
58
How does the nurse administer IV therapy?
``` IVP Intermittent infusion Continuous infusion PCA Epidural analgesia ```
59
How does IV therapy change through the lifespan?
Newborn and infant - Veins are tiny and difficult to locate and cannulate - IVs normally put in scalp because you can see the veins better Toddler and preschooler - Avoid areas over joints - children’s increased activity level School-age child or adolescent - Fear of invasive procedures Adult or older adult - Requires special care because of age-related changes in the skin and vessels - Vessels become more fragile - “Rolling”

P&A II midterm (8 decks)

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