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NRSG 201 > Lab 12 IV part 2 > Flashcards

Lab 12 IV part 2 Flashcards

1
Q

how is O2 sat affected in darker skinned people

A

An SpO2 reading is usually overestimated in people with darker skin so always have to use clinical judgment when accessing a patient and not just the pulse oxe reading

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2
Q

what does JVT indicate

A

indicates slow blood flow through the superior vena cave or in the right side of the heart

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3
Q

what is a normal JVD measurement

A

usually 4 cm or less

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4
Q

what angle is a JVD measurement taken at

A

usually with the HOB at 45 degrees (since when people lay down they usually have JVD)

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5
Q

what does it indicate if a pt has bilateral JVD

A

this would indicate RHF

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6
Q

what does it indicate if a pt has only one distended jugular vein

A

means there is an obstruction in that vein

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7
Q

what causes an S3 sound

A

when blood leaks through the atrioventricular valve during diastole usually due to a fluid overload

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8
Q

whats another name for an S3 sound

A

Ventricular gallop

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9
Q

in what phase of heart contraction is an S3 heard

A

heard in early diastole

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10
Q

what does an S3 sound like

A

Lub-Dub-a (the extra “a” sound at the end)

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11
Q

what is another name for S4

A

Atrial gallop

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12
Q

in what phase of heart contraction is an S4 heard

A

heard in late diastole

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13
Q

what causes an S4 heart sound

A

results from the sound of the atria pushing blood into a stiff or hypertrophic ventricle or through narrowed AV valves

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14
Q

what are the three main mechanisms that cause edema
*think anything that would cause fluid to leak out of the intravascular space

A

-increased capillary hydrostatic pressure
-Decreased plasma oncotic pressure (the pressure that the plasma proteins create to draw fluid into the cells)
-increased capillary perm

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15
Q

what is one condition that can cause increased capillary permeability

A

an allergic reaction

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16
Q

what are 3 conditions that can cause decreased plasma oncotic pressure
*think anything that decreases solutes in the blood

A

-malnutrition
-liver failure (decreased production of plasma proteins)
-renal failure

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17
Q

what is dependant edema

A

edema of body parts that are lower than the heart that is affected by gravity and position

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18
Q

what is generalized edema

A

edema that is not effected by gravity or where the body part is in relation to the heart

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19
Q

what is generalized edema usually caused by

A

poor venous return

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20
Q

what is peripheral edema

A

edema that affects the lower extremities

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21
Q

what type of iv fluid would you use to treat hypovolemia

A

Lactated Ringers
0.9% NS
blood
**anything Isotonic since you want the fluid to stay in the intravascular space

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22
Q

what kind of IV fluid would you use to treat hypervolemia

A

you wouldn’t use any IV fluid usually since the pt is already overloaded with fluid

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23
Q

what is paracentesis

A

a procedure to remove fluid from the abdomen if the pt has ascites

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24
Q

what is thoracentesis

A

a procedure to remove fluid or air from the lungs

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25
Q

what is normal serum levels of Na with units

A

135-145 mmol/L

26
Q

what IV fluids could you use to correct hyponatremia

A

-NS 0.9%
-if it is very serious you can use hypertonic solutions (3% Na)

27
Q

would fluid restrictions be indicated for a patient that is hyponatremic

A

yes since if they are drinking lots it will dilute the blood

28
Q

what is body fluid osmolarity

A

285 mOsm/L

29
Q

if a patient has severe hypokalemia what would a treatment be

A

40-60 mmol KCL IV

30
Q

what is the max amount of potassium you can give by IV per hour

A

10-20 mmol/hr MAXIMUM

31
Q

what are the treatments for hyperkalemia

A

C-Calcium gluconate
B-Bicarb IV (causes K to shift into cells)
-Insulin
-Glucose
-Kayexalate (makes you poop out K)
-Dialysis
-Salbutamol (causes k to shift into cells)

32
Q

what is osmolarity

A

the number of solute particles per 1 L of solution Osmol/L
*so this is a measurement of volume

33
Q

what is osmolality

A

the number of solute particles per 1 Kg of solution Osmol/Kg
*this is a measurement of weight

34
Q

how much K does LR contain in mmol/L

A

4 mmol/L

35
Q

what are two things a person can do to prevent catheter occlusion

A

-Flush IV saline locked catheters every 24 hours
-ensure the IV bag is hanging at least 1 meter above the patient

36
Q

what are 4 clinical indicators of an interstitial infiltrated IV

A

-cool to the touch
-pallor
-swelling
-hardness

37
Q

what would be 3 interventions to treat an interstitial infiltrated IV

A

-Discontinue IV
-Warm compress
-Elevation of limb

38
Q

what are 3 ways to prevent phlebitis

A

-avoid infusing acidic alkaline or high osmolality solutions through a peripheral vein
-avoid prolonged use of the same vein
-avoid movement near the IV site

39
Q

What are clinical indicators of phlebitis

A

-warmth redness pain
-purulent drainage from the site
-red line moving up the vein
-the vein becoming palpable and starting to feel like a cord

40
Q

what are 3 interventions to treat phlebitis

A

-discontinue IV
-Warm compress
-Elevation of limb

41
Q

what would a leaking IV site look like

A

fluid or blood would be leaking out around the site but the connections would still be secure

42
Q

what are interventions to treat a leaking IV

A

often the only thing to do is disconnect the IV

43
Q

what is cellulitis

A

an infection of the skin

44
Q

what are some ways to treat cellulitis if it occurs

A

-discontinue IV
-Warm compress
-elevation of limb
-IV antibiotics

45
Q

what are some way to treat a hematoma if it forms at an IV site

A

-discontinue IV
-warm compress
-elevate limb

46
Q

what is one intervention to try and treat an air embolism

A

trendelenburg position (lay on left side so the air bubble moves from right atrium to pulmonary artery)

47
Q

what is a vesicant drug

A

any drug that can cause tissue damage when it escapes the vein and enters the surrounding tissue

48
Q

what is extravasation

A

when a vesicant medication gets out of the vein and into the surrounding tissue

49
Q

what is speed shock

A

a systemic reaction caused by administering an IV med to quickly and it creates toxic levels of medication in the plasma

50
Q

what amount of urine does an adult and an older frail pt have to be retaning before a catheter is indicated

A

residual volume has to be greater than 500 ml in an adult and greater than 250 mL in a frail older client

51
Q

what is a coude tip catheter

A

an attachment that is used for males with enlarged prostates which makes it easier to insert the catheter

52
Q

what are indications that it is time to remove a urinary catheter

A

H-hematuria
O-Obstruction
U-urology surgery (or general surgery)
D-Decubitus ulcer (person is incontinent with stage 3 or 4 pressure ulcer)
I-Input output (if you need to track input output in critically ill patients)
N-Nursing end of life comfort care
I-immobilization

53
Q

what is the houdini decision support tool used for

A

it gives you a list of conditions and if none of them are present the nurse should remove the urinary catheter

54
Q

can a nurse independently remove a catheter without doctors orders

A

Yes they can

55
Q

when should a catheter drainage bag be emptied

A

when it is less than 2/3 full or at least every 8 hours

56
Q

how often should a urinary catheter be changed

A

every 8-12 weeks

57
Q

how often should a catheter bag be changed

A

should be changed monthly

58
Q

how far do you pull the syringe back when removing the saline solution from the catheter

A

pull back 0.5 mL to prevent adherence and create a vaccum so it draws out the liquid from the balloon

59
Q

what would a nurse have to monitor after removing a catheter

A

have to monitor for the time of first voiding and the amount voided after 8 hours

60
Q

what is normal serum potassium levels

A

3.5-5.3 mmol/L

NRSG 201 (12 decks)

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