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NRSG 202 > Seminar 9 > Flashcards

Seminar 9 Flashcards

(50 cards)

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1
Q

what volume can be IV pushed

A

less than 20 mL

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2
Q

What certain conditions must be met in order for a RN to give a medication IV push

A
  • the rate is appropiate for staying at the bedside to monitor.
  • the medication is approved this way by pharmacy.
  • the volume is less than 20 mL
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3
Q

why are some meds better to be given through a CVAD

A

certain medications are bigger to give in a larger vessel due to their vesicant or irritating properties.

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4
Q

what things can cause a catheter occulusion

A
  • clamped or kinked catheter
  • tip against wall of vessel
  • thrombosis
  • precipitate buildup in the lumen
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5
Q

signs and symptoms of a catheter occulsion

A
  • sluggish infusion or aspiration
  • unable to infuse and or aspirate
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6
Q

What are some interventions the nurse can take to try and trouble shoot a catheter occlusion

A
  • instruct pt to change position, raise arm and cough.
  • assess for and alleivate clamping or kinking
  • flush with NS using a 10 mL syringe (do not force)
  • fluoroscopy to determine cause and site
  • anticoagulant or thrombolytic
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7
Q

What are the causes or a embolism

air, catheter or thrombus

A

-catheter breaking
- dislodgement of thrombus
- entry of air into circulation

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8
Q

S+S of an embolism

air, catheter or thrombus

A

chest pain, resp distress, HoTN, tachycardia

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9
Q

What interventions can a nurse do to deal with a embolism

air, catheter or thrombus

A

-clamp catheter
- place pt on left side with head down. (if air suspected)
- admin oxygen
- notify MRP

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10
Q

If an air bubble travels to the brain, heart, or lungs, it can cause a

A

MI, CVA, or resp failure

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11
Q

if pt has a suspected venous air embolism what should the nurse do

A

place client on left side in trendelenberg position

encourages bubble into right atrium

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12
Q

If pt has an suspected arterial air embolism, what should the nurse do

A

the nurse should keep client in supine flat position

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13
Q

causes of a catheter related infection

A
  • contamination during insertion or use.
  • migration of organisms along catheter.
  • immunosuppressed client
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14
Q

S+S of a catheter related infection, local and systemic

A

local: red, swelling, warmth, purulent drainage, tenderness
systemic: fever, chills, malaise

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15
Q

What interventions can the nurse take to help a catheter related infection that is local in nature

A

-culture of drainage from site
- warm, moist compress
- catheter removal if indicated

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16
Q

what interventions can the nurse take to treat a systemic catheter related infection

A
  • blood cultures
  • abx therapy
  • antipyretic therapy
  • catheter removal if indicated
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17
Q

What can cause a pneumothorax or hemothorax

A

inadvertent puncturing of lung at the time of inserting needle into the vein

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18
Q

what are S+S of a pnemothorax or hemothorax

A
  • decreased or absent BS
  • resp distress
  • chest pain
  • distended unilateral chest
  • decreased or absent breath sounds
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19
Q

what interventions can the nurse take to help a patient with a pneumothorax or hemothorax

A
  • position in semi-fowlers
  • admin oxygen
  • adminster analgesic if ordered
  • prepare for x-ray/chest tube insertion
  • call MRP STAT
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20
Q

What are some causes of a catheter migration

A
  • improper suturing
  • insertion site trauma
  • changes in intrathoracic pressure
  • forceful catheter flushing
  • spontaneous
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21
Q

what are S+S of catheter migration

Study These Flashcards
A
  • sluggish infusion or aspiration
  • edema of chest or neck during infusion
  • client complaint of gurgling sound in ear
  • dysrhythmias
  • increased external catheter length
22
Q

What interventions should be done if the nurse suspects catheter migration

Study These Flashcards
A
  • fluoroscopy to verify position
  • assist with removal and new CVAD placement
23
Q

What are some causes of a catheter causes arrhythmia

Study These Flashcards
A

line advances into right atrium which irritates the heart

24
Q

S+S of a catheter induced arrhythmia

Study These Flashcards
A
  • palpitations or pounding in chest.
  • tachycardia/bradycardia
  • chest pain/discomfort
  • SOB
  • weakness, fatigue, dizziness
25
what are some interventions that can be done for a patient who is experiencing catheter arrhythmia
- medications. - vasovagal maneuver - cardioversion/ defibrillation/ pacing - catheter procedures (ablation) - pacemaker - heart surgery
26
On PICC lines that have a zero, where should the nurse start counting
measure from the zero to the insertion site | Power PICCS and power PICC solo
27
On PICC lines without visible markings, how should the nurse measure
measure from the hub to the insertion site | ex, PICC with groshong valve
28
In addition to the 10 med rights, IV meds require additional checks, what are these
1. Dilution: does the med need to be diluted. 2. Compatibility: is it compatible with other fluids/meds in the same IV line. 3. Rate/duration: how long is the med administered over | found on parenteral manual
29
what things need to be on a medication label
1. drug name 2. dose/volume (concentration) 3. route 4. 2 patient identifiers
30
The nurse can use pre-fille saline syringes for medications. **true or false**
False! do not do this
31
What needs to be to abx kept in the fridge
they need to be warmed prior to admin- set at room temp for about 30 minutes
32
What type of needle should be used when drawing medication from a ampoule
a filtered blunt needle
33
if a drug is not listed on a the parenteral compatibility list, what should the nurse assume
that it is incompatible
34
when administering a IV push medication into an incompatible solution, what needs to be done if the incompatible solution is running via IV infusion.
the running IV needs to be stopped and the line flushed before and after each medication with 10 mL NS.
35
when giving IV opioids, the nurse always needs to be sure to check
baseline vitals (BP, HR, RR) and sedation scale prior to med admin
36
How many mls is needed to flush a peripheral line
3-5 ml NS
37
how many mls is needed to flush a central line
10 ml NS
38
how many mL's does the nurse need to flush a saline locked peripheral line with post medication administration
10 mL of NS
39
how many mls does the nurse need to flush a saline locked central line with, post med admin
20 mL of NS
40
after giving a med via a saline locked line, what does the nurse need to ensure when flushing post medication
The the first 5-10 mL is given at the same rate as the med, and the following 5-10 is given with push pause method
41
what size syringe should be used for patency/flush with VADS
10 mL or larger
42
What technique do you need to use when locking a VAD
positive pressure disconnect technique (this is while pushing the plunger slightly)
43
what is drug speed shock
a systemic reaction cause by the rapid injection of a medication into the cirulation, results in toxic levels of medication in plasma
44
S+S of drug speed shock
flushed face, HA, chest tightness, irregular pulse, syncope, shock, cardiac arrest
45
what is chemical phlebitis
inflammation of the vein caused by the medication infused through a catheter
46
what are S+S of chemical phlebitis
erythemia, edema, pain, palpable venous cord
47
what is infiltration/extravasation
medication inadvertently injected into surrounding tissue of IV site
48
what are S+S of infiltration/extravastion
tenderness, pain, tissue necrosis, nerve damage
49
what practices can lead to potential adverse drug events
- unlabeled/mislabeled syringes - syringe to syringe transfer - unnecessary dilution - use of saline flush syringes to dilute IV medication
50
what volume of flushes/med needs to be documented on the in and out record
20 mL

NRSG 202 (11 decks)

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