WEEK 4 IV THERAPY

Question 1

What is the term for IV solutions that contain solutes that mix, dissolve, and cross semipermeable membranes?

Answer 1

Crystalloids

Question 2

What is the term for IV solutions that contain protein or starch, and do not cross semi-permeable membranes?

Answer 2

Colloids

Question 3

Name 4 examples of crystalloid solutions

Answer 3

Dextrose, NS, Lactated ringers, plasmalyte

Question 4

Name 4 examples of colloid solutions

Answer 4

Dextran, pentaspan, hetastarch, blood products

Question 5

What are 2 disadvantages of crystalloid solutions?

Answer 5

3x volume required for fluid replacement
Shorter half life

Question 6

What is one advantage of crystalloid solutions?

Answer 6

Inexpensive

Question 7

What are 2 advantages to colloid solutions?

Answer 7

Replaces fluid volume for volume
Longer half life

Question 8

What is one disadvantage of colloid solutions?

Answer 8

More expensive

Question 9

What fluid compartment is affected by isotonic solutions?

Answer 9

Extracellular fluid

Question 10

Name 3 examples of isotonic solutions

Answer 10

Ringer’s, NS, D5

Question 11

What fluid shift is caused by hypotonic solutions, and for what purpose is this used?

Answer 11

From extracellular fluid to intracellular fluid; maintenance fluid

Question 12

What is the risk with hypotonic solutions?

Answer 12

Cell swelling

Question 13

Name one example of a hypotonic solution

Answer 13

NS 0.45

Question 14

What fluid shift is expected with hypertonic solutions, and for what purpose is it used?

Answer 14

From intracellular fluid to extracellular fluid; used to treat hypovolemia and hyponatremia

Question 15

What are 2 risks associated with hypertonic solutions?

Answer 15

Intravascular fluid overload and intracellular dehydration

Question 16

Name 2 examples of hypertonic solutions

Answer 16

Dextrose 10%, NS 3%

Question 17

What is the purpose of plasma expanders?

Answer 17

Increase osmotic pressure

Question 18

Why does hypokalemia develop in patients with normal renal function who are NPO?

Answer 18

The body cannot conserve potassium

Question 19

Why is knowing renal function important when administering potassium?

Answer 19

Risk for hyperkalemia

Question 20

How should potassium always be administered?

Answer 20

By IV pump and never IV push

Question 21

How is placement of a central venous catheter confirmed?

Answer 21

X-ray

Question 22

What are 2 things langara students can do with central lines?

Answer 22

Assess
Manage fluids/medications above the pump

Question 23

What are 3 principles to remember when choosing an IV site?

Answer 23

1. In children and older adults, avoid sites that are easily moved/bumped
2. Avoid arm on same side as mastectomy or AVG for dialysis
3. Place at most distal site possible to allow for use of proximal sites later

Question 24

What are 2 risks with an infusion rate that is too slow?

Answer 24

1. CVS compromise/collapse
2. Clot formation/loss of IV site

Question 25

What is the term for inadvertent administration of fluids into the tissues surrounding the blood vessel?

Answer 25

Infiltration

Question 26

What is the term for inadvertent administration of medication/irritating substances into the tissues surrounding the blood vessel?

Answer 26

Extravasation

Question 27

What are 6 symptoms of infiltration/extravasation?

Answer 27

1. Pallor 2. Swelling 3. Pain 4. Skin cool to touch (one sided only) 5. Damp dressing 6. Slowed infusion rate

Question 28

What are 5 things done to treat infiltration/extravasation?

Answer 28

1. Stop infusion, remove catheter 2. Elevate extremity 3. Active ROM 4. Warm/cold compress 5. Restart infusion proximal to site or in other extremity

Question 29

What are 2 things done to prevent infiltration/extravasation?

Answer 29

1. Choose site and catheter carefully 2. Secure catheter well

Question 30

What are 3 symptoms of phlebitis that differ from symptoms of infiltration?

Answer 30

1. Increased skin temperature 2. Erythema 3. Red line along vessel with palpable band

Question 31

What are 3 things done to prevent phlebitis?

Answer 31

1. Rotate sites every 7-8 days 2. Avoid lower extremities 3. Hand hygiene and surgical asepsis

Question 32

What should be done at an IV site with phlebitis that has drainage present?

Answer 32

Swab for culture

Question 33

How is cellulitis different from phlebitis?

Answer 33

Cellulitis is bacterial infection to the skin while phlebitis is irritation to the blood vessel

Question 34

How is catheter embolus prevented?

Answer 34

Never reinsert stylet into catheter

Question 35

How often should site to source checks be performed?

Answer 35

q1h

Question 36

What are advantages of administering medications via minibag?

Answer 36

1. Medication diluted - decreased risk of adverse reaction 2. Good for medications with short stability 3. Good for clients with fluid restrictions

Question 37

About what rate is considered TKVO?

Answer 37

25 ml/hr