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Pediatrics Ch22

IVs, TPN

QuestionAnswer
What does a nurse monitor an IV site for Infiltration, Inflammation, Patency
What can IV medications cause Phlebitis
How often must the nurse observe an IV site Every hour
Who is most at risk for infiltration Active children
What signs can indicate infiltration Leakage, Tense turgor, Cool skin, Blanched skin
Why can adverse reactions occur to IV medications occur within seconds Reaches the heart and brain
What can cause fluid overload Rapid IV flow rate
What are the signs of fluid overload Increased pulse, Increased blood pressure, Distended neck veins, Puffy eyesWhat can a slow IV infusion rate cause
What does the nurse monitor for IV lines Flow, Burettes, Site condition, Child’s responses
What can prepare children for an injection and make them less frightened of it Giving injections to dolls or puppets
What are infusion pumps used for Controlling administration of small volumes of fluid, Prevent changes in rate from position changes or activity
What should always be given to infants who are NPO Pacifier
What is another name for saline lock Heparin lock
What is another name for heparin lock Saline lock
What is a heparin lock Device that keeps a vein open for intermittent medicine administration
Describe the physical characteristics of a heparin lock IV needle attached to ¾ inch tubing, plugged by a resealable rubber insert
What prevents clotting with a heparin lock Periodic flushing with saline or heparin solutions
What is a peripherally inserted central catheter (PICC) used for Moderate length therapy
What is the internal path for a PICC The median, cephalic, or basilica vein in the antecubital area threaded into the superior vena cava
Who inserts PICC lines Specially trained RNs
What are the IV infusion sites for children Scalp, Subclavian, Dorsal hand, External jugular, Forearm, Dorsal foot veins
What are tiny, flexible tubes that can be inserted into a vein in the chest for long term IV access Hickman, Goshong, Broviac catheters
What products can be delivered through long term central venous access devices Medications, Chemotherapy, Fluids, Blood products, Hyperalimentation, TPN
What is hyperalimentation TPN
Which long term central venous access device is used for children Pediatric broviac
How long does a pediatric broviac catheter remain in place 1 month to 1 year, or longer
How often are pediatric broviac catheters flushed Daily or Weekly
What should be done if a pediatric broviac catheter leaks Tubing should be taped, a clamp applied, and medical intervention obtained
What is an implanted port Infusion port implanted under the skin into a large central vein, generally beneath the clavicle
What is the advantage of an implanted port Nothing protrudes from the body that can be dislodged, and it is less apparent
What is curtailed with an implanted port Vigorous contact sport and playing with the bulge created by the device
How is an extremity that an IV catheter is inserted into for parenteral nutrition positioned Restrained on an arm board
What are adult IV pumps set for 15 drops/ml
What are pediatric IV pumps set for 60 drops/ml
How much fluid should a burette contain 1 hour’s worth
What does a nurse observe a burette for Low bag and burette volume, Flow rate, Insertion site condition, Moisture at or around insertion site
What is documented for all children receiving IV fluids I&O
What can occur with TPN Hypoglycemia, Hypercalcemia, Electrolyte imbalance
How is TPN discontinued Gradual rate reduction
What is the best IV site for an infant Scalp – foot, hand, forearm
What is the best IV site for toddlers Nondominant hand, arm, foot
What is the best IV site for children who are not infants or toddlers Nondominant hand or forearm
How is an infant prepared for IV insertion Not fed immediately before
How is a toddler prepared for IV insertion Immediately before explain in simple terms, Show equipment
How is a preschool child prepared for IV insertion Immediately before explain in concrete terms while demonstrating on doll, Allow to touch equipment, Let help, Tell ok to cry
How is a school age child prepared for IV insertion On the same day, Explain and demonstrate, Ask child questions, Let help, Tell ok to cry
How is an adolescent prepared for IV insertion Several hours to a day before, Approach on adult level
Created by: futurenurse
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