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Pediatrics Ch22
IVs, TPN
| Question | Answer |
|---|---|
| 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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