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MT IV therapy
MT NHCC IV therapy
| Question | Answer |
|---|---|
| What are the 4 purposes of intravenous therapy? | Replace or maintain fluids, correct electorlyte imbalance, provide nutrition and deliver medications |
| What are the 4 ways that medication is delivered through IV's? | Primary bag (Heparin), Piggyback (antibiotics), Saline lock, IV push |
| What is a consideration when giving antibiotics by IV piggyback? | Need to think about compatibility |
| What are the 5 things that must be inclued in Total parenteral nutrition? | Dextrose concentration, Amino acids, Lipids, Vitamins, D10 or D50 |
| What is D10 and D50? | Very concentrated carb solution |
| When is a hypotonic IV solution used? | Want to give person extra water without electrolytes. Want to rehydrate them |
| When is an Isotonic IV solution used? | Given during & after surgery, Maintain fluid balance, Replace fluids |
| When is a hypertonic IV solution used? | Least common. Given for very specific reasons such as cerebral edema, Hyponatremia. Need to be very aware of lung sounds. Can put someone into CHF. |
| What is the indication for a hypotonic IV solution? | Rehydrate cells |
| What is the indication for a Isotonic IV solution? | Expand ECF |
| What is the indication for a hypertonic IV solution? | Pull fluid from cell |
| Type of solution used in Hypotonic IVs? | DW5 and 0.45% NaCl |
| Type of solution used in Isotonic IVs? | 0.9% NaCl, LR |
| Type of solution used in Hypertonic IVs? | 3% NaCl, 5% NaCl |
| What is another name for a mini-drip chamber? | micro drip |
| What is the the drop rate per ml of a mini drip chamber? | 60gtt/ml |
| What is the drip rate of a macro-drip chamber in ml? | 10, 12. or 15 gtt/ml |
| What is macro-drip tubing used used for? | is used when ansolution needs to infuse more rapidly |
| What is micro-drip tubing used for? | Less risk of flowing in too rapidly if the IV needle or catheter changes positions in the client's vein. |
| What types of fluids are given to Replace or maintain fluids? | Sodium chloride, Dextrose, Lactated Ringers |
| What types of fluids are given to · Correct electrolyte imbalance? | Sodium chloride, Potassium (typically IVPB), Calcium |
| What types of fluids are given to Replace or maintain fluids? | Sodium chloride, Dextrose, Lactated Ringers |
| What types of fluids are given to · Correct electrolyte imbalance? | Sodium chloride, Potassium (typically IVPB), Calcium |
| What type of IV fluids must be vented? | Meds that are given from a bottle. Ex. Nitroglycerin. Both bottle and tubing must be vented. |
| What is the purpose of D5W? | D5W – Adds enough calories to prevent ketosis. Dextrose is quickly metabolized. |
| What is Ringer’s solution used for? | Replaces fluids, sodium, potassium, calcium, & chloride |
| What is Lactated Ringer’s used for? | Ringer’s plus lactate-precursor bicarbonate → used for metabolic acidosis |
| What is blood volume expanders? | used to increase volume of blood, dextran, plasma, human serum albumin |
| State the purpose of the controller and dial A-Flow Regulator? | The purpose of a controller is to regulate the amount of fluid going into the IV |
| What are 3 types of controllers? | Manual (RN counts drips and sets drip rate via clamp), Machine (IV pump, most often used), Dial-a-Flow (RN sets dial to desired flow rate) |
| How often should the nurse assess the IV? | should be made hourly for a client with an IV (An hour is the minimum standard.) |
| What should the RN check at the beginning of the shift? | Fluid type, Amount, Flow rate, IV site, Assess client for signs of fluid volume deficit or fluid volume overload, Flow sheet |
| What should the RN assess on the IV site? | Swelling, Redness, Dressing (dry & intact) Check for tenderness |
| What should the RN monitor on a patient receiving IV therapy? | response to therapy – will depend on IV solution & patient condition, for complications |
| What are the 3 Most common complications? | Infiltration, Phlebitis, Thrombus |
| What are the complications of IV therapy? | Infiltration, Phlebitis, Thrombus, Fluid overload, Air emboli Infection, Allergic reaction – more common w/ medication |
| What causes Infiltration? | Dislodged needle, Penetrated vessel wall |
| What are the signs and symptoms of infiltration? | Swelling, pallor, coldness or pain around the infusion site; significant decrease in the flow rate |
| What causes Phlebitis? | Mechanical trauma from needle or catheter, Chemical trauma from solution, Septic (due to contamination) |
| What are the signs and symptoms of Phlebitis? | Local, acute tenderness; redness, warmth and slight edema of the vein above the insertion site |
| What causes Thrombus? | Tissue trauma from needle or catheter |
| Why is it important to keep the IV system intact during the client’s gown change? | Don’t have to redo IV, Don’t contaminate any part of it |
| For which clients would it be especially important to keep the line closed? | Immunosuppressed clients, Infection, Diabetic, Wound healing |
| What are 3 problems that can occur when there is an alteration in the rate of flow? | Infiltration, Fluid overload/alteration, too much or not enough medication |
| What are 2 measures that can be taken to eliminate air from IV tubing? | Don’t let bag run dry. Flush the line/tubing |
| Your client has an IV in place for fluid replacement. You enter the client’s room to find the IV is 4 hours behind. What would you do? | Assess client & site, Check line, saline flush, Adjust to correct rate |
| How would you explain infiltration to a client? | Depends on the client, The fluid escaped into surrounding tissue, We’re going to have to change sites, Comfort measures, I’ll keep an eye on it, This happens |
| What interventions should be taken when infiltration occurs? | Stop IV, Call IV team, Change site, Notify MD if medication |
| When would you anticipate that Hypotonic IV fluids would be ordered? | Dehydration |
| When would you anticipate that Isotonic IV fluids would be ordered? | Surgery, fluid maintenance |
| When would you anticipate that Hypertonic IV fluids would be ordered? | cerebral edema, hyponatremia |
| What are the signs and symptoms of Thrombus? | Symptoms similar to phlebitis. IV fluid flow may cease if clot obstructs needle |
| What causes Fluid Overload? | Too large a volume of fluid infused into circulation |
| What are the signs and symptoms of Fluid Overload? | Engorged neck veins, increased BP and dyspnea |
| What causes Infection? | Non-sterile technique used in starting, infusion- Improper care of infusion site- Contaminated IV solution |
| What are the signs and symptoms of Infection? | Fever, malaise and pain, swelling, inflammation or discharge at the IV site |
| What are the nursing considerations for Infiltration? | - Discontinue the infusion if symptoms occur, Restart the infusion at a different site, Limit the movement of the extremity with the IV |
| What are the nursing considerations for Phlebitis? | - Discontinue the infusion immediately- Apply warm moist compresses on the affected site- Avoid further use of the vein- Restart the infusion in another vein |
| What are the nursing considerations for Thrombus? | - Stop the infusion immediately- Apply warm compresses as ordered by the physician- Restart the IV at another site- DO NOT RUB OR MASSAGE THE AFFECTED AREA! |
| What are the nursing considerations for Fluid Overload? | - If symptoms develop, slow the rate of infusion- Notify the physician immediately- Monitor VS- Carefully monitor the rate of fluid flow |
| What are the nursing considerations for Infection? | Use scrupulous aseptic technique, when starting an infusion, Change the dressing over the site regularly, Change the IV tubing per agency policy- Always wash hands before working with IV |
| What is the most common way to give patients medications by IV? | IVPB |
| What are the two ways to give medications by IV? | IV Push and IV Piggyback |
| How are IV Push medications given? | can be given through a mainline IV or an intermittent infusion device. Medications are usually injected over 1 minute or longer, according to drug literature. |
| How are IVPB medications given? | uses gravity to determine flow rate. A roller clamp is used to adjust the flow rate of these infusions as well. The secondary solution is plugged into an intermittent IV infusion device using long tubing, or it is added to a primary IV line using either |
| What interventions should be taken when infiltration occurs? | Stop IV, Call IV team, Change site, Notify MD if medication |
| Describe specifically what you would do if Blood backs up tubing when your client gets up to walk? | Lift tubing & bag higher |
| Describe specifically what you would do if Air bubbles are in the tubing? | Depends on how much. May need to prime line. Tap line. Insert open syringe at port |
| Describe specifically what you would do if IV bag ran dry and there is only air in the drip chamber? | get new bag, do saline flush |
| Describe specifically what you would do if IV site looks fine, but the IV is not running? | Check clamps, infiltration, saline flush |
| Describe specifically what you would do if IV fluid level indicates that the IV is running ahead? | Assess client, adjust rate |
Created by:
2007Nurse
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