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ch. 36 IV sol+med
fundamentals 2
| Question | Answer |
|---|---|
| what is the main route to supply the patient with fluids and medications when the patient is not able to take them orally? | IV or intravenous |
| what are the advantages of giving IV drugs | they are instantly available to all tissues |
| when a patient in put on IV fluids what must be done to monitor them for fluid overload? | They must be placed on INTAKE & OUTPUT recording(I & O) |
| examples of substances given by IV route. | fluids, electrolytes, meds, blood , plasma, other blood components, glucose, AA's, lipids,saline |
| 1500-2000L of fluid | the average amount of fluid average adult needs in 24 hours |
| common electrolytes replace via IV | NA, K, Cl. ordered by docotor |
| Isotonic IV solution | same osmolality as blood,expands fluid volume of body. used for electrolyte replacement |
| Hypotonic IV solution | less solute more extrcellular fluid, may cause fluid shift out of vascular space. used for electrolyte replacement |
| Hypertonic IV solution | have greater tonicity than blood. used for electrolyte replacement |
| patient with head injury would be given what type of IV fluid to draw fluid out of the cells? | glucose, mannitol, sucrose. reduces cerebral edema |
| these are used to dilutedrugs for parenteral use | sterile water, desxtrose in water, normal saline |
| Normal Saline is? | Isotonic, and 9% used for trauma, diabetic ketoacidosis, with blood transfusion, Hyponatremia |
| Hyperkalemia | high level of potassium in blood. see in burn vicitums, people with Renal failure, trauma |
| Hyponatremia | low blood sodium levels because of poor excretion of water. give them normal saline IV |
| 3 types of IV sets | primary, secondary or piggyback, parallel or Y IV sets |
| when should IV tubing be changed? | every 24-72 hours or by site policy, iv bag should be labeled with date and time |
| Primary IV infusion set is used for all fluids except? | Blood products because they need special filter in drip chamber |
| Primary IV set delivers different drop amounts, what are regular drops? | 10-20gtt/ml used for most adults |
| Primary IV set delivers different drop amounts, what are macrodrops drops? | 10 ggt/ml used for viscous fluid like blood, also for regular fluids |
| Primary IV set delivers different drop amounts, what are microdrops? | 60 ggt/ml used for small amounts of exact fluid, for infants, children and elderly |
| Medications(antiobiotics, antineoplastics) are give via the IV set type? | piggyback. |
| Antineoplastics | chemo therapy drugs given IV |
| antiobiotics, antineoplastics drugs should not be given how? | In a Bolus dose! |
| This IV set type is used to give Blood products? | Y-type, usually has normal saline(other solutions will cause blood cells to lyse or clump) on one side of the Y. saline is started first and then blood. saline stoped once blood started, line is flushed with saline when blood finished. |
| this is used as a backup to prevent fluid overload in conjuction with a infusion pump? | controlled-volume IV set(goes between IV bag and entry to infusion pump) |
| Burette is what and is where | tubelike chamber that holds a small amount of liquid that drips into the iv tubing |
| Intermitten access device | used to give patients meds that don't need continious or large amount of IV fluids. called saline lock, PRN lock, INT lock has a catheter cap on the end and IV tubing is removed. |
| What is flushed in a intermmitten Lock to keep it patent(open) or from forming a clot? | Saline or diluted Heparin |
| These prevent particles from entering the vein | Filters( blood needs 1.2 micron) |
| People on TPN or meds that need almost 100% accuracy must be on what(ex:heparin,cardio,chemo drugs)? | Programmed Infusion pump |
| When IV fluid is deposited outside the vein this is called? | Infiltrated |
| CADD-PCA, | these pumps deliver specific amounts of pain meds or Analgesics |
| 3 types of devices used to prevent needle sticks? | Butterfly needle(for elderly, infants), over the needle catheters, through the needle cath. |
| when petipheral vein is hard to find where is cat inserted? | large subclavianvian vein and positioned insuperior vena cava or right atrium. can stay in for 6-8 weeks. |
| where are PICC lines or mid line cathers placed? | uppper arm in the Cephalic or Basilic vein |
| Catheter embolus | piece of the catheter obstructing blood flow |
| Infiltration | most common, fluid leaks out of th vein into the tissue, will see edema around the site and TISSUE WILL BE COOL TO THE TOUCH,pale. discontinue infusion |
| Phlebitis | iritation of vein by the needle, catheter, medication or additives in the IV solution. signs:erthema, warmth, swelling, tenderness |
| Bloodstream infection | Septicemia, infectious agents are introduced into the bloodstreamsigns: fever, chills, pain, headache. stop immediately and oder blood cultures |
| IV complications | Speed shock- fluids or meds given by Bolus are given to quickly |
| check IV sites how often? | at least once a hour, document findings |
| before starting blood infusion what should be done 1st? | get baseline Vital signs |
| before giving nest dose of IV fluids check for what? | adverse effects of previous given med, check for signs of infection or inflammation |
| how much IV fluid is given and over what peroid of time? | 1000mL over 8, 10, 12 hour peroid. put time tape on bag to see if patient is getting needed IV fluid over time. |
| most used site for pherpheral IV's | veins of forearm and hand |
| least used pherpheral IV's site and why | antecubital because mivement causes irritation or damage to vein, keeping arem extended may cause muscleor nerve damage |
| Venoscope is what | tool used to illuminate the tissue and outline the vein when hard to see |
| when doing venipuncture in the elderly's fragile veins what can help? | using a blood pressure cuff. 6 in above selected site, inflate to 10 mm Hg above diastolic pressure |
| these promote the growth of fungal infections and antimicrobial resistance | antibiotic ointments at IV insertion sites |
| preferred site for infusions or intermittent doses of meds? | veins most distal to the Antecubital area is used 1st because a new site cannot be placed distal to an old site! Cephalic, basilic and the Antebrachial veins of the lower arms and the back of the hand |
| for infants the veins where are used? | inthe scalp and the foot last if no other veins are available |
| check IV flow rate when? | after patient has ambulated, return from a test, been turned in bed, been up to bathroom |
| when giving Potassium chloride or antibiotics how are the administered? | they are usually diluted in 50-250 ml of fluid, because they are irritating to the veins |
| what electrolyte is never given as a bolus because it can cause Cardiac Arrhythmia and arrest? | Potassium(must be diluted in afluid) |
| lidocaine(Xylocaine)(?hydrochloride) | can be given via bolus or infusion, antiarrhythmic agent |
| Heparin | anticogulant(in form of sodium salt) |
| signs to monitor for a Heparin drip infusion? | patient brusing, bleeding gums, blood in stool or urine. NURSING STUDENTS DO NOT CHANGE HEPARIN INFUSION DRIPS!! |
| Speed shock | a systemic reaction that occurs when substances unfamilar to the body are infused rapidly. signs of this are: lightheadness, tightness of chest, flushed face, irregular pluse. cardiac arrest may occur! |
| primary bag of fluids is composed of what? | Potassium |
| potent drugs and irratating drugs are diluted in what? | 1000mL of fluid(drugs:K,insulin, sodium bicarbonate, Ca ,magnesium sulfate, vit B & C |
| IV Push or Bolus | giving medication directly into vein over a few minutes. via injection port on Iv tubing, PRN lock, or direcly in vein. LPN'S don't give bolus injections! |
| Antineoplastic medications? | destroy or alter growth of maglinant cells and are toxic to normal and abnormal cells, are chemotherapy drugs |
| Transfusion | IV administratin of blood or it componenets. include plasma,packed red blood cells, platelets |
| Autologous | from the patients own body-blood from patient is reinfused after surgery |
| short term IV therapy | up to 2 weeks |
| TPN is given how? | through a central line because very irritating to the peripheral veins and can lead to Thrombophlebitis(vein inflamation followed by a clot) |
| when giving TPN assess patient for? | weight gain,blood glucose level, |
| when fluids are givento hydrate patient assess for? | good skin tugor, I & O , moist mucous membranes |
| when giving antibiotics check for signs of what? | temp, infection clearing on any wounds,allergic reactions, ck Leukocyte count |
| where is documentation done for mecication? | on the MAR |
| before attaching new IV connectors, adaptors, or IV tubing what should be done 1st? | clean the port with an alcohol swab prior to flushing or interrupting the system |
| what technique is used when handling IV fluids and tubing? | Aseptic technique because iv sites provide access for bacteria to enter the bloodstream |
| What is chlorihidine? | antimicrobial agent used at IV insertion site |
Created by:
VRoberts
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