| Term |
 |
|
| Description |
|
|
| IV Therapy Indications |
fluid volume maintenance, fluid volume replacement, med administration, blood administration, TPN, emergency line, |
| Advantages of IV Therapy |
faster absorption, rapid distribution, emergency access, unconscious patient |
| Infection Control in IV |
70% isopropyl alcohol inhibits bacterial growth, apply with friction; Iodine, inhibits bacterial growth, penetrates cell wall |
| IV and Dressing changes |
PICC-every 6 weeks, IV inserted by paramedic w/in 24 hours, Peripheral site every 72 hours, Blood and TPN every 24 hours, CVC every 48-72 hours or 3xper week. |
| Nursing responsibilities for IV sites |
assess site whenever in room, document at least every 8 hours, site CDI (clean, dry, intact), sterile technique, changine tubing and solution, awareness of complications, awareness of fluid types, 5 rights |
| Complications of IV therapy |
Pain and irritation, infiltration and exravasion, occlusion, loss of patency, phlebitis, fluid overload |
| Pain and irritation of IV-intervention |
increase amt of dilutent, arm board |
| Infliltration |
seepage of IV fluids into tissue when IV cath penetrates vein |
| Extravasion |
escape of irritating agent into tissue |
| Extravasion and Infiltration Assessment |
swelling, pain, cool to touch, decreased flow, wet dressing, no back flow. |
| Causes of Infiltration and Extravasion |
catheter permeates vein, poor taping of site, over manipulation |
| Intervention for Infiltration and Extravasion |
Remove IV, cool compress |
| Occlusion causes |
kinked tubing, patient lying on tubing, infusion too slow |
| Occlusion assessment |
IV stops dripping |
| Occlusion intervention |
milk IV, aspirate, irrigate (if no resistance OK, if resistance may be clot> |
| Occlusion Prevention |
don't let IV run dry, flush periodically with 1-5 cc of NSS and before and after any intermittent IV therapy. |
| Phlebitis Causes |
bacterial, chemical, mechanical |
| Phelebitis Intervention |
remove IV, cool compress |
| Phlebitis Assessment |
erythemia, pain or burning, warmth, edema, cordlike vein. |
| Bacterial Phlebitis possible cause |
IV left in too long |
| Chemical Phlebitis Cause |
irritating fluids |
| Mechanical Phlebitis |
clot at tip of cannula, cath too large for vein. |
| Crystalloids |
clear fluids, dextrose of saline, can be Iso, Hypo or Hyper tonic |
| Colloids |
cloudy, yellowish, used to raise osmotic pressure, Dextran is clearish |
| Isotonic IV |
same tonicity as body 0.9% NSS |
| Indications for Isotonic IV |
Hypotension (increases BP), Hypovolemia |
| Complications of Isotonic IV |
fluid overload |
| Examples of Isotonic Solutions |
0,9% NSS, D5W(isotonic in bottle, hypotonic in body), Lactated Ringers |
| Indications for Hypotonic IV |
Will cause fluid to shift from intravascular to intracellular space. |
| Indications for Hypotonic IV |
dehydration |
| Hypotonic Solutions |
.45% sodium chloride, 5%dextrose water (becomes hypotonic in body) |
| Complications of hypotonic solution |
May cause edema |
| Indications for hypertonic IV |
low bp, slight edema but not w/CHF, pulls fluid from intracellular space to intravascular space |
| Hypertonic IV Solution |
Not as strong as Albumin, 10% Dextrose in Water D10W, 5% normal saline, D5 Ringers Lactate |
| Complications of Hypertonic IV |
more fluid in bloodstream can cause circulatory overload. |
| PCA |
Patient Controlled Analgesia |
| 3 settings of PCA |
drug dosage, lockout period, basal rate |
| Central Venous Therapy Indications |
inadequate vascular access, complex treatment regimes, hyperosmolar infustions ie parenteral nutrition, irritating or vesicant druges, (ie. dopamine cancause necrosis) rapid absorption, long term therapy. |
| Contraindications for Central venous therapy |
altered skin integrity, anomalies of central vasculature, cancer in area, coagulopathies, fractured clavicle, septicemia, radiation to insertion site |
| Common insertion pathways for Central Venous Therapy |
subclavian, jugular, femoral vein, cephalic vein(is peripheral but the line runs to central area) |
| Risks and Complications of Central Venous Therapy |
Air embolism, pneumothorax, sepsis,chest pain, confusion, hypotension, dyspnea, pallor, tachycardia, tachypnea, unresponsiveness |
| Components of Intravenous Nutritional Support |
amino acids, carbohydrates, electrolytes, minerals, vitamins, lipids, other (ie insulin) |
| Lipids in Intravenous Nutritional Support |
lipids are administered via Piggy back. (white, thin liquid) |
| Cautions for IV nutritional support |
not refrigerated, observe for spoilage (fat on top, discoloration), expiration dateNo filter. , must be infused on IV pump, glucose monitored, gradual weaning. Daily weights, |
| Complications for IV nutritional support |
hypoglycemia, hyperglycemia, dehydration, infection |
| Indications for IV Nutritional Support |
bowel surgery, chronic weight loss, bowel rest, coma, excess nitrogen loss, hepatic or renal failure, malnutrition, low serum albumin, hypermetabolic states |
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