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Nursing 132

IV fluid administration

Dehydration sometimes produces hypo-tension and tachycardia
Fluid overload often results in hypertension and bounding pulses
sites to exclude for very young and older adult (these patients have fragile veins and this site may be easily bumped) The dorsal surface of the hand Areas of venous valves or bifurcation
sites to exclude infected site redness, tenderness, warmth at site/presence of exudate.Veins on ventral surface of the wrist,Veins in the antecubital fossa (bend)sites distal to previous vein puncture site (insertion needs to be proximal to compromise area)
ISOTONIC have the same osmolality as body fluids and are used most often to replace extracellular (intravascular) volume (e.g., simple dehydration after prolonged vomiting)
HYPO-TONIC have an osmolality less than body fluids and are used most often to hydrate cells (e.g., hypertonic dehydration, required water replacement)
HYPER-TONIC have an osmolality greater than body fluids and are used most often to increase extracellular fluid volume (e.g., replace electrolytes, treat shock)
Potassium chloride should never be given by IV push or added to a small volume of IV solution.
Potassium chloride is administered orally or as a premixed IV additive by pharmacy or the manufacturer in a larger volume of IV fluids.
Verify that the patient has adequate renal perfusion (i.e., at least 30 mL/hr urine output for adults) before administering IV fluids containing potassium chloride.
Infusion of blood products requires a blood administration set, which contains an in-line filter.
Dextrose 5% in water* Isotonic D5W Dextrose 10% in water Hyper-tonic D10W Dextrose 50% in water Hyper-tonic D50W
Saline Solutions 0.45% sodium chloride (half normal saline) 0.33% sodium chloride (one-third normal saline) 0.9% sodium chloride† (normal saline) 3% sodium chloride 5% sodium chloride Hypo tonic ½ NS, 0.45% NS Hypo tonic ⅓ NS Isotonic NS, 0.9% N, S 0.9% NaCl Hyper tonic 3% NS
Catheter Size (gauge)14, 16, 18 20 22 14,16,18 Trauma, surgery, blood transfusion 20Cont. or intermittent infusions,blood transfusion 22Continuous or intermittent infusions, children and elderly patients; administration of blood or blood products in pediatrics and neonates
catheter size 24-26 Butterfly needle (scalp vein needle) 24-26Fragile veins for intermittent or continuous infusions; administration of blood or blood products in pediatrics or neonates butterfly-Administration of IV fluids in infants
solution given rapidly needs to be infused with macro drip tubing, which delivers large drops (standard drop size is 10 or 15 gtt per mL, depending on the manufacturer).
Tourniquets are used to reduce venous return and cause distention in the veins where an IV catheter will be inserted
The veins of older patients are more fragile, and therefore a _________ __________ ________ may be used instead. blood pressure cuff
In infants, ______ _____ may be used because they are smaller than tourniquets. rubber bands
Because tourniquets can be a source of contamination, ________ ______ products are preferred. single-use
A 40-year-old patient is to have an IV started per-operatively. Which catheter would be most appropriate for this patient? 16- to 18-gauge
The use of the _______ for an IV site is common with children but is contraindicated in adults because of the danger of thrombophlebitis. foot
18 gauge Adult patient scheduled for major surgery 22 gauge Older adult requiring IV medications butterfly Infant requiring IV fluids 20 gaugeYoung adult requiring fluid maintenance
Created by: 1237552963