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IV Final Review

IV final review for State (Ohio) Boards Certification

Who regulates practice for LPN (in Ohio) Ohio Revised Code Section 4723.17
Who establish the rules for LPN (in Ohio) Ohio Board of Nursing
Piggy backs on antibotics only scoope of practice /can do
Mix, prepare, reconstitute antiboitics additive ONLY scoope of practice /can do
Initiate, convert, flush intermittent infusion devices/ heparin lock or NS flushes scoope of practice /can do
Initiate, maintain D5W, NS, Lactated Ringer's, Sodium Chloride 0.49% and 0.02% sterile water scoope of practice /can do
Scope of Practice site location Prepare an adult(18yr+)for IV therapy in Peripheal intravenious (hand forearn and/or andecubital fossa area only).
Aspirate and IV line to maintain patency Scoope of Practice /can not do
Initiate, regulate, or maintain blood components Scoope of Practice /can not do
Initiate, Maintain, Of TPN, antineoplastics Scoope of Practice /can not do
program or set PCA pump Scoope of Practice /can not do
Initiate PICC, central lines Scoope of Practice /can not do
IV push/ bolus drugs Scoope of Practice /can not do
Assimble and maintain wquipment for gravity drip, eledtronic controlling devices, excluding patient controlled devices Scoope of Practice /can do
Maintain an infusion of the authorized solution through pre-existing CVA or PIIC Scoope of Practice /can do
Verify the type of perpheral IV solution Scoope of Practice /can do
Preform routine IV administreation set changes on a peropheral IV line Scoope of Practice /can do
preform routine dressing change at the insection site of a peripheral venous or arterial infusion. PIIC or central venous pressure subclavian infusion Scoope of Practice /can do
discontinue a perihgeral IV device Scoope of Practice /can do
Scoope of Practice /can do Discontinue a peripheral infusion site
Scoope of Practice /can do Hand subsequent containers of spedified solution that contain vitamins or electrolytes if a RN initiated the same infusion
PCA pump Patient controlled analegesia pump allow patient to self adminmister and regulate delivery of medication for pain control on an as needed basis
Electronic infusion device flowcontrol device should be guided by the patients age and condition, setting and prescribed therapy. It probide accurate flow rate easy to use and have alarms that signal problems with the infusion
Who is allowed to give orders to administrateIV? Physicians. Sentist, Optometrists, Podiatrists, RN who is either on site or available by telecommunication
Does there have to be a designated person at your facility to do IV therapy? In most settings Yes ; How ever when LPN is preforming IV in LTC or intermideate care facility for the mentally retarded' RN must be on the premises or accessible by some form of telecommunication
Who gives course certification for course Board of Nursing under the Revised Code 4723.17
Functions of body fluid Maintain blood volume, regulates body temperature, transports to and from cells, sedium for cellular metabolism, assists digestion through hydrolysis, acts as aolvent for solutes for cell function and excertion of wast
Ways of accessing fluid balance Assess vital signs, infusion rate of IV fluids, intake and out put, daily weights(on same scale, asme time of day, same clothes. Assess body systems is best method for assessment of fluid and electrolyte imbance
Organs involved in maintaining homeostasis Lungs, kidneys, heart, Lymphatic system, nervous and endocrin system
Function of the lungs Maintain acid base balance, removal of 300-500ml of water daily through exhalation
Volumetric Pumps(what does it require to use?) all volumetric pumps require special tubing
When using a controller, does that decrease us from having to monitor pts It is always best to recommend that the nurse monitor the infusion visually and not rely on the filusion device to detect infiltrations
S/S of Fluid volume deficit Tachycardia, weak, thready pulses, decrease pules volume,
S/S of Fluid volume dificit Lungs clear, respirations may be rapid and shallow
S/S of Fluid Volume Excess Increase in total body fluid or analtered distribtion of body fluids
S/S of Fluid Volume Excess Galloping heart rhythm in adults
S/S of Fluid Volume Excess Distended neck veins, Slow empting hand veins
S/S of Fluid Volume Excess Bounding full pules
S/S of Fluid Volume Excess Peripheral edema
S/S of Fluid Volume Excess Tachypnca and dyspnea
S/S of Fluid Volume Excess Irritated cough, hacking cough becoming labored
S/S of Fluid Volume Excess Cracles in lungs and Decrease o2 Cyanosis
S/S of Fluid volume deficit Flat Veins, poor peripheral vein filling <4cm CVP
S/S of Fluid volume deficit Frank or postural hypotension
S/S of Fluid volume deficit Cool extremities with delayed capillary refill,
Impaired skin intehrity Skin with an abnormal condition
Why are we using needless systems The use of protected needles or needleless equiptment significantly decreases the risk of needle stick injuries
What info do we need to know to caculate the flow rate Drip rate or drip factor and washing hygiene,appropriate skin antisepsis
Barrier Precautions Primary(gloves), Secondary(gowns, face shields, masks)
Layers of veins Tunica intima, tunica adventitia, tunica media
Tunica intema Innermost: composed of endothelial lining layer of cells
Tunica adventitia Outermost Layer: Composed of connective tissue
Tunica Media Middle Layer: Composed of nerve fibers, tissue and muscle
Why do we need to know a patient's BSA, age, conditions, ect. befor giving an IV for site selection and vein dilation to pick aproperate needle and tubing and vein site for iv product
Why do you maintenance of fluid Maintains homeostasis, fluid is distributed in 3 compartments intracellular(40%)intravascular (5%) interstitial (15%)
Causes of Hypertonic Fluid Dehydration Inadequid fluid intake
Dauses of Hypotonic Over hydration more fluid gained than solute
Lure lock on piggy Type of the fitting connector with locking mechanism
What do you check for when you examine an IV bag Integrity, color, clariety, exp. date
Primary Set Referred to as standard sets and are available as vented or non-vented
Secondary Set 2 Types,the piggy backset and the volume controlled set
Flexible plastic system vented sets Have an air filter attachment to the spike pin that allows air to enter the container
Flexible plastic system non-vented sets This set has a stright spike pin w/out an air vent device
What are over the needle catheters used for? After venipuncture the needle is withdrawn and discarded leaving a flexible catheter w/in the vein
When do you use scalp needles-short-term-therapy On infants in nic unit
Specific agents recommended for hand washing: Antiseptics, soap, antimicrobial agents
How many seconds do you wash your hand 15-20 seconds
Transmission based precautions Airborn (HEPA filter mask) droplet(googles, face shild) contact (gown and gloves)
Conditions that lead to electrolyte imbalance Diarrhea, vomiting, diuretics, sweating
Main Objectives of IV therapy Large volumes of medication and intravenous flueds can be administered in to a vein
How do you evaluate a patient's perparedness for IV therapy? Talk w/ pt, consider fears and anxiety, ask pt history/ diagnosis, ask about transfers/setting
If a vein is suitable for IV therapy how does it feel? A soft, stright,smooth vein is ideal for venipuncture
How do you located a vein in a dark skinned person? Establish baseline color in daylight, give then a window to provide access to sunlight and /or use tangential lighting the illuminate the blue veins
How do you distend a vein? Ues a tourniquet which trapl blood in the veins by applying enough pressure to impeded venous flow
What Microcrobal solution to cleanse the cannula? Clean area thoroughly with 70% isopropyl alcohol
How do you prevent rolling of the veins? Pull skin taut below the puncture site to stabilize the vein
How do you apply tape using the chevron technique? Cross the end of the tape over the opposite of the end of the needle so the tape sticks to the patient's skin
Where all do you apply your labels The venipuncture should be labled on the side of the transparent sressing or across the hub
Label the tubing according to agency polecy and procedure So that practioners on subsequent shifts will be aware of when the tubing must be changed.
Place a strip on all parenteral solutions with: The name of the solution and additives, initial of the nurse, and the time the solution was started.
Where do you document after you start an IV Documentation in the patient's medical record should contain sufficient information to identify infusion procedures, precrebed treatments, complications, nursing interventions, and pt outcomes
Is Piggy back is positioned higher or lower than the primary bag? Higher
Primary infusion is positioned where? Lower than secondary container
What is the disadvantage of over the needle catheters? Increase the risk of infusion related to phlebitis
When flushing IV lines with heparin (Hep-Lock): It is used to maintain patency of the line and not used to reach therapeutic levels.
It is recommended that the lowest possible concentration of heparin be used: 10 to 1000u
Local advers reactions of IV therapy are? Pain, irritation, infiltration, extravasations, phlebitis,hematoman
Systemic adverse reactions of IV therapy: Septicemia, flued overload, air/pulmonary embolism, speed shock
Why use an indirect method? Prevents hematoma
How do you avoid a thrombosis? Use pumps and controllers to manage rate control, avoid placing cannula in areas of flexion, use filters, avoid cannulatation of lower extremities, Choose microdrip tubing (60) when iv flow rates are below 50 mln
What do you do if an IV infiltrates? Stop IV immediately, use warm or cold compress and elivate extremities 4 inch
Techniques to prevent circulatory overload are? frequent monitoring of patient, administration of component slowly, place patient in upright position
Gauges size 14-16 Multiple trauma, geart surgery, transplants
Gauge size 18 Major trauma or surgery, Blood administration
Gauge size 20 Minor trauma or surgery, Blood administration
Gauge size 22 Pediatric use, person w/small veins
mL/hr x drop factor= drips (gtt) per minutes
The piggy back set has: Short tubing (30 to 36 in) w/a standard drop factor of 10 to 20 drop/mL
When to Change IV gauze dressint? Every 48hours on phriheral sites or when the integrity is compromised
Transparent semi permeable dressing should be changed how often Every 72 hours
What standard of precaution do wi use when changing administration set? Sterile
How many times is the needle used? 1 time
How often do we change the primary or secondary set? Every 72 hours and immmediately when contamination is suspected or when the ingegrith of the product is compromised
What to we sue to flush geplock or intermittent device? 0.9 sodium chloride
What vain is approprate for antibotic? Anticubital vein ( because antibotic is tick and we need to use a strong vein)
How do we prevent circulatory system overload? Monitor the infusion rate, know the solution's physiologic effect on the circulatory system
What do we do if IV solution is behind schedule Recalculate all infusion that are not on time
To prevent circulatory system overload we monitor the I/O on: All patience receiving IV fluids
Patients health information that must be known befor starting IV: Know the pt cardio vascular history
Created by: kharrell