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IV Final Review
IV final review for State (Ohio) Boards Certification
| Question | Answer |
|---|---|
| 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
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