Iv piggy back lab.
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| Intravenous therapy is used for? | 1.) Fluid administration.
2.) medication administration.
3.) blood administration.
4.) Iv access line.
5.) drawing blood.
6.) long-term nutritional support.
(Need a doctors order)
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| Peripheral lines catheter size: | 22, 20, 18 gauge.
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| peripheral line IV bag last up to: | 24 hours.
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| Peripheral line tubing is changed every: | 72-96 hours.
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| Peripheral line is put in: | for a few days/short term use.
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| Midline is: | 4-6 inches long and inserted in the anteculital area, ends in the vein before the axilla.
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| Midline is used for: | home care, antibiotic therapy. It last longer than a peripheral line.
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| Central venous lines are used for: | 1.) infusion of TPN or irritatig medications.
2.) long-term or home IV or medication therapy.
3.) short term use in hospitals for therapy.
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| Types of central venous lines: | 1.) single or multiple lumen catheters.
2.) PICC
3.) tunneled catheters or implanted access port catheters.
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| For central venous lines you should always | take an x-ray to confirm where the tip is.
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| Central venous lines are put in by: | the MD into the subclavian or internal jugular vein.
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| the tip of the catheter (in central venous lines) sits: | in the superior vena cava above the right atrium.
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| central venous lines lumens are flused with | heparinized normal saline (50-100 units/ml in 9 ml NS)
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| acute care central venous catheters are: | single or multilumen
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| long term care central venous catheters are: | PICC, tunneled catheters, implanted access port.
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| PICC: peripherally inserted central catheter is placed into: | brachial, cephalic or femoral vein and advanced into the superior or inferior vena cava. (confirm with x-ray)
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| PICC line can remain in place for: | 6 months.
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| For PICC lines always measure: | the exposed catheter part. If it is not the same length as before, stop iv and call doctor and get an x-ray.
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| PICC is used for: | long term IV therapy, TPN, chemotherapy, narcotic infusions, blood access, popular for home care.
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| Tunneled catheters are used for: | long-therm therapy, PED's.
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| tunneled catheters contain: | a dacron cuff causing adhesion to form in the chest, this stabilizes the catheter in place and DECREASES the occurrence of infection.
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| Tunneled catheter enters via the | subcutaneous tunnel on chest, enters subclavian vein and advanced into subclavian vein about right atrium, other end exits chest.
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| VAD: vascular access device is used | For long term chemotherapy, medication administration, or blood sampling. Can last for several months to 10 years without being changed.
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| Complications of IV's | 1.) infection.
2.) infiltration.
3.) tissue damage.
4.) fluid overload.
5.) phlebitis.
6.) anaphylaxis.
7.) speed shock.
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| infection: | redness, Increased WBC, normally local, fever, chills.
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| Infiltration: | catheter comes out of vein and leaks. Can cause tissue damage, burns, decreased movement, looks swollen, glassy, cool to touch.
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| fluid overload: | put pt. on pump to prevent. elderly pt., kidney disease, cardiac disease pt at risk.
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| phlebitis: | inflammation of where catheter is placed in vein. Looks red, vein is hard and red lines up arm. Needs to be taken out.
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| speed shock: | happens when meds are given too fast into IV (IV push) and you get anaphylaxis.
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| Blood administration: | Need two nurses, hang normal saline with blood, packed cells are good for 4 hours, whole blood is good for 6 hours. Prime tubing with saline not blood.
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| Notes about blood administration: | Never run anything with blood (except normal saline), infuse over 3-4 hours per unit of WB or PRBCs, FFP and platelets may be infused quickly.
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| Transfusion reactions: | 1.) hemolytic- ABO or RH incompatibility. Get a clotting reaction.
2.) allergic -sensitive to foreign plasma proteins.
3.) febrile- clients antibodies respind against transused WBC, PLTS or Plasma, pt will spike temp.
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| Transfusion reactions part 2: | 4.) bacterial- blood contaminated with organisms.
5.) circulatory overload- CHF, need to run blood slower. Crackles will be heard and lasix are given.
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