Fluids, IV Therapy, Blood Transfusion
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| What is the purpose of IV fluid therapy? | show 🗑
|
||||
| show | Colloids, plasma proteins, Albumin
🗑
|
||||
| show | Blood Pressure
🗑
|
||||
| show | Hypertonic fluids.
🗑
|
||||
| What is the problem with using hypertonic solutions? | show 🗑
|
||||
| show | Decreased LOC/Confusion
🗑
|
||||
| What happened if you expand the intracellular compartment to fast? | show 🗑
|
||||
| show | Cyrstalloid and Colliod.
🗑
|
||||
| show | And electrolytic containing solution.
🗑
|
||||
| show | Isotonic, Hypotonic, Hypertonic.
🗑
|
||||
| show | Because they can pass through semipermeable membranes.
🗑
|
||||
| show | Containe proteins and starches.
🗑
|
||||
| show | Pass between compartment. They draw the fluid to them.
🗑
|
||||
| Name four problems with IV fluid therapy? | show 🗑
|
||||
| show | Pain,tenderness, erythema-red streaks at vein, edema, hardness of vein, increased temperature. Slow flow rate, area warm to touch.
🗑
|
||||
| show | Inflammation of the vein.
🗑
|
||||
| show | Permanent
🗑
|
||||
| show | Localized, at tip of catheter and on.
🗑
|
||||
| show | Poor blood flow around cath, friction, IV left in too long, clotting, motion frequency.
🗑
|
||||
| What is TX for Phlebitis? | show 🗑
|
||||
| Infection causes? | show 🗑
|
||||
| S/SX of infected IV? | show 🗑
|
||||
| show | D/C IV, culture tip, call DR.
🗑
|
||||
| S/SX of infiltration? | show 🗑
|
||||
| Infiltration causes? | show 🗑
|
||||
| TX for Infiltration? | show 🗑
|
||||
| Prevention of Infiltration? | show 🗑
|
||||
| show | Watch for cool, swollen hard or painful site.
🗑
|
||||
| show | Administration of a vesicant (blistering) solution into surround tissue. It is infiltration that results in tissue damage and necrosis from the product admin.
🗑
|
||||
| An irritant? | show 🗑
|
||||
| show | Pain, stinging, or burning, redness swelling.
🗑
|
||||
| show | Discontinue IV, attempt aspirate drug, apply ice, research antidote, Call Dr., Admin irr/vesicant through Central Venous Device
🗑
|
||||
| show | Who receive hypertonic, acidic, or irritating agents; geriatric w/fragile veins; pediatric who are active.
🗑
|
||||
| Client dvlps unexplained fever with chills and rising pulse? | show 🗑
|
||||
| What three things can and LVN NOT do? | show 🗑
|
||||
| What can an RN NOT due with a central line? | show 🗑
|
||||
| show | Ask the doctor for an xray to determine.
🗑
|
||||
| Name some Isotonic fluids? | show 🗑
|
||||
| Why do you need to be careful with LR and dehydration? | show 🗑
|
||||
| What does the liver do to lactate (LR)? | show 🗑
|
||||
| What are two common uses for Normal Saline (NS)? | show 🗑
|
||||
| Name a Hypotonic solution? | show 🗑
|
||||
| show | It has more dissolved particles than bodly fluid.
🗑
|
||||
| What does a hypertonic fluid do? | show 🗑
|
||||
| show | Hydration and nutrition. Solution causes cells to shrink. Used in severe salt depletion (very rare)
🗑
|
||||
| show | They can move fluids very quickly.
🗑
|
||||
| show | TPN and PPN. Nutrition.
🗑
|
||||
| show | 10% solutions can go peripheral but all others 20% and above must use a central line.
🗑
|
||||
| show | The fluids are very irritating to veins.
🗑
|
||||
| How do you infuse hypertonic dextrose saline solutions. | show 🗑
|
||||
| show | Blood products.
🗑
|
||||
| show | Type and cross match.
🗑
|
||||
| Which of the two main catergories of fluids do plasma expanders fall under? | show 🗑
|
||||
| Whate are Colloids used for? | show 🗑
|
||||
| show | Renal insuffiency and CHF
🗑
|
||||
| show | Peripheral
🗑
|
||||
| show | Central
🗑
|
||||
| What are components of TPN? | show 🗑
|
||||
| show | 24 hr supply.
🗑
|
||||
| show | Non function GI, bowel obstruct, acute infla, colitis, chrons, malabsoroption, chemo, burns, sepsis, onocology, pancreatitis
🗑
|
||||
| show | By weighing daily.
🗑
|
||||
| What is the consideration with IVS and glucose? | show 🗑
|
||||
| What should you monitior with TPN? | show 🗑
|
||||
| show | To make sure they are exreting electrolytes.
🗑
|
||||
| Why do you use micron filter with TPN | show 🗑
|
||||
| show | To avoid hypoglycemic shock from cutting of the sugar.
🗑
|
||||
| Can you run other things in the TPN IV tubing? | show 🗑
|
||||
| What is an important consideration with albumin? | show 🗑
|
||||
| What are some potential complications with TPN? | show 🗑
|
||||
| show | BUN
🗑
|
||||
| show | IV
🗑
|
||||
| Whate are some items of IV that you should assess? | show 🗑
|
||||
| How long is the IV bag good for? | show 🗑
|
||||
| How long is IV tubing good for? | show 🗑
|
||||
| How long is a peripheral site good for? | show 🗑
|
||||
| show | So you can be prepared and have the next bag ordered from pharm and ready.
🗑
|
||||
| show | Good indication of patent IV but not always.
🗑
|
||||
| show | Y site compatability with other drugs you may be administering.
🗑
|
||||
| If you add another drug in and it becomes cloudy what is happening and what do you do? | show 🗑
|
||||
| show | Use the drug book, call pharmacy.
🗑
|
||||
| show | Until the DR has ordered it stopped.
🗑
|
||||
| show | Usually by syringe.
🗑
|
||||
| show | Printed on the bag.
🗑
|
||||
| show | By roller clamp or clip.
🗑
|
||||
| show | Higher
🗑
|
||||
| Name and important act you must do with contious infusion? | show 🗑
|
||||
| Continous infusion limits what and what type of risk? | show 🗑
|
||||
| What method of infusion should you not use with central line? | show 🗑
|
||||
| show | Vancomycin
🗑
|
||||
| Name three things you cannot use gravity free flow with... | show 🗑
|
||||
| show | The running rate of the IV
🗑
|
||||
| What is does secondary rate mean with a pump? | show 🗑
|
||||
| One ml of Heperain for IV contains how many heparin units? | show 🗑
|
||||
| show | you check the dose with a second person.
🗑
|
||||
| show | You must check to make sure that the rate hase been changed back to the primary rate when the secondary rate is finished.
🗑
|
||||
| What is positive pressure technique? | show 🗑
|
||||
| show | The roller clamp of the primary bag.
🗑
|
||||
| PCA administration can be programmed fro what three things? | show 🗑
|
||||
| What does the DR order for PCAs? | show 🗑
|
||||
| Name six types of IV Access? | show 🗑
|
||||
| show | Q8hrs and before and after meds.
🗑
|
||||
| Why do you flush a line before giving the medication. | show 🗑
|
||||
| show | 2-3ml
🗑
|
||||
| show | Chlorhexidine gluconate.
🗑
|
||||
| show | Peripheral venous Cath.
🗑
|
||||
| What is the most common complication associated with peripheral vein catheter? | show 🗑
|
||||
| Phlebitis is at higher risk when used as an IV site. | show 🗑
|
||||
| What should youdo to IV solutions that have been out of the refrigerator? | show 🗑
|
||||
| If the solution has a "RED LABEL" | show 🗑
|
||||
| show | Any change discard.
🗑
|
||||
| Why should you not use felt tip pens to mark directly on IV plastic bag. | show 🗑
|
||||
| In an emergency sitiuation peripheral IV was started w/o proper asepsis, Emergency or outside. When should it be replaced? | show 🗑
|
||||
| When do you NOT use cholorhexidine gluconate when preparing IV Site. | show 🗑
|
||||
| General tubing changes? | show 🗑
|
||||
| show | At least once a shift.
🗑
|
||||
| What do you do if the Venipuncture is unsuccessful for needle/catheter insertion. | show 🗑
|
||||
| show | Apply traction with thumb and index finger to stablize; maintain traction until venipuncture is complete. Select smaller gauge cath. Advance catheter slowly.
🗑
|
||||
| Vein is fragile and "ballons" around needle on vein entry? | show 🗑
|
||||
| Infiltration occurs? | show 🗑
|
||||
| show | Clamp tubing, infuse antidote for specific medication, according to Dr's order.
🗑
|
||||
| Troubleshooting alarm sounds. | show 🗑
|
||||
| show | Evaluate every 2 hours.
🗑
|
||||
| show | Cut tip of catheter with sterile scissors, place in sterile container and send to lab to culture.
🗑
|
||||
| TX of FVE | show 🗑
|
||||
| Prevention of FVE with IVE | show 🗑
|
||||
| show | One that has multiple positions for drip rate on it. Check all positions for the drip rate to avoid FVE.
🗑
|
||||
| Who is at risk for FVE with IV? | show 🗑
|
||||
| S/SX of air embolism? | show 🗑
|
||||
| Air embolism is a problem with what type of line and not with what type of line? | show 🗑
|
||||
| TX for Air Embolism? | show 🗑
|
||||
| Prevention of Air Embolism? | show 🗑
|
||||
| Speed Shock is? | show 🗑
|
||||
| show | Syncope (transient sudden loss of conciousness with inability to maintain upright posture) cardiac arrest and shock.
🗑
|
||||
| show | Know what you are giving and how fast you can administer it, rate of administration.
🗑
|
||||
| show | Vancomyacin
🗑
|
||||
| Home care considerations with IV therapy? | show 🗑
|
||||
| show | PICC line.
🗑
|
||||
| Some Drugs that are incompatible with saline solutions? | show 🗑
|
||||
| show | DFfeeling for resistance.
🗑
|
||||
| show | "observed" not noted...Write "no IV related complicateion observed...Document catheter length when removing. DO NOT write client tolerated procedure well - provide statement from client.
🗑
|
||||
| show | Temp discontinue primary infusion, flush client's injection port, initiate NS (or what compatible) solution as the primary, proceed with "PB" into the "new" compatible primary. When done, restart original primary solution, use a new needleless cannula.
🗑
|
||||
| LAB Values? | show 🗑
|
||||
| HGB/HCT Values? | show 🗑
|
||||
| BUN | show 🗑
|
||||
| Hyperkalemia Cause? | show 🗑
|
||||
| show | Abdom. cramping, diarrhea, Increase GI motility, muscle twitching & cramps (early phase or mild), paresthesias (early or mild), muscle weakness, leading to paralysis (late or severe) Weakness noticed 1st in legs, Cardiac most severe (V Fib, C arrest)
🗑
|
||||
| Medication for Hyperkalemia? | show 🗑
|
||||
| Hyokalemia causes? | show 🗑
|
||||
| S/Sx of Hypokalemia? | show 🗑
|
||||
| show | Oral potassium. IV potassium is NEVER given IV Push.!!!! To irritating for a continuous IV infusion into a peripheral IV site. Do not give more than 20meE in one hour. Never give IM or Sub!!
🗑
|
||||
| FYI regarding Potassium | show 🗑
|
||||
| show | Increase in sodium (3% NS IVs), high NA+ meds, salwater drowning. Watery diarrhea. Renal failure.
🗑
|
||||
| show | Neuroligcal symptoms-LOC. Agitation, confustion, seizures, spontaneous muscle twitches, muscle weakness and reduced or absent DTRS (sever or late). Thirsty not good indicator in elderly. Decrease urine ouput, dry swollen tongue, edema, increase CVP & BP
🗑
|
||||
| show | Treat the cause. Hypotonic IVS (D5w or 0.225% NaCl or 0.45% NaCl. Diuretics if problem is sodium gain. Low sodium diet. Patient safety, daily weights, monitor Neuro, limit high sodium.
🗑
|
||||
| Hyponatremia Causes? | show 🗑
|
||||
| show | Neuro, HA, depressed or excessive sometime both, diminished Deep tend reflex. Hypovelmia (sodium loss) tach, thready pulse, Post.Hyper.,weight loss. Hypervolemia(water gain) weight gain, increased BP & CVP, rapid bounding pulse. Pitting edema.
🗑
|
||||
| show | Fluid restriciton. Initially if not severe give LR or NS. When neuro symp give 3% NaCl. Hypertonic saline must be use CAUTIOUSLY. Pt safetly, Elevating HOB, Daily Weights.
🗑
|
||||
| show | hypotonic, 0.45NS, D5W, D5 and 0.33NS
🗑
|
||||
| Hypercalcemia cause? | show 🗑
|
||||
| S/SX of Hypercalcemia? | show 🗑
|
||||
| show | Fluid Volume Replacement: saline IV's, lasix, calcitonin inhibits bone resorption. Flush it out keep in the bones.
🗑
|
||||
| show | Rapid infusion of citrated blood causes temporary removal of circulating ionized calcium. Malnutrion.
🗑
|
||||
| show | Numbness & tingling, carpopedal spasms, twitches, cramps, tetany, seizure, jitteriness, laryngeal spasm and resp arrest from muscle tetany, bruising petechiae, hypotension, decreased HR, diminshed pulses, Increase GI, abdomial cram0ping, anxiety
🗑
|
||||
| TX of hypocalcemia? | show 🗑
|
||||
| show | Whole Blood, packed RBC's, leukocytes, platelets, Fresh frozem plasma, Albumin, and cyoprecipates & WBC's.
🗑
|
||||
| show | To increase circulating blood volume, to increase oxygen carrying capacity, to provide cellular components as replacement therapy.
🗑
|
||||
| How is blood transfusions used to increase circulating blood volume? | show 🗑
|
||||
| show | Packed Red Blood cells.
🗑
|
||||
| show | Group O
🗑
|
||||
| show | Whole blood must be given ABO identical.
🗑
|
||||
| What type of blood transfusion would one use to provide cellular components as replacement therapy? | show 🗑
|
||||
| Blood transfusion as replacement therapy for Neutorpenic patients? | show 🗑
|
||||
| show | 300-550mls
🗑
|
||||
| Amount of Packed RBC's | show 🗑
|
||||
| Amount ot leukocyte-poor RBC's | show 🗑
|
||||
| What do Leukocyte-poor RBC's Prevent? | show 🗑
|
||||
| show | Not breaking down of red blood cells.
🗑
|
||||
| One unite has to be infused within how many hours? | show 🗑
|
||||
| Blood must be started within how many minutes after leaving the blood bank? | show 🗑
|
||||
| BT must be completed within what amount of time? | show 🗑
|
||||
| What is the controlled temperature that blood must be stroed in the refrigerator? | show 🗑
|
||||
| show | 0.9% Normal Saline
🗑
|
||||
| What size gauge catheter does the nurse use to connect to the current IV or star an IV with? | show 🗑
|
||||
| show | Pt name, ID#, Pt blood type & RH type are compatible with donors group and RH type, expiration date, inspect for blood clots, empty urine draingate or have patient void. hospital # match number on record on the blood bag.
🗑
|
||||
| When can blood not be returned to blood bank? | show 🗑
|
||||
| show | Normally it is not- more common in maternity and postanesthia care. Hemolysis of the blood occurs at 104F
🗑
|
||||
| show | 1.5-2hrs. Elderly clients and those with respiratory or cardiac conditions may need to adjust flow.
🗑
|
||||
| show | Blood with bubbles, cloudiness, dark color or sediment.
🗑
|
||||
| For baseline vitals before a blood transfusion, the physician should be notified if the patient has a temperature of? | show 🗑
|
||||
| show | Prime in-line filter with blood.
🗑
|
||||
| show | Max of 5ML/min
🗑
|
||||
| show | The first 15 minutes
🗑
|
||||
| How often do you take VS for BT? | show 🗑
|
||||
| S/SX of Adverse reactions of Blood transfusion? | show 🗑
|
||||
| show | Each time the client is checked.
🗑
|
||||
| show | It is when a client is having cold blood infusion, apply warm pack to site to improve flow rate.
🗑
|
||||
| show | If it rises 2 degrees F, this could be indicative of a transfusion reaction.
🗑
|
||||
| What are transfusion reactions? | show 🗑
|
||||
| Hemolytic S/SX | show 🗑
|
||||
| show | Stop transfusio immediately & removing blood tubing. Start NS infusion at "Keep Open" rate with a new IV tubing. Obtain VS, notify Blood Bank STAT, administer O2, Notify Dr. Monitor VS every 15 mins for shock & urine output hourly for acute renal failure
🗑
|
||||
| show | Get order for IV expansion and diuretic or vasopressor to dilate renal blood vessels to prevent acute renal tubular necrosis. Complete transf. reaction form. Send two blood samples (different sites), urine specimen,blood and tubing & transfusion record.
🗑
|
||||
| Bacterial Reaction during Blood Transfusions S/SX? | show 🗑
|
||||
| Bacterial Reaction TX? | show 🗑
|
||||
| show | Draw blood culture before antibiotic administration. Send remaining blood and tubing to lab for culture and sensitivity.
🗑
|
||||
| show | Stop transf immed., if symptoms are severe-immediate resuscitation necessary. VS for possible anaphylatic shock. If symp are mild, stop transf. or follow hosp. policy and obtain Dr's order. for signs of progress. allergic reaction as trans. continues.
🗑
|
||||
| Potential circulatory overload TX? | show 🗑
|
||||
| show | Antihistamines, vasopressors, fluids, steroids.
🗑
|
||||
| show | Be prepared for CPR.
🗑
|
||||
| show | Room temperature and old blood.
🗑
|
||||
| What is a citrate reaction caused by during a blood transfusion? | show 🗑
|
||||
| What can a Citrate reaction do during a blood transfusion do to the pt.? | show 🗑
|
||||
| show | It can cause hypocalcemia.
🗑
|
||||
| show | 10 drops/ml
🗑
|
||||
| The nurses resposiblities for IV skills and IBPB meds are? | show 🗑
|
||||
| What responsibilities doe the nurse have during the initiation phase? | show 🗑
|
||||
| What responsibilities do the nurse have during the monitoring phase? | show 🗑
|
||||
| How often should you monitor IV? | show 🗑
|
||||
| Don't put tape on what? | show 🗑
|
||||
| What are ways to assess for patency? | show 🗑
|
||||
| show | Frequently used in hemorrhage or shock.
🗑
|
||||
| How many percent Hbg and Hct when transfuse 1 unit of whole blood? | show 🗑
|
||||
| What is the minimum gauge IV needle used for transfusion? | show 🗑
|
||||
| How many ml in 1 unit of Packed RBC? | show 🗑
|
||||
| show | Plasma
🗑
|
||||
| How many ml in 1 unit of whole blood? | show 🗑
|
||||
| show | 50-70ml
🗑
|
||||
| show | under 100
🗑
|
||||
| Whed do use Packed RBC's? | show 🗑
|
||||
| What is the most concern for low platelet? | show 🗑
|
||||
| show | Used to treat bleeding d/t thrombocytopenia; functionally abnormal platelets.
🗑
|
||||
| How long it needs to separate plasma from blood and frozen to have Fresh Frozen Plasma | show 🗑
|
||||
| show | 200-500ml
🗑
|
||||
| show | 1 year
🗑
|
||||
| How long Fresh Frozen Plasma after thawing can be used? | show 🗑
|
||||
| When do you use albumin transfusion? | show 🗑
|
||||
| How many ml in 1 unit of albumin? | show 🗑
|
||||
| show | Stored up to 5 years.
🗑
|
||||
| When do you use cryoprecipatates transfusions? | show 🗑
|
||||
| show | 6 hrs.
🗑
|
||||
| How many ml in 1 unit of cryoprecipatates? | show 🗑
|
||||
| show | Cardiac dysrhythmias.
🗑
|
||||
| show | 15 minutes
🗑
|
||||
| show | premedicate with an antipyretic nd or an antihistamine.
🗑
|
||||
| show | Febrile
🗑
|
||||
| When a patient has burns, hypoprotenemia what is transfused? | show 🗑
|
||||
| show | 11-12.5 seconds PT, 0.8-1.1 INR
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
tlarsen14