IV Administration

Descrição

NCLEX NURSING 110 (Exam 2 ) FlashCards sobre IV Administration, criado por Gwen Paparone em 04-10-2016.
Gwen Paparone
FlashCards por Gwen Paparone, atualizado more than 1 year ago
Gwen Paparone
Criado por Gwen Paparone aproximadamente 8 anos atrás
50
3

Resumo de Recurso

Questão Responda
Peripheral Insertion Responsibility of the RN In the peripheral extremities (Arm/leg)
Central Placement Intravenous line in a central vein- direct to the heart( Jugular, femoral or subclavian vein) Responsibility of the physician or nurse practitioner.
Whose responsibility is maintaining the IV Line? The RN
Indications of IV placement 1. Expand/reduce intravascular volume 2. To correct electrolyte imbalances. 3. To administer medications. 4. To administer blood/blood products. 5. Patient Status 6. Nutritional Support 7. Emergency access
Crystalloids IV fluid containing various concentrations of electrolytes that may expand or reduce the intravascular volume
Intravascular volume Volume of blood in a patients system
What determines whether or not an IV fluid expands or reduces intravascular volume? Osmolarity
Isotonic Solution osmolarity? 280-295
Example of Isotonic solution? Normal Saline Solution
Hypertonic Solution Osmolarity >280-295
Example of hypertonic solution 5% Dextrose and normal Saline solution
Hypotonic osmolarity <280-295
Examples of Hypotonic Solutions Half Normal Saline
Why is 5% dextrose in water isotonic in the bag and hypotonic in the plasma? What is the clinical significance? the glucose (solute) dissolved in sterile water is metabolized rapidly by the body’s cells.
Colloids IV solutions that contain large protein molecules and stay in the vascular space (plasma volume expanders) Increase osmotic pressure in vascular space
What is the major intracellular electrolyte? Potassium (K)
What is the major extracellular electrolyte? Sodium (Na)
What are the normal potassium levels? 3.5-5.5 MEQ/L
What are the normal Na levels? 135-145 MEQ/L
Why might an order for IV D5NSS with 20 MEQ KCL per liter be ordered? For a patient with a potassium level below 3.5
Name the methods of IV administration 1. Direct IV push 2. Via secondary line in a piggyback or miniinfuser 3. ADD-vantage containers
When administering a piggyback medication what should you ALWAYS check? The "compatibility" of the medication to the fluid in the primary IV tubing
How should blood be administered? In a separate IV line, primed with 0.9 NSS ONLY
What tubing is specifically for blood? The set Y tubing
Total Parenteral Nutrition (TPN) Solution containing amino acids, electrolytes, glucose, and vitamins.
How is a TPN administered? Via a central IV line
Can you ever administer nutritional solutions peripherally? Yes but the solutions are made differently from TPN
Why would patient status effect the need for IV fluids? Patients who are unconscious, or post-operative for example may need IV access for fluids, medications, and /or nutritional requirements to maintain homeostasis
What is meant by emergency access as an indication for IV placement? Establishment of a worthwhile IV line. (It can be difficult to establish an iv line when a patient is in cardiac arrest for example)
QSEN Infection control considerations -IV placement is invasive -Maintain proper hand hygiene -Chlorhexadineis preferable to alcohol and batadine
IV bags Standard size- 1000 ml unbreakable- puncture-able bag
IV bottles glass and subject to breaking- need to be vented.
When would an IV bottle be used When using chemicals that have the potential to leech through the plastic
Macrodrip 10-20 gtts per ml
Microdrip 60 gtts per ml
Filter Strain solution to remove contaminants
Extension sets Extend tubing and add extra ports
Peripheral locks Prevent IV from flowing out
Transparent Semipermeable membrane stabilize the cannula, offer protection and provide visualization of the site
How often are dressing supposed to be changed? Every 2 days or PRN
Pumps measure in ml per hour
Mini infuser Controlled intermittent administration of IV fluid
Patient Controlled Analgesia (PCA) is any method of allowing a person in pain to administer their own pain relief.
PCA dosage amount administered with each dose
PCA lockout period time between dosage
Basal Rate Continuous rate
How often should you assess the IV site? Every 2 hours or whenever you enter the room
How long are most IV fluids good for? 24 hours in most institutions
Occlusion loss of patency
Causes for occlusions? 1. kinked tubing 2. backflow of blood 3. Clot
How can you tell when an IV is occluded? Flow is sluggish
Intervention for occlusion Discontinue IV- Do not milk, aspirate, or irrigate
Infiltration Seepage of non vessicant IV fluid into the tissue when IV cath penetrates the vein.
Vessicant Irritating to the tissue
Causes of Infiltration Dislodgment of catheter Overmanipulation of the catheter Failure to secure the catheter properly
Assessment of infiltration Pain, Edema, cool skin, decreased IV flow, damp dressing, no blood return at IV site.
Intervention for infiltration Discontinue IV Elevate extremity Apply warm compress insert IV in unaffected arm Document
Extravasation Infiltration of vessicant fluid into the tissues
Indications for warm compress to treat extravasation? Vasodilation- increases drug distribution- and local concentration
Indications for cold compress to treat extravasation? Vasoconstriction- allows for local removal
Other interventions for extravasation? Direct injection by the physician can be necessary
Phlebitis Inflammation of inner layer of a vein
Causes of phlebitis Bacterial- poor asepsis Chemical- irritating medications Mechanical - poorly secured caheter, too large for vein
Assessment of phlebitis Redness, tenderness, pain, vein is often red hard and cordlike
Intervention Discontinue IV apply warm compress restart IV in unaffected arm
Vascular Access Devices catheters cannulas, or ports designed for repeated access to vascular system
Catheter Soft flexible tube
Cannulas Require a needle introducer,
Ports Implanted under the skin
Insertion sites for VAD Jugular, Subclavian, Cephalic, Femoral
Indications for VAD no peripheral vein access Central venous pressure Complex treatment regimes Hyperosmolar Infusions Vesicant drugs Long term IV therapy
How would you confirm placement of a VAD? X-Ray
How is dressing change on a VAD done? Aseptic sterile technique
Types of cathter VADs Single lumen Multiple lumen Triple Lumen Catheter (TLC)
Distal Port VAD 16G best for viscous fluids, volume monitoring
Proximal port VAD 18G Best for drawing labs and medications
Medial Port 18G TPN
TLC placement not for longer than 6 weeks- not routinely replaced Sterile dressing change X-ray for placement
PICC LINE indicated primarily for? Long term antibiotics
PICC placement pearls Sterile dressing change May remain up to 6 months or longer Never smaller than 10ml syringe X-ray for placement
Midline catheter shorter than PICC - placed in peripheral vein- tip in distal part of vein- no x-ray necessary may remain 8 weeks
Implanted port tip in subclavian or external jugular implanted in sub q of chest wall chemotherapy need x-ray for placement
Huber needle Non-coring needle used to access an implanted port
Normal WBC 5000-10,000
IV formula Gtts/min=(volume)(Set calibration)/Time in minutes

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