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Level III: NCM 112 - Care of Clients with Problems in Oxygenation, Fluid and Electrolytes, Infectious, Inflammatory and Immunologic Response, Cellular Aberrations, Acute and Chronic > 112 RLE Skills Lab Amaranto - Considerations and Preparations of IVF > Flashcards

112 RLE Skills Lab Amaranto - Considerations and Preparations of IVF Flashcards

1
Q

What is intravenous therapy?

A

Used to sustain clients who are unable to take substances orally.

  1. Replaces water, electrolytes, and nutrients MORE RAPIDLY than oral administration.
  2. Provides IMMEDIATE access to the vascular system for the rapid delivery of specific solutions without the time required for the gastrointestinal tract absorption.
  3. Provide a vascular route for the administration of medication or blood components.
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2
Q

Define the intravenous devices

A 
Intravenous cannula
Intravenous tubing
Intravenous gauges
Intravenous container
Intravenous filter
The electronic IV fusion device
Patient Controlled Analgesia
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3
Q

What is an intravebous cannula

A

The set is a wing-tip needle with a metal cannula, plastic or rubber wings, and a plastic catheter or hub.

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4
Q

The needle of IV cannula’s specific measurement is __________.

A

The needle is 0.5 to 1.5 inches in length, with needle gauge sizes from 14 to 26.

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5
Q

What is common in IV cannula?

A

Infiltration.

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6
Q

The butterfly infusion is used in which population group?

A

Used commonly in children and older clients, whose veins are likely to be small or fragile.

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7
Q

Define IV gauges.

A

The gauge refers to the diameter of the lumen of the needle of cannula.

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8
Q

What is the characteristic of the IV gauges measurement?

A

The SMALLER the gauge number, the LARGER the diameter of the lumen; the LARGER the gauge number, the smaller the diameter of the lumen.

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9
Q

The size of the gauge that will be used depends on what factor?

A

The size of the gauge used depends on the solution to be administered and the diameter of the available vein.

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10
Q

Determine the gauge colors and sizes.

A

Only geek girls pick big yellow panties.

14-26

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11
Q

The orange gauge 14 is used for what purpose?

A

Trauma, Rapid BT, Surgery

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12
Q

The green gauge 16 is used for what purpose?

A

Rapid fluid replacement, trauma, rapid BT.

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13
Q

The gray gauge 18 is used for what purpose?

A

Rapid fluid replacement, trauma, rapid BT.

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14
Q

The pink gauge 20 is used for what purpose?

A

Most infusions, Rapid fluid replacement, trauma, routine VC.``

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15
Q

The blue gauge 22 is used for what purpose?

A

Most infusions, neonate, pediatrics, older adults, routine BT

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16
Q

The yellow gauge 24 is used for what purpose?

A

Most infusions, neonate, pediatrics, older adults, routine BT, neonate or pediatric BT

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17
Q

The purple gauge 26 is used for what purpose?

A

Pediatrics, neonate

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18
Q

Define the IV container.

A

Container is usually plastic; some solutions are in glass containers.

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19
Q

How do you assess an IV container?

A

Squeeze the plastic bag to ensure intactness and assess the glass bottle for any cracks before hanging.

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20
Q

Does the nurse prepare the IV containing medication?

A

In most agencies, the pharmacy department prepares solutions containing medication; in some situations the nurse needs to reconstitute the medication. Agency protocol and pharmacy instruction should always be followed.

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21
Q

What is IV tubing?

A

IV tubing contains a spike end for the bag or bottle, drip chamber, roller clamp, Y site, and adapter end for attachment to the cannula that is inserted into the patient’s vein.

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22
Q

What is a macrodrip chamber?

A

The drop factor varies from 10 to 20 drops (gtt/ml) depending on the manufacturer.

This chamber is used id the solution is thick or is to be infused rapidly.

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23
Q

What is a microdrip?

A

The chamber has short metal piece (stylet) where drop forms.

The chamber delivers about 60 gtt/ml.

Used if fluid will be infused at slow rate less than 50 ml/hr (titration and pedia)

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24
Q

What is the use of an IV filter?

A
  1. Provide protection by preventing particles from entering the client’s veins.
  2. Used in IV lines to trap small particles such as undissolved substances, or medications that have precipitated in solution.
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25
Q

What are the things the nurse must consider in IV filters?

A

Change filters every 24 to 72 hours to prevent bacterial growth.

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26
Q

When is intermittent infusion devices used?

A

Used when intravascular accessibility is desired for intermittent administration of medications by IV push or IV piggyback.

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27
Q

What can you do to ensure the patency of intermittent infusion devices?

A

When administering medication, flush 1 to 2 ml of normal saline to confirm the placement of the IV cannula; administer the prescribed medication and then flush the again to maintain patency.

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28
Q

What is the use of an electronic IV infusion device?

A

Control the amount of fluid infusing and should be used with central venous lines, arterial lines, solutions containing medication, and parenteral nutrition infusion.

29
Q

What is the function of patient-controlled analgesia?

A

Control the amount of fluid infusing and should be used with central venous lines, arterial lines, solutions containing medication, and parenteral nutrition infusion.

30
Q

What does PCA regimen includes?

A

The PCA regimen may include a basal rate of infusion along with the demand dosing, basal rate infusion alone, or demand dosing alone.

31
Q

What are three parts of th blood vessels?

A

Tunica intima
Tunica media
Tunica adventitia/externa

32
Q

What are the preferred IV sites?

A

Cephalic and basilic vein.

On the hands, antecubital, and forearm.

33
Q

What are the iv sites to avoid?

A
  1. Edematous extremity
  2. An arm that is weak, traumatized, or paralyzed.
  3. The arm on the same side as a mastectomy.
  4. An arm that has an arteriovenous fistula or shunt for dialysis.
  5. A skin area that is infected.
34
Q

What are the five precautions for IV lines?

A
  1. On insertion, an IV line can cause initial pain and discomfort to the client.
  2. An IV puncture provides a route of entry for microorganisms into the body.
  3. Medications administered by the IV route enter the blood immediately, and any adverse reactions or allergic responses can occur immediately.
  4. Fluid (circulatory) overload or electrolyte imbalances can occur from excessive or too rapid infusion of IV fluids.
  5. Incompatibilities between certain solutions and medications car occur.
35
Q

What can happen if there is excessive fluid retention as caused by the IVF?

A

Heart problems such as high blood pressure.

36
Q

What can you do to prevent excessive fluid retention as caused by the IVF?

A

Always check the physician’s order.

37
Q

Determine the function of luer lock plug?

A

this is detachable and if one uses heplock, this covers the tubing for sterility.

38
Q

What is the function of flashback chamber?

A

part of the cannula where you can check for backflow.

39
Q

What is the function of the needle grip?

A

where you would press and hold to retract the needle from the plastic catheter.

40
Q

What is the function of injection port cap?

A

where you can administer medication but flip it first to open.

41
Q

Should you write in the plastic container of IV fluids for labelling?

A

The ink may be absorbed in the bottle, used iv tags instead.

42
Q

Determine the function of the piercing spike.

A

punctures the rubber cap of the IV.

43
Q

Determine the function of venting.

A

allows air to enter the iv bottle in order to displace iv solution as it infuses.

44
Q

Determine the function of drip chamber.

A

This is where you can check for the number of drips per minute.

45
Q

What is the function of roller clamps?

A

part of the intravenous tubing where you could regulate the drip rate.

46
Q

What is the function of luer adapter?

A

a screw connection on a syringe that creates a leak-free seal. Care providers can connect needles, tubing, and other equipment to the lock to perform various activities involved in patient care.

47
Q

True or false:

Intermittent IV devices –only heplock, there is no IV tubing or IVF.

A

True

48
Q

How can you check for the patency of tubing?

A

In checking for the patency of the tubing, the nurse can flush 1-2 mL of saline or more than that. If it is patent, proceed to the medication administration. The nurse should do it slowly as the patient could feel pain and discomfort. Flush again with 1-2 mL of saline to maintain the patency of IV device.

49
Q

What should the nurse check in the electronic IV infusion device?

A

In electronic IV infusion device, the nurse should recheck if the drip rate is correct. This is usually found in the OR used by anesthesiologists.

50
Q

Why is the PCA locked out and the physician won’t tell the patient about it?

A

The physician doesn’t tell the patient that they locked out the PCA as this every time the patient feels pain, they press the PCA which promotes autonomy and control over their health that acts as placebo effect.

51
Q

What are the characteristics of veins?

A

Thinner than the artery.
Contains deoxygenated blood.
Transports blood from the body to fhe heart.

52
Q

Why are the veins used in IV insertion instead of the artery?

A

Thinner walls

Bleeding easily controlled

53
Q

What keeps the blood moving to the heart?

A

The valves as assisted by the skeletal muscle pump.

54
Q

The lower extremities of the vein is not preferred for IV insertion as _________.

A
  • The diameter is wider which increases the risk for clot formation.
  • Prone to infection.
  • Likelihood of movement during an ambulation or other activities.
  • The tendency for gravitational pull which is conducive excessive fluids on the lower extremities.
55
Q

Where does the IV insertion for pediatrics is done?

A

IV insertion for pediatrics could be done in the scalp or the lower extremities, however, lower extremities is preferrable as IV therapy in the scalp could invoke pity and affect the parents emotionally.

56
Q

What should you consider in iv insertion?

A

the nurse should start distally first as the distal parts such as the basilic and cephalic vein could not be used if the antecubital vein ruptured.

57
Q

What is the cephalic vein?

A

superficial and easy access; found in the hands.

58
Q

The cephalic vein can be found in ________.

A

Hands.

59
Q

What is a basilic vein?

A

largest arm vein in the upper extremities.

60
Q

Which hands should the nurse insert the IV?

A

Non-dominant to prevent movement.

61
Q

What can you use to prevent flexion of an IV site?

A

Splinters. If it is in the arm, it would serve as its own splinter.

62
Q

Should the nurse avoid checking BP on the arm of IV inserted site?

A

Yes as this contributes to the pressure in the veins.

63
Q

There should be no backflow as this could ______.

A

introduce microorganisms to the blood.

64
Q

What should the nurse do is the nurse found out discoloration around the IV site?

A

Remove and do not reinsert.

65
Q

Why can’t the nurse identify if the cause of infection is the IV site?

A

IV site is covered by the IV.

66
Q

What is the infection of the veins?

A

Phlebitis.

67
Q

What are the considerations in IV insertion in patients who had masectomy?

A

the nurse should use the arm on the side of breast which had not undergone mastectomy. However, if both breast is used, the nurse could choose either side but carefully monitor the patient and inform the physician.

68
Q

Aside from the basilic ans cephalic vein, what is the other vein that nurse could use in IV insertion?

A

The brachial vein could be used however it is deeper than the former stated veins.

69
Q

What is the 10 consideration in IV site selection?

A
  1. Veins in the hand, forearm, and antecubital fossa are suitable sites.
  2. Veins in the lower extremities (legs and feet) are not suitable for an adult client.
  3. Veins in the scalp and feet may be suitable sites for infants.
  4. Assess the veins of both arms before selecting a site.
  5. Start the IV infusion distally to provide the option of proceeding up the extremity if the vein is ruptured or infiltration occurs; if infiltration occurs in the antecubital vein, the lower veins in the same arm usually should not be used.
  6. Determine the client’s dominant side, and select the opposite side for a venipuncture site.
  7. Bending the elbow on the arm with an IV mat easily obstruct the flow of solution, causing infiltration that could lead to thrombophlebitis.
  8. Avoid checking blood pressure on the arm receiving IV infusion if possible.
  9. Do not place restraints over the venipuncture site.
  10. Use an arm board as needed when the venipuncture site is located in an area of flexion.

Level III: NCM 112 - Care of Clients with Problems in Oxygenation, Fluid and Electrolytes, Infectious, Inflammatory and Immunologic Response, Cellular Aberrations, Acute and Chronic (1 decks)

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