Administration of Intravenous Fluids Flashcards
These solutions have the same osmolality as body fluids and is used to increase extracellular fluid volume.
Isotonic solutions
What solution is used before or after the infusion of blood products?
0.9% saline or normal saline
This is used primarily to replace extracellular fluid deficits such as fluid loss from burns, bleeding, and dehydration.
Ringer’s lactate solution
These are also called plasma expanders, they pull fluid from the interstitial compartment to the vascular compartment.
Colloids
A common complication of using butterfly sets for intravenous therapy is:
Infiltration
When would you consider using a butterfly set for IV administration?
For children and older adults, who have small or fragile veins
This technique ensures that the the IV tubing is free from air, which may act as an emboli.
Priming
Where are the most common IV insertion sites?
Inner arm: cephalic, basilic and median cubital veins are best for IV placement in adults.
Which areas would you avoid placing IV cannulas in?
Avoid areas with “FISTED”:
Flexion areas
Infection and Infiltration
Same side as mastectomy
Trunk veins, thrombophlebitis
Exudates
Dialysis (vascular graft/fistula)
What is the drop factor for a macrodrip chamber?
Between 10 to 20 gtts/ml
When would a nurse consider using a microdrip chamber?
If fluid is to be infused at a low rate or if the solution contains medications that need to be titrated i.e. pediatric patients
How frequently should IV sites be changed?
Every 72 to 96 hours
How frequently should IV tubings be changed?
Every 96 hours
If you suspect an air embolism, how would you position the client?
On left side with head of bed lowered (Trendelenburg’s position) to trap the air in the right atrium.
This is a complication of IV therapy that results from the administration of fluid too rapidly.
Circulatory overload
What action would the nurse take to prevent a hematoma when discontinuing an IV line?
Apply pressure to the site for 2-3 minutes and elevate the extremity
Edema, pain, numbness and coolness at the IV site suggests which complication of IV therapy?
Infiltration
This is the seepage of the IV fluid out of the vein and into the surrounding interstitial space.
Name a common way for checking if the IV device is still in the vein.
Lower the IV fluid container below the IV site and check for backflow of blood in the tubing, which suggests the IV device is in the vein.
What signs and symptoms would you expect in a patient who has experienced phlebitis as a result of IV therapy?
Heat, redness, and tenderness at the site, and sluggish IV infusion.
A nurse is administering fat emulsion to a malnourished client and notes that the solution appears frothy and there is separation of the emulsion into layers or fat globules. what should the nurse do?
Do not use the solution and return the solution to the pharmacy. These signs indicate instability or breakdown from factors such as improper storage or temperature fluctuations.
Why is insulin usually added to a parenteral nutrition solution?
To control blood glucose level because of the high concentration of glucose in the parenteral nutrition solution
This is usually added to a parenteral nutrition solution to reduce the buildup of a fibrinous clot at the catheter tip.
Heparin
Parenteral nutrition solutions should be administered within how many hours from the time they are prepared?
24 hours
What is the normal infusion time for packed red blood cells?
Between 2 and 4 hours, generally no more than 4 hours otherwise hemolysis may occur.
How soon and how rapidly should platelets be administered if required?
They should be administered immediately upon receipt and usually over 15 to 30 minutes.
What is the normal infusion time for fresh frozen plasma?
FFP is used to provide clotting factors. They should be infused within 2 hours of thawing so clotting factors are still viable.
During inspection of a unit of blood, the nurse notes a cloudy appearance and pink discoloration. What should the nurse do?
Do not use the blood product. A cloudy appearance usually indicates that the bag is contaminated, and a pale pink discoloration indicates possible hemolysis of RBCs.
The universal RBC donor type
Type O
What gauge needle is used to administer blood products?
Large bore, 18 or 19-gauge, to achieve maximum flow rate and prevent damage to RBCs
What immediate actions would the nurse take if the patient shows signs of transfusion reactions?
SCAR:
Stop the transfusion
Change administration set
Administer normal saline
Report to blood bank and primary care provider
Within minutes of blood transfusion, a client develops fever, tachycardia, hypotension and abdominal, chest, back, and flank pain. This could indicate which reaction?
Acute hemolytic transfusion reaction, caused by ABO incompatibility
A client receiving transfusion develops urticaria, pruritus and facial flushing. A mild wheeze is also noted. The nurse would prepare to administer which medication?
This indicates an allergic reaction. Administer anti-histamine, corticosteroids, and epinephrine as prescribed.
A client receiving transfusion develops a maculopapular rash, watery diarrhea and jaundice. This is indicative of which complication?
Transfusion-Associated Graft-versus-Host Disease
This occurs when the recipient’s immune system mounts an immune response against the donor lymphocytes.
Which medication would be given to a client who develops iron overload during transfusion?
Deferoxamine IV or Subcutaneous
Hemolysis of RBCs from blood products that are not fresh could lead to which electrolyte imbalance?
Hyperkalemia, because potassium is released when RBCs are hemolyzed.
