Chapter 17-21 Flashcards
3 major electrolytes our bodies need to function properly:
sodium Na
potassium K
chloride Cl
potassium imbalance can cause:
muscle twitching and irregular heartbeat
human body is mostly water consisting of:
60% of body weight is fluid
Other electrolytes:
magnesium
calcium
zinc
bicarbonate
phosphate
sulphate
2/3 of our body fluids are found:
within body cells (intracellular)
remainder of 1/3 of our body fluids found:
inside blood vessels (intravascular) and spaces between cells (ingerstitial)
electrolyes assist in transporting nutrients to and from cells within the body play a role in:
muscle & nerve function
The body fluid balance, and electrolyte composition are primarily maintained by the:
Respiratory system
gastrointesinal system
Circulatory system
renal system
integumentary system
doctors will order IV fluid in the following situations:
-The patient is unable to take fluids by mouth
-The patient has an abnormal loss of body fluids, such as from severe, vomiting or diarrhoea
-The patient is injured or has life-threatening conditions
-The patient has had major surgery
-The patient requires medication that can be given only intravenously
-The patient requires prophylactic antibiotics while undergoing surgical are invasive diagnostic procedures
-to restore the bodies acid base balance
-to restore blood loss by haemorrhage
-To stabilize patient with a bleeding disorder, such as haemophiliac
-To correct dehydration by restoring the bodies, water electrolytes in So on
-To provide nutrition when the patients gastrointestinal track is resting
ive equipment that contains solution for iv therapy?
IV bag (largest bag is 1000cc or ml)
to start an iv ——— needs to be inserted into a pt’s vein:
IV or catheter
a plastic tube usually attached to the puncturing needle, inserted into a blood vessel for infusion, injection or pressure monitoring, is called:
angiocatheter (angiocath)
farthest part from the body
distal
distal end of catheter has an adapter that attaches to tubing and connected to:
IV bag or solution
Device used to start an IV in smaller peripheral veins for short term IVs, and when fragile veins make insertion of a larger intra-catheter difficult;
butterfly
disadvantage of butterfly needle:
Can easily slip a ravine, and allow IV solution to seep into the surrounding interstitial tissues
Device used to deliver long term IV therapy ranging from weeks to years used for chemotherapy medication, blood or blood products hyper alimentation and monitoring central venous pressure. They’re also use for patients with poor veins to reduce the trauma of repeated IV starts. Increases patient comfort and helps reduce anxiety and patients who must have frequent venous access:
Central venous IV
Small, flexible, plastic tube, the tip of which is placed in the superior or inferior vena cava or the right atrium. It is inserted to a central vein that is one that lives in the chest cavity or that is linked directly to the right atrium the main access veins used, or the internal and external jugular in the sub, clavicle veins Sometimes the femoral vein:
Central venous access device or catheter CVD or CVC
An intravenous catheter that is inserted into a vein. Usually in the upper arm, called a peripheral vein and threaded into a larger be near the heart essential mean it is used with longer-term Ivy therapies needed such as for antibiotics, chemotherapy or total parenteral nutrition:
PICC or peripherally, inserted, central catheter
Complications that can arise from the insertion of a central line include:
development of an air embolism
An arrhythmia
Infection
Perforation of a vessel
components of a Dripset:
-a spiked end that inserts into the IV bag
-a drip chamber, through which you can see the solution dripping as a drains from the bag
-A roller clamp used to adjust the speed of the infusion
-Two or three access port, along the length of the tubing that I used to administer IV meds, or add a second IV line
Includes a length of tubing with a special spiked end used to pierce the port on the IV bag
Mainline IV administration set
Two ports that can accommodate TYV bags that allow the infusion of two separate solutions similtaneously
Y tubing set and blood infusion set
Blood and blood products must always be run with:
Normal Celine
When a separate or secondary infusion line is needed the most popular set up is a:
medication administration set or Add-a-line or mini bag
The device that controls the intravenous infusion rate by monitoring either the drops per minute the IV said delivers for the volume of fluid delivered:
controller
A number of these pumps are available operating on different principles to deliver IV solutions, conveniently and accurately some units comprise more than one pump, allowing for the delivery of multiple IV solutions for one. Patient concurrently these devices, exert pressure on the IV tubing providing accurate delivery of a program volume offer, read outs of how much solution has infused at how much remains to be absorbed and will set an alarm if some thing obstruct the infusion or if the IV bag runs dry
electronic fusion pump
A mechanism by which a patient can self administer analgesic intravenously with the assistance of a computerized pump. It allows for the introduction of specific doses of preset intervals into the IV line.
patient controlled analgesia
A chamber added to an IV line between the bag and the line to control volumes more closely. It is used to ensure safety when the volume of fluid delivered must be carefully monitored often with children.
The Buritrol
No devices are needed. When gravity is used to deliver IV solution bag is on an IV port is held higher than the IV site solution drips into the tubing and into the patient vain by gravity, the nurse, regulates infusion rate by manually adjust in the roller clamp on the IV tubing to the required gtt/min
IV gravity based system
Device that provides intervenous access when needed without continuous infusion. It sits in the van, and must be flushed a specific intervals with saline solution or heparin solution.
Heparin, Hep-Lock, saline lock, PRN adaptor
A medication given into the vein or into an ongoing IV infusion, using a syringe and needle
IV push or IVP
Ivy orders must have the following components which provide the nurse with the information they required to carry them out:
flow rate
Start date
Stop date
Solution ordered
Common IV solutions:
Ringers lactate solution
2/3 and 1/3
D5W
Normal saline
5% dextrose and 0.9 NaCl.
0.45% NaCl.
IV solution containing water, electrolytes, sodium potassium, calcium chloride, used for milder cases of metabolic, acidosis for dehydration, and for shock, burn patients who have lost a lot of extra cellular fluid in order,l
Ringers lactate solution
IV solution one of the most frequently ordered, contains 3.3% glucose and 0.3% sodium chloride. Main purpose of the solution is maintaining adequate hydration, normal fluid balance. It is used for maintenance purposes versus restorative or resuscitative purposes.
2/3 and 1/3
IV solution also written as 5% DW means 5% dextrose in water solution is used primarily to replace water loss as in dehydrated patience and to provide some nutrients about 200 cal per liter. It is not provide electrolytes frequently used to keep the van open when the physician wants access to the van through an IV line but has not ordered a saline lock to keep the van open sometimes the physician order a certain amount of solution for hour and sometimes not.
D5W
Can also be written as 0.9% NaCl solution of pure ordinary salt made up of sodium and chloride in water, referred to as a physiological or isotonic because it will not alter normal electrolyte balance. It is used to treat patients who have lost a lot of body fluids as from hemorrhage, the solution restores electrolyte balance, but it’s not contain any calories, and unlike dextros solutions will not interfere with the sugar levels in a person with diabetes. It is the only intravenous fluid that may be run with blood. The moment the blood stops long, this solution will kick in. It is also used to flush the tubing … all IV meds are mixed in this solution and is used for keeping the vein open unless the patient is severely compromised with somesuch condition has congestive heart failure and should not have any also used to flush wounds and eyes because it’s not irritating
Normal Saline
The solution is used to treat, dehydration, another fluid for daily maintenance of body, fluids, and nutrition. It is similar to normal saline.
D5NS 5% dextrose and 0.9 NaCl
this has equal proportions of sodium and chloride, but half the sodium chloride of normal saline is often used to dilute acid in the blood when a patient is experiencing metabolic acidosis a condition in which the body is too acidic. It may be a better maintenance fluid, if larger amounts have to be administered.
0.45% NaCl
med given to hemophiliacs for clotting:
Factor VIII or 8 or cryoprecipitate
Why would a surgeon order prophylaxis
Blood usually packed cells available for patients having major surgery in case of excessive blood loss during surgery crossmatch for a patient and held in love for him or her
 When someone has two fewer red blood cells their number causes is usually treated with the infusion of packed cells
anemia
Any situation in which a person loses an excessive amount of blood usually over 750 cc is called hemorrhage. This causes the body to go into shock most effective way to treat massive haemorrhage is by blood replacement.
acute blood loss
Before receiving a blood transfusion, patient must have a:
Group and screen, and then the blood must be crossmatch
Types of blood products:
whole blood
Platelets
Fresh, frozen plasma
Packed cells
Albumin
Cryo-precipitate
Ordered as a unit of blood approximately 520 cc of donated blood maybe used to treat excessive blood loss resulting from trauma surgery or burns but is not frequently ordered
Whole blood
Extracted from whole blood in order for someone with thrombocytopenia or a low blood platelet count. Anyone with these is at risk for bleeding disorder in particular disseminated, intravascular coagulopathy, potentially fatal condition, characterized by widespread bleeding, and these are ordered by the unit.
Platelets
