Chapter 20: Intravenous Therapy Flashcards
access away from the body center in the arm and hand veins for adults
Peripheral catheters
access by placement of a flexible catheter into one of the patient’s large veins with the tip placed in either the superior vena cava or the right atrium and may be required when infusing hypertonic solutions or when peripheral venous access is inadequate
Central venous Catheters
You are assessing the IV site…
For appearance every hour and should be labeled with date/time/initial for when it was started
You are assessing equipment…
1) the solution container should be checked for expiration date, if fluid is clear, and if it is the right fluid
2) IV bags should be changed every 24 hours
3) Tubing should be changed every 72-96 hours or 3-4 days
same osmotic pressure as within the cell and useful for hypotension caused by hypovolemia. Ex: Normal Saline (NS) 0.9% or Lactated Ringers
Isotonic Fluids
Lower osmotic pressure than the cell, Used when patient needs cellular hydration. Fluids shift out of blood and into cells and interstitial spaces. Ex: Dextrose 5% (D5W) or 0.45% Saline 1/2 NS
Hypotonic Fluids
Greater osmotic pressure than the cell and pulls fluid from the cells into the vascular space. Ex: 3% saline (NaCl)
Hypertonic Fluids
When fluid enters subcutaneous tissue, swelling and/or tenderness above the site and area around site feels cool to touch and looks pale in color
Infiltration
When the medication leaks out of the vein
Extravastion
Signs of this complication include: inflammation of the vein, redness, tenderness,warmth and firmness to touch around the IV site
Phlebitis
Red,warm to touch, tender to touch and possible weeping, oozing purulent drainage are signs of…
Infection
If complications are assessed the nurse should…
Inform the nurse and instructor
IV should be dc’d and restarted in another location
For Phlebitis and infiltration…
apply warm moist soaks
For infection…
catheter tip should be cultured
Fluid Overload may occur…
1) If client is very old or young
2) Received IV fluids too rapidly
3) Has altered regulatory mechanisms (e.g, renal or cardiac impaired)
Assessments for fluid overload should include…
lungs, weight gain, and decreased urine output
Treatment of fluid overload include…
1) slowing IV to keep it open and notifying doctor
2) Assess breath sounds
3) Place client in high or semi fowler’s position
4) Administer oxygen as needed
