Chapter 29 - Intravenous and Vascular Access Therapy

Question 1

What are the goals of IV therapy?

Answer 1

-maintain fluid & electrolyte balances
-administer continuous or intermittent medications
-replenish blood volume

Question 2

VAD

Answer 2

vascular access device

Question 3

CVAD

Answer 3

central vascular access device

Question 4

What does a short-peripheral IV line need to be locked with?

Answer 4

preservative-free 0.9% sodium chloride or normal saline

Question 5

Risk for Isotonic Solutions

Answer 5

increased risk or fluid overload in patients with renal or cardiac disease

Question 6

Hypotonic Solutions can…

Answer 6

exacerbate a hypotensive state

Question 7

Hypertonic solutions can irritate…

Answer 7

veins and risk heart failure and pulmonary edema

Question 8

Solutions and medications with an osmolarity greater than ____mOsm/L are infused through a CVAD

Answer 8

900

Question 9

D5W is an __________ solution

Answer 9

isotonic

Question 10

D10W is a __________ solution

Answer 10

hypertonic

Question 11

D50W is a __________ solution

Answer 11

hypertonic

Question 12

0.45% NS is a ___________ solution

Answer 12

hypotonic

Question 13

0.33% NS is a ___________ solution

Answer 13

hypotonic

Question 14

0.9% NS is an ___________ solution

Answer 14

isotonic

Question 15

3-5% NS is a ___________ solution

Answer 15

hypertonic

Question 16

Dextrose in saline solutions are _____________

Answer 16

hypertonic

Question 17

Lactated ringer is __________ solution

Answer 17

isotonic

Question 18

Dextrose 5% in LR is _____________

Answer 18

hypertonic

Question 19

Phlebitis

Answer 19

inflammation that causes a blood clot to form in a vein

Question 20

CLABSI

Answer 20

central line-associated bloodstream infection

Question 21

How often should you assess CVADs?

Answer 21

at least daily

Question 22

Assess short-peripheral catheters at least every ___ hours

Answer 22

4

Question 23

How often should you change a gauze IV dressing?

Answer 23

every 2 days

Question 24

How often should you change transparent semipermeable membrane (TSM)?

Answer 24

every 5-7 days

Question 25

Markers of Vascular Volume:

Answer 25

-urine output
-vital signs
-distended neck veins
-lung auscultation
-cap refill

Question 26

Markers of Interstitial Volume:

Answer 26

-skin turgor
-dependent edema
-oral mucous membrane
-thirst
-behaviour
-loc

Question 26

How full do you fill the IV drip chamber?

Answer 26

1/3 to 1/2 full

Question 27

How do you prime extension tubing?

Answer 27

-slowly inject saline to fill the tubing and connector, remove all the air

Question 28

Do you apply tape over a tsm dressing?

Answer 28

no, it prevents moisture from being carried away from the skin

Question 29

When do you use gauze dressings instead of tsm?

Answer 29

-drainage
-excessive perspiration or sensitivity
-allergic reaction

Question 30

What do you write on IV dressing label?

Answer 30

-date and time of iv insertion
-gauge size and length
-initials

Question 31

MARSI

Answer 31

medical adhesive-related skin injury

Question 32

s and s of fluid volume deficit (FVD)

Answer 32

-decreased urine output
-dry mucous membranes
-decreased cap refill
-tachycardia
-hypotension
-shock

Question 33

s and s of fluid volume excess (FVE):

Answer 33

-dyspnea
-crackles in lung
-edema
-increased urine output

Question 34

s and s of electrolyte imbalances

Answer 34

-abnormal serum electrolyte levels
-change in mental status
-alterations in neuromuscular function
-cardiac arrythmias
-changes in vital signs

Question 35

s and s of phlebitis

Answer 35

-pain
-redness
-warmth
-swelling
-induration
-presence of palpable cord along course of vein

Question 36

How to treat chemical phlebitis:

Answer 36

-apply heat
-elevate limb
-consider slowing infusion rate

Question 37

How to treat mechanical phlebitis:

Answer 37

-apply heat
-elevate limb
-monitor for 24 to 48 hours
-consider removal if s and s persist

Question 38

How to treat bacterial phlebitis:

Answer 38

remove IV

Question 39

What do you teach patient about activity restrictions with IVs?

Answer 39

-avoid strenuous exercise
-protect site when bathing or showering

Question 40

gravity infusion requires calculating _________

Answer 40

gtt/mL

Question 41

What flow rate does microdrip tubing deliver?

Answer 41

usually 60 gtt/mL, rates less than 100mL/hr

Question 42

What is the flow rate of macrodrip tubing?

Answer 42

10-15 gtt/mL and used for rates greater than 100mL/hr