Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Therapeutic II > Exam 1 - Peripheral IV, Blood Glucose Testing, Blood Products > Flashcards

Exam 1 - Peripheral IV, Blood Glucose Testing, Blood Products Flashcards

1
Q

reasons for peripheral IV therapy

A
  • prevent or treat fluid or electrolyte imbalances
  • give meds
  • give blood products
  • provide nutrition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is max dextrose solution for peripheral IV nutrition

A

12.5% dextrose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what should you consider for peripheral IV

A

location and size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

should you go small with your IV catheter so it’s easier

A

no, don’t go small because it may not last

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

always go _____ when picking IV site and move _____ if necessary

A

distal….proximal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

common sites for peripheral IV in adults

A
  • dorsum of hand
  • forearm (intern’s vein)
  • antecubital fossa (cephalic and basilica veins)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

common site for peripheral IV in peds

A
  • scalp veins

- feet and ankle veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

are the veins used for blood draws the same as ones used for peripheral IV and why

A

not necessarily because some veins are very positional and should be avoided for IV’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what gauge peripheral IV catheters for adults

A

18 and 20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what gauge can be used for elderly or those with difficult peripheral access

A

22 gauge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what gauge can be used for teens

A

18-22 gauge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what gauge can be used for children

A

20-22 gauge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what gauge can be used for infants

A

22-24 gauge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

clean or sterile gloves for inserting peripheral IV

A

clean gloves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

at what angle for needle for peripheral IV insertion

A

shallow low angle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

bevel up or down for peripheral IV needle

A

bevel up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

once see flash of blood along the catheter what do you do with the needle

A

lower it to skin level and advance slowly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

before retracting needle during IV insertion what do you do

A

release the tourniquet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

when retracting needle during IV insertion what is important to do

A

hold pressure below the catheter tip to stop blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

should you ever reinsert the needle during IV insertion

A

never

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

when to assess IV site in adults

A
  • beginning of shift
  • prior to medication
  • whenever accessed or flushed
  • if pt complains of pain or discomfort at site
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

when to assess IV site in peds

A
  • beginning of shift
  • if infusing, hourly
  • before meds
  • whenever accessed/flushed
  • pt or parent request
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is phlebitis

A

inflammation of vascular endothelial wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

inflammation of vascular endothelial wall is

A

phlebitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

if phlebitis is accompanied with a blood clot it is called

A

thrombophlebitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

factors that can contribute to phlebitis

A
  • catheter gauge
  • size of vein
  • length of time catheter in place
  • type and pH of solution
  • use of small or lower extremity veins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is required in order for lower extremity veins to be used for IV access

A

an order

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

infiltration is characterized by what symptoms

A

swelling
cool to touch
pale to pink
tender to touch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

phlebitis is characterized by what symptoms

A 
swelling
warm to touch
erythematous
tender to touch
"cord" like vein with reddened line proximally from site
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

infiltration would be ____ to touch

A

cool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

phlebitis would be _____ to touch

A

warm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

nursing actions for infiltration

A
  • remove IV
  • may insert more proximal
  • replace IV in unaffected arm
  • warm pack
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

nursing actions for phlebitis

A
  • remove IV
  • insert in unaffected arm
  • avoid insertion in affected arm
  • warm pack
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

complications of peripheral IV

A
  • catheter occlusion
  • fluid overload
  • infection
  • air embolism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what is the universal blood donor

A

O-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what is the universal blood recipient

A

AB+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Rh positive can receive _____

A

positive and negative blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Rh negative can receive _______

A

only negative blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what is included in whole blood (7)

A
  • red cells
  • white cells
  • platelets
  • electrolytes
  • plasma
  • antibodies
  • added anticoagulant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what is whole blood indicated for

A

massive blood loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

is a filter needed for whole blood

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what is a normal volume for a unit of whole blood

A

500 mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what is usual adult peds dose of whole blood

A

20mL/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what does packed red blood cells contain

A
  • mainly red cells with plasma removed

- some white cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what is a normal volume for unit of packed red blood cells

A

300 mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what is packed red blood cells indicated for

A

raise hemoglobin or hematocrit when dangerously low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

one unit of packed red blood cells raises hemoglobin by ___

A

1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

one unit of packed red blood cells raises hematocrit by _____

A

3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

is a filter needed for packed red blood cells

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what is a normal peds dose for packed red blood cells

A

10mL/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

what are platelets made of

A

platelets separated from plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

what is normal volume for one unit of platelets

A

50-70 mL of platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what are indications for platelets

A

to stop bleeding or when platelets low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

one unit of platelets increases platelet count by how many

A

5000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

is a filter needed for platelets

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

what is fresh frozen plasma

A

plasma is separated from whole blood and then frozen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

one unit of fresh frozen plasma is usually what volume

A

200-250 mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

what are indications for fresh frozen plasma

A

clotting deficiencies, DIC, liver disease, warfarin reversal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

is a filter needed for fresh frozen plasma

A

no, but should be matched to pt blood type and Rh factor

60
Q

what is cyroprecipitate

A

prepared from plasma, contains factor VIII, von Willebrand’s factor, factor XIII and fribrinogen

61
Q

one unit of cryoprecipitate is usually what volume

A

5-20ml

62
Q

what is cryoprecipitate indicated for

A 
hemophilia A (factor VIII deficiency
von Willebrand's disease
and factor XIII deficiency
63
Q

what is albumin

A

plasma derivative

64
Q

does albumin need to be ABO or Rh matched

A

no

65
Q

what two concentrations are there for albumin

A

5% and 25%

66
Q

what are the indications for albumin

A

when crystalloid solutions are not adequate for volume expansion or when there is a capillary leak

67
Q

what does albumin do in the vessels

A

it provides oncotic pressure to keep plasma fluid in the intravascular space

68
Q

what blood product uses a filter to draw up, but not with administration

A

albumin

69
Q

what other plasma derivatives are there

A

factor VIII, factor IX, and ISG (immune serum globulin)

70
Q

when giving blood what must be obtained by the patient

A

consent

71
Q

what does blood transfusion consent include

A

the advantages, disadvantages, risks, complications, and if alternative methods could be used

72
Q

when is consent for blood transfusions delayed

A

in emergency situations, such as trauma

73
Q

in pediatric pt’s who gives consent for blood transfusions

A

parent or legal guardian

74
Q

who usually obtains blood transfusions

A

the patient’s provider

75
Q

for patient’s who oppose blood and blood products for religious reasons what would be given instead

A
  • increase crystalloid or some may agree to albumin in order to increase intravascular volume
76
Q

do blood administration policy’s and guidelines vary by facility

A

yes

77
Q

how long do you have before hanging blood to get vitals

A

30 mins

78
Q

when is it best to send for blood

A

after taking vitals and checking IV patency

79
Q

how long can blood last before it must be hung

A

it must be hung within 30 min, but preferred

80
Q

if blood not hung before 30 mins what do you do with it

A

send it back to blood bank

81
Q

can you put blood in the unit refrigerators

A

no

82
Q

when administering blood use the _______ IV access you can

A

largest

83
Q

what gauge do you use for blood administration

A

18g is preferred, but can use 20g

84
Q

does blood transfusion tubing include a filter

A

yes

85
Q

how long is blood tubing good for

A

24 hours

86
Q

how many units of blood can be used per tubing

A

6 units

87
Q

what personal protective equipment is required for blood admin

A

clean gloves and face shield if concerned for blood splashes

88
Q

how many RNs need to check blood product

A

2 RNs

89
Q

what gets checked by 2 RNs during blood transfusion

A 
blood product type
donor ID#
donor blood type
patient blood type
any special prep
90
Q

if any blood info does not match from blood compatibility tag and blood bag what do you do

A

send it back to blood bank

91
Q

can the 2nd nurse checking the blood product be an LPN

A

yes

92
Q

what type of tubing is used for most blood transfusions

A

Y tubing

93
Q

what do you prime blood transfusion tubing with

A

normal saline

94
Q

what would happen if you used lactated ringers or dextrose solution to prime blood transfusion tubing

A

it would hemolyze the red cells

95
Q

can you use lactated ringers or dextrose to prime blood transfusion tubing

A

no

96
Q

what is the only other product that can be infused or piggy backed to blood transfusion

A

only normal saline

97
Q

can you ever add medications or piggyback anything following blood transfusion

A

no, only normal saline

98
Q

how long is blood good for

A

4 hours

99
Q

why is blood expired after 4 hours out of the blood bank

A

the risk for bacterial infection is greater and RBCs begin to die

100
Q

at what rate do you first infuse blood and for how long

A

at 30ml for 15 minutes

101
Q

why do you infuse blood slower at first

A

to see if there is any adverse reaction to the infusion

102
Q

after 15 min with no reaction to blood transfusion what do you do

A

take vitals and increase the infusion to what is ordered

103
Q

at what point are vitals taken at the end of the blood transfusion

A

within 15 minutes of the end of the transfusion

104
Q

what do you do if patient is having a reaction to blood transfusion

A

stop the infusion immediately and if patient is stable take vitals

105
Q

what documentation is included for blood transfusions

A

all vitals, product type, donor ID #, how long it infused, and how pt tolerated

106
Q

what is frequently given with minor blood transfusion reactions

A

Benadryl and tylenol

107
Q

if mild blood transfusion reaction occurred are they able to receive another unit of blood later

A

yes

108
Q

evidence shows that most reactions to blood tranfusions occur within the first_____ minutes

A

15

109
Q

4 most common types of blood transfusion reactions

A
  • febrile non-hemolytic
  • acute hemolytic
  • allergic
  • anaphylactic
110
Q

of the 4 types of blood transfusion reactions which is the most common

A

febrile hemolytic

111
Q

what happens with febrile hemolytic blood transfusion reaction

A
  • happens within 6 hrs
  • antigen-antibody response to donors WBC
  • sudden chils, fever, headache, flushin, muscle pains, chest pain, dyspnea
112
Q

what would be ordered for a febrile hemolytic reaction

A

antipyretics

113
Q

what happens with allergic reaction to blood transfusion

A

during transfusion or within 1 hr after

  • sensitivity to foreign plasma proteins
  • flushin, itching, hives
114
Q

what would be administered for allergic reaction to blood transfusion

A

antihistamines (Benadryl)

115
Q

blood trans reaction: antigen-antibody response to donors WBCs

A

febrile hemolytic

116
Q

blood trans reaction: sensitivity to foreign plasma proteins

A

allergic reactions

117
Q

what happens with acute hemolytic blood trans reaction

A

ABO incompatibility, happens due to some sort of mislabeling

  • occurs within 5-15 min
  • chills, fever, low back pain, tachycardia, tachypnea, hypotension, renal failure, hemoglobinuria, cardiac arrest, death
118
Q

nursing actions for acute hemolytic blood trans reaction

A

check vitals q 5 min and ABC support

119
Q

blood trans reaction: ABO incompatibility

A

acute hemolytic

120
Q

what happens in an anaphylactic reaction to blood transfusion

A
  • infusion of IgA protein to IgA deficient recipient
  • reaction happens immediately
  • anxiety, wheezing, respiratory distress, nausea and vomiting, cramping, shock, cardiac arrest
121
Q

nursing actions for anaphylactic reaction to blood transfusion

A

support ABC and admin epinephrine

122
Q

what may be given to high risk pt’s such as though with CHF while receiving blood transfusions

A

Lasix to avoid fluid overload

123
Q

blood trans reaction: infusion of IgA protein to IgA deficient recipient

A

anaphylactic reaction

124
Q

lab testing procedures performed in an area where pt is located instead of traditional lab

A

point of care testing

125
Q

what is the purpose of blood glucose testing

A
  • test for hypo or hyperglycemia

- effectiveness of insulin or oral hypoglycemic meds

126
Q

is a prescriber order required for blood glucose testing

A

yes

127
Q

what type of blood is used for blood glucose testing

A

any type (capillary, venous or arterial)

128
Q

how is blood glucose value reported

A

in milligram per deciliter (mg/dl)

129
Q

what is normal glucose range

A

60 - 100

130
Q

critical low value for BG

A

less than 40

131
Q

critical high value for BG

A

more than 500

132
Q

if BG high or low on first test what should you do

A

repeat the test

133
Q

when are quality control tests done for glucometer testing

A

24 hrs prior to patient testing, usually done on nights

134
Q

fight or flight response with increased adrenaline and glucagon are adrenergic signs and symptoms of what and why

A

hypoglycemia due to decline in plasma glucose

135
Q

change in mental status from confusion and agitation to loss of consciousness are neuroglycopenic signs and symptoms of what and why

A

hypoglycemia due to shortage of glucose in brain

136
Q

do the neuroglycopenic symptoms of hypoglycemia occur before or after the adrendergic symptoms

A

usually concurrently or after the adrenergic signs

137
Q

what are the nurses response to hypoglycemia

A
  • admin 25-50 grams of dextrose (D50)
  • graham crackers, saltines, and juice
  • glucagon
138
Q

what are the classic signs and symptoms of hyperglycemia

A

three Ps = polydipsia, polyuria, polyphagia

139
Q

aside from 3 P’s what are other signs of hyperglycemia

A

anorexia, nausea, vomiting, fatigue, rapid shallow respirs, loss of consciousness, dehydration, hypotension, tachycardia

140
Q

what are kussmaul’s respirations

A

rapid shallow respirations that are compensating for metabolic acidosis by blowing off excess CO2

141
Q

if a persons breath smells fruity and they are breathing quick shallow breaths what is it an indication of

A

hyperglycemia

142
Q

what can the manifestations of hyperglycemia ultimately lead to

A

diabetic ketoacidosis (DKA)

143
Q

how does symptoms of hyperglycemia lead to DKA

A

increased glucose levels cause body to use fat for energy which increases production of ketones

144
Q

when increased glucose levels cause the body to use fat for energy it results in an increased production of what which is called

A

increased ketones and is called diabetic ketoacidosis

145
Q

would you correct hyperglycemia quickly or slowly and why

A

slowly because if not it can lead to rebound hypoglycemia

146
Q

treatment of hyperglycemia would be

A
  • fluid resuscitation

- regular insulin

147
Q

what is fluid resuscitation

A

bolus of normal saline (.9%)

Therapeutic II (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions