Exam 2: IV Therapy Flashcards
What is the indication for a peripheral IV catheter?
Short term use to allow administration of IV meds, fluids, or blood
resuscitation (rapid absorption), routine maintenance, replacement, redistribution
What do the various gauge sizes indicate?
Determines infusion flow rate
Why is it important to maintain asepsis when placing and accessing an IV site?
Prevent spread of infection
What is the process for assessing an IV site?
Location, gauge, visual inspection (bruising, redness, swelling), Infiltration/extravasation/phlebitis
What are the signs and symptoms of infiltration, extravasation, phlebitis, and a localized IV infection?
Infiltration and extravasation (Similar in that both fluid entering interstitial area)
Infiltration - skin feel cool, edema
Extravasation - meds cause tissue damage (vesicant: K+, IV contrast, etc.)
Phlebitis: redness and heat at IV site, swelling, purulent drainage, streaking
How is infiltration, extravasation, and phlebitis treated?
D/C IV - stop infusion, remove catheter
Warm compress for phlebitis, infiltration
Cold compress and admin antidote for extravasation
What is the purpose and the procedure for scrubbing the hub?
Asepsis, alcohol or chlorhexidine for 15-30 seconds and allow to dry
Why do we flush an IV catheter? When do we flush an IV catheter?
Ensure patency of catheter
Prevent mixing of medications within the catheter
Accomplish:
Prior to blood sampling
Prior to and after IV med administration
At least every 12 hours when IV not in use
When do we discontinue a peripheral IV?
PT D/C
IV has complication
IV therapy is no longer needed as verified with provider
What is the definition of a Central Venous Access Device (CVAD)?
Devices with catheters that terminate in a central vein
Ends in superior vena cava?
Have direct access to RA of heart
What are the indications for a CVAD?
Long term access to the central venous circulation for administering large volumes of fluid, parenteral nutrition, or for medications that may irritate peripheral vessels
Can draw blood as well
How do we confirm a CVAD is available for use?
X-ray to confirm placement
Provider must place order that line is ok to use
What is a PICC line and what is it used for?
Peripherally inserted central catheter - catheter tip sits in the superior vena cava
Commonly inserted for long term antibiotic use
Clients may be be discharged with one in place
What types of meds are preferred to be given through a CVAD?
Anything is better through a CVAD -> Blood, fluid
Meds that may irritate peripheral vessels (Vesicants)
What are the components of a CVAD assessment?
Visualize external elements and insertion area
Ensure line is secure and catheter is not pulled out of body
Assess integrity of dressing and last dressing change
Assess surrounding skin
Line should be flushed to ensure patency
When should a CVAD dressing be changed?
If wet, soiled, or dislodged
Every 7 days
What is CLABSI?
Central line associated bloodstream infection
Considered a hospital acquired infection
How do we prevent CLABSI?
Hand hygiene
Maintaining aseptic technique when accessing device
Avoid insertion in the femoral site
Routine cleaning with chlorhexidine wipes
Scrub access hub with alcohol prior to each use
Remove central lines that are no longer needed
Change dressing as needed/per protocol
Where do you find the rate for pushing an IV medication?
Medication order (but not in order?)
Drug reference guide
What is the process for pushing a medication through an IV line?
Flush - med - flush
Med injected by syringe directly into an injection site of an existing IV
Administered over short period of time; usually <5 min
What is the difference between a continuous infusion and an intermittent infusion?
Continuous: medicated or non medicated. Fluids go for a set rate: maintenance fluids. Meds at set rate for desired pharmacological effect
No end date or time until doc says
Intermittent: method of administering meds at a set interval
Via secondary (piggyback) line
Common with antibiotics
Why do we use IV pumps?
Ensures consistent rate that can be changed if needed
Safety
What are indications that your client requires blood products?
Hemoglobin, hematocrit
Client is losing blood
What is the process for ordering, obtaining and checking blood products?
Order from provider
Patient consent
Assessment
- Baseline vitals with temp,
- Verify IV line is functioning
Patient education
2 nurse check
- Verify blood components delivered were the ones that were ordered
- Client’s blood type is compatible with the delivered product the right pt is receiving the blood
When should vital signs be taken when administering blood products?
Prior to infusion
15 min after start of transfusion (RN must stay with pt for first 15 mins)
Conclusion of transfusion
What are symptoms of a transfusion reaction?
Allergic rxn
Chills, fever, flushing, hives, SOB, tachy
What is the process for treating a transfusion reaction?
Stop blood and remove tubing
Infuse normal saline
Notify provider
Treat s/s
Stay with pt
Send blood and tubing to blood bank
