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N1115 - Trans. to Associates > Exam 2 - IVF > Flashcards

Exam 2 - IVF Flashcards

1
Q

purpose of IVF

A

maintenance
replacement
administer meds
administer blood products

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2
Q

what are the 3 types of IVF

A

isotonic
hypotonic
hypertonic

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3
Q

What is the rule of 300?

A 
below = hypotonic
above = hypertonic
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4
Q

will a cell change with isotonic solution?

A

no

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5
Q

what occurs with isotonic solution?

A

the amount of water transported into the cell is equal to the amount of water transported out of the cell

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6
Q

examples of isotonic solution

A

NS

LR (blood loss, truma)

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7
Q

when would you give an isotonic solution?

A

when fluids need to be replaced

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8
Q

when would you give NS?

A

fluid resuscitation
metabolic acidosis
hypercalemia
mild hyponatremia

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9
Q

too much NS can cause which electrolyte imbalance?

A

hypernatremia

hyperchloremia

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10
Q

LR contraindication

A

kidney injury

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11
Q

when would you use LR?

A

maintenance in postop
hyponatremia
fluid loss

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12
Q

Example of hypotonic solution

A

0.45 NS

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13
Q

when would you administer a hypotonic solution?

A

remove waste

replace insensible fluid loss

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14
Q

Can you bolus 1/2 NS?

A

No, rapid swelling will occur, cardiovascular collapse, or increased ICP

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15
Q

what occurs with hypotonic solution?

A

water is transported into the cell making the solute concentration higher

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16
Q

what occurs with hypertonic solutions?

A

water is pulled OUT of the cells making the solute concentration lower

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17
Q

examples of hypertonic solution

A

3% NS
mannitol
PPN
colloids: dextran, albumin, D5NS, D5LR

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18
Q

indication for 3% or 5% NaCl

A

critical hyponatremia

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19
Q

what VS to monitor when administering 3% or 5% NaCl

A

BP

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20
Q

how would you administer 3% or 5% NaCl

A

slowly; closely monitor

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21
Q

what does administering albumin do?

A

pulls fluid into the vessels to be excreted

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22
Q

What does Dextran do?

A

volume expander
-pulls fluid out of cells into vascular space
-reduces clotting ability
increases BP, circulatory volume

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23
Q

when is dextran used?

A

hypovolemic shock

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24
Q

peripheral parental nutrition (PPN) may be administered through

A

a large peripheral vein

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25
Q

total parental nutrition (TPN) must be administered throguh

A

a central line

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26
Q

what to monitor with PPN or TPN administration

A

glucose imbalance
fluid, electrolyte imbalance
fluid overload

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27
Q

how soon to pull refrigerated IV meds

A

15-20 minutes to allow it to come to room temperature

28
Q

fluid overload nursing care

A 
elevate HOB
KVO at 10-21 mL/hr
assess pt
-VS, lung sounds, mental status, O2 SAT, edema
administer diuretics

*contact HCP

29
Q

when air enters the R ventricle, lodges against pulmonic valve and stops the valve action/flow of blood

A

air embolism

30
Q

how to prevent an air embolism

A

use locking ports on tubing
prime all tubing
fill drip chamber half full
IV pump air detection alarm

31
Q

air embolism s/sx

A 
dyspnea
palpitations
coughing
JVD
wheezing
chest, shoulder, low back pain
shock
-weak, rapid pulse; hypotension; decreased LOC
32
Q

air embolism txment

A 
clamp the line
place on L trendelenburg
fix air leak
administer O2
assess, tx according to orders
33
Q

infiltration or extravasation (damaged tissue) are used

A

interchangably

both involve infusion of solution into the surrounding tissue instead of vein

34
Q

infiltration, extravasation s/sx

A 
swelling around site
coolness at site
slowed rate
leakage from site
pump alarm indicating pressure
35
Q

how to prevent infiltration, extravasation

A 
frequent site monitoring
flush for patency prior
avoid IV at areas of flexion
secure IV to avoid movement
give vesicant IV push meds through side port on IV tubing
36
Q

infiltration treatment

A 
agency policy
stop infusion, remove IV
start new site above or opposite arm
isotonic solution used: warm compress, elevation
hypertonic solution used: cool compress
37
Q

extravasation treatment

A

agency protocol

common extravasation protocol:
stop infusion
assess, notify HCP
administer antidote through existing cannula
remove cannula
38
Q

common vesicants

A 
vasopressors
Ca
K
Dilantin
phenegran
vanc
chemotherapy
39
Q

What is phlebitis?

A

inflammation of the vein

*no clot

40
Q

phlebitis treatment

A

DC IV, restart above or other arm
warm compress
NSAIDS

41
Q

what is thrombophlebitis

A

clot with inflammation

42
Q

s/sx of thrombophlebitis

A

localized pain
redness
warmth
edema

43
Q

thrombophlebitis treatment

A

DC IV, restart above or opposite arm
cold compress FIRST
warm compress, elevate LATER
may culture drainage from catheter tip

44
Q

thrombophlebitis prevention

A 
avoid trauma
wash hands
aseptic technique
monitor hourly
flush with saline prior to administering meds
45
Q

blood leakage into surrounding tissue

A

hematoma

46
Q

cause of hematoma r/t IV

A

cannula goes through the vein
cannula is too big
cannula slips out of vein
-no secure adequately

47
Q

hematoma treatment

A

remove cannula
apply pressure
pressure dressing x24 hours
elevate extremity

48
Q

how to prevent IV clotting/obstructions

A

do not let bag run dry
do not let tubing kink
maintain adequate flow
flush as appropriate

49
Q

Bolus

A

give fluid fast
1 L/hour
500 mL/hour

50
Q

Maintenance drip

A

KVO

75 mL/hr

51
Q

safest, easiest methods of administering IV medications

A

mixing in large volumes

52
Q

first step if you were to mix a medication with IVF

A

make sure they’re compatible

53
Q

most dangerous method of medication administration

A

IVP

bolus

54
Q

IVP should be administered over less than __ minute

A

1

55
Q

how an order should be written if IV med is to be given over 1 minute

A

“IV over x minutes”

56
Q

IVP advantages

A

fluid sensitive pt
rapid action
only one stick for multiple doses

57
Q

IVP disadvantages and safety concerns

A

most dangerous
acts instantly
ALWAYS VERIFY with another nurse
always check site for patency and placement FIRST

58
Q

volume-controlled infusions

A

50-100 mL fluid

59
Q

3 types of volume-controlled infusions

A

volume-control admin. set
piggyback sets
syringe pumps

60
Q

advantage of volume-controlled infusions

A

reduced risk of rapid-dose infusion (given over 30-60 minutes)
admin. meds that are stable
allows control of IV fluid intake

61
Q

Piggyback size and connection location

A

25-250mL

UPPER Y-port

62
Q

syringe pump is ___ operated

A

battery

63
Q

syringe pump allows meds to be given in doses that range from __ to __ mL

A

5-60 mL

64
Q

syringe pump container volume

A

150 mL

65
Q

intermittent venous access is aka

A

saline or heparin lock

66
Q

SAS method

A

S - saline flush (patency)
A - administer med
S - saline flush (clear med)

67
Q

IV home therapy education begins when?

A

while in the hospital

-s/sx of infection
infusion pump
maintain IV admin. equipment

N1115 - Trans. to Associates (21 decks)

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