exam 2 lecture 6 Flashcards
vascular access device
peripheral: needle + over-the-needle catheter
central: peripherally-instered central catheter + surgically implanted
volume control set
used for accurately giving volume of drug to patient
accurate solutions and amounts
add-vantage system
powder in the container
place container into top of IV bag
very fast
macrodrip
delivers large quantities
faster rates
10,15,20 gtt/mL
microdrip
delivers smaller amounts
60 gtt/mL
used in pediatrics
patients who need smaller or closely regulated amounts of IV solution
rate
driving force / resistance
components of resistance to flow
tubing: macrobore vs microbore
in-line filter
viscosity of IV fluid
length of tubing
venous backpressure
volume fill
smaller mL has higher percentage of excess
larger mL has lower percentage of excess
drop conversion factor - drop number
the initial educated guess
actual depends on: visocisty of CSP, surface tension, density
butterfly needle
keeps the needle from moving while in vein
over-the needle catheter
plastic cap –> less risk when moving,
central venous therapy
infusion of large volume of fluid
multiple infusions
long-term infusion therapy
infusion or irritating medications like potassium
infusion of fluids of high osmolarity
parenteral nutrition (PN)
central line
hickman or broviac
peripherally inserted central catheter
catheter inserted into arm then into subclavian vein
central vein catheter - surgically implanted
multiple lumens - gives flexibility when giving multiple medications
hickman catheter
requires surgical insertion
dacron cuff prevents excess motion
vascular access port (VAP)
port under skin connected to a catheter
needles for VAP
requires non-coring needle
straight noncoring needle
right angle non-coring needle
advantages for central venous therapy
access to central veins
rapid infusion of large amounts of fluid
a way to draw blood and measure CV pressure
reduce need for repeated venipunctures
reduce risk of vein irritation from infusing irritating substances
risk of central venous therapy
sepsis
thrombus formation
perforation of vessel
air embolism
disadvantages: cost + requires more skill to insert
risks associated with infusion
complications from damge to inner lining of vein
stenosis, thrombus, venous occlusion, chemical inflammation
controllers
drop counting sensor
automatic clamping device (controller)
infusion pumps
powered devices
provides pressure 2-12 psi –> high end of pressure is used for intra-arterial infusions
cuation: excessive infusion pressure can be a hazard to infiltration at site of injection
features of infusion pumps
volumetric delivery, independent of vascular back-pressure, position of patient, composition of solution, or tubing resistance
safety features: occlusion of line, infusion complete, air in line, empty container, flow rate error
becoming increasingly smart
IV infusion pumps
use commercial syringes
smart machines
very usefuk for giving intermittent IV medications
provides best control for small volume infusions
useful for pediatric patients
