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IV Therapy > Final > Flashcards

Final Flashcards

1
Q

names of parts of IV tubing

A
  1. Spike / Piercing Pin
  2. Vent (glass requires one!)
  3. Drip chamber
  4. Roller Clamp
  5. Y-port
  6. Luer Lock / Hub
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2
Q

what makes something hypotonic

A

Less than 250

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3
Q

range of isotonic

A

250-375 mOsm/L

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4
Q

what makes something hypertonic

A

> 375 mOsm/L

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5
Q

3 examples of hypotonic solutions

A
  1. sterile water
  2. 0.45% sodium chloride
  3. 2.5% dextrose in water
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6
Q

hypotonic fluid affects on body

A

shifts fluid out of the intravascular compartment, hydrating the cells and the interstitial compartments (into intracellular space)
~water moves into cells, possibly causing them to burst

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7
Q

hypertonic fluid affect on body

A

draws fluid into the intravascular compartment from the cells & the interstitial compartments
~will shift ECF from the interstitial spaces into the plasma
~water w/in a cell moves to the ECF, causing cells to shrink

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8
Q

3 examples of isotonic solutions

A
  1. 0.9% sodium chloride (normal saline)
  2. Lactated Ringer’s solution
  3. 5% dextrose in water (D5W)
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9
Q

3 examples of hypertonic solutions

A
  1. 5% dextrose in 0.9% NaCl
  2. 5% dextrose in Lactated Ringer’s
  3. 10% Dextrose
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10
Q

hypotonic fluid affects on body

A

body fluids shift out of blood vessels and interstitial spaces

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11
Q

isotonic fluid affects on body

A

Expand the intravascular portion of the extracellular fluid compartment

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12
Q

2 precautions with hypertonic solution

A
  1. Irritating to vessel walls

2. May cause circulatory overload

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13
Q

3 indications for hypotonic solution

A
  1. Hypertonic dehydration
  2. Water replacement
  3. Diabetic ketoacidosis after initial sodium NaCl replacement
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14
Q

3 indications for isotonic solution

A
  1. Fluid loss
  2. Dehydration
  3. Hypernatremia
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15
Q

solutions you need to be cautious with

A
  1. high osmolarity due to potential irritation of the vein
  2. solutions that can act on the heart (K, Mg, etc)
  3. Calcium gluconate d/t necrosis and sloughing if extravasion occurs
  4. B complex, need to go slow d/t GI effects
  5. Large doses of niacin (never over 2mg) d/t vasodilation and hypotension
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16
Q

3 contraindications to hypertonic solutions

A
  1. CHF
  2. Pulmonary edema
  3. Can cause/increase HTN
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17
Q

precaution with hypotonic solution

A

Do not give to pts with low BP because it will further aggravate hypotension

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18
Q

2 precautions with isotonic solutions

A
  1. Renal/cardiac dz with increased risk of fluid overload

2. May cause dilution of hemoglobin and lower hematocrit

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19
Q

how do you calculate osmolarity

A

Solution Osmolarity = total mOsm/vol x 1000mL/L

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20
Q

Drip rate formula

A

[Volume (mL) x drop factor (drops/mL)] / Time (min) = Drops/min (flow rate)

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21
Q

solutions you need to be cautious with

A
  1. high osmolarity due to potential irritation of the vein
  2. solutions that can act on the heart (K, Mg, etc)
  3. Calcium gluconate d/t necrosis and sloughing if extravasion occurs
  4. B complex, need to go slow d/t GI effects
  5. Large doses of niacin (never over 2mg) d/t vasodilation and hypotension
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22
Q

what does magnesium do to blood vessels

A

dilates them

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23
Q

Will folate precipitate with other nutrients?

A

Yes

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24
Q

Things Mg could help (3)

A
  1. STEMI
  2. Migraines
  3. Bronchial hyperreactivity
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25
Q

side effects of calcium

A

kidney stones, hypercalcemia

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26
Q

special consideration with calcium gluconate

A

Avoid extravasion, could cause sloughing and necrosis

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27
Q

caution with potassium (3)

A
  1. renal insufficiency
  2. Endocrine disorders
  3. Potassium-sparring diuretics
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28
Q

what is calcium gluconate the antidote for

A

magnesium sulfate

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29
Q

what does magnesium do to blood vessels

A

dilates them

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30
Q

Who should you not give IV Mg to (4)

A
  1. Neuromuscular diseases like myasthenia gravis
  2. Renal insufficiency
  3. Heart block
  4. Pregnancy
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31
Q

Things Mg could help (3)

A
  1. STEMI
  2. Migraines
  3. Bronchial hyperreactivity
32
Q

common administration rates of Mg

A
  1. Push: Up to 1500 mg over 20-40 min

2. Drip: Up to 3000 mg over 2 hours.

33
Q

how to administer potassium

A

KCl 2mEq/mL, max 100mEq in 24 hours when giving high dose vit C or in solution using D5W as carrier

34
Q

General conditions to caution or not use trace elements with (4)

A
  1. renal disease
  2. biliary excretion conditions
  3. pregnancy
  4. inborn metabolism issues (Wilson’s)
35
Q

What must be decided for each patient as you are formulating his or her potential IV therapy? (6)

A
  1. Push v drip
  2. carrier solution
  3. nutrient to use
  4. solution osmolarty
  5. Vein to be used
  6. Infusion rate
36
Q

3 conditions to caution with copper

A
  1. cholestasis
  2. cirrhosis
  3. Wilson’s disease
37
Q

condition to caution zinc with

A

copper deficiency

38
Q

condition to caution manganese with

A

cholestasis

39
Q

How soon must you use uncontaminated multidose vials (Under USP Chapter 51)?

A

Most use multidose vials within 28 days.

40
Q

what does PICO stand for

A
  1. Patient, Population, or Problem
  2. Intervention
  3. Comparison
  4. Outcome you would like to measure
41
Q

General conditions to caution or not use trace elements with (4)

A
  1. renal disease
  2. biliary excretion conditions
  3. pregnancy
  4. inborn metabolism issues (Wilson’s)
42
Q

CPT codes

A

procedure codes for a medical, surgical, or diagnostic service

43
Q

differences b/w push and drip

A

Push: use syringe, shorter infusion, lower volume, more concentrated, butterfly needle, involved

Drip: IV bag/bottle, longer infusion, higher volume, less concentrated, angiocatheter, less involved

44
Q

Iv infusion osmolarity for veins

A

Large 1400, Medium 700, Small 400

45
Q

Compounded IV solutions fall under the USP exemption for Immediate Use if they are used within_____________ of starting the preparation of the solution.

A

w/in 1 hour

46
Q

How recently must lab tests (CBC, CMP) have been completed in order to be able to administer an IV treatment?

A

Within the last 6 months or more recently if have any underlying health issues.

47
Q

what does PICO stand for

A
  1. Patient, Population, or Problem
  2. Intervention
  3. Comparison
  4. Outcome you would like to measure
48
Q

J codes are related to

A

drugs that ordinarily cant be self-administered

49
Q

CPT codes

A

procedure codes for a medical, surgical, or diagnostic service

50
Q

IV push osmolarity for veins

A

Large 1200, Medium 950, Small 400

51
Q

Iv infusion osmolarity for veins

A

Large 1400, Medium 700, Small 400

52
Q

what can be used to alter pH of an IV solution

A

bicarb

53
Q

How recently must lab tests (CBC, CMP) have been completed in order to be able to administer an IV treatment?

A

Within the last 6 months or more recently if have any underlying health issues.

54
Q

Review the effects of high dose vitamin C on blood sugar.

A

will induce insulin and decrease glucose levels

55
Q

meaning of high specific gravity

A

dehydration

56
Q

meaning of position glucose on UA

A

glucose is >170

57
Q

meaning of positive protein on UA

A

renal disease, infection, trauma, HTN, malignancy, poisoning, toxemia

58
Q

What do you do to treat an ecchymosis?

A
  1. apply pressure after catheter/needle is removed
  2. elevate extremity above the patient’s head to maximize venous return
  3. apply cold pack to the site
  4. heme hydro
59
Q

Vitamin C may cause a false negative in what UA test?

A

blood

60
Q

What should you add to high dose vitamin C due to its weak chelating properties?

A

0.3-1 ml 10% calcium gluconate for each 10 g of vitamin C to maintain blood calcium levels

61
Q

Review the effects of high dose vitamin C on blood sugar.

A

will induce insulin and decrease glucose levels

62
Q

What is the ml/kg dosage of Epinephrine given during anaphylaxis for an adult versus a child?

A

Adult: 0.2-0.5

Children: 0.01

63
Q

What is the Oral versus IV dosage of Diphenhydramine for an adult?

A

Oral: 25-50 mg every 6-8 hours

IV/IM: 10-50 mg every 2-4 hours

64
Q

If you suspect a patient is experiencing infiltration, what steps to you take to help?

A
  1. stop IV/push and remove catheter/needle immediately
  2. apply pressure for at least 1 min with a few drops of rescue remedy on cotton ball- tape and hold area above heart level for 5-10 minutes
  3. if the patient is experiencing burning pain, first apply ice for an analgesic effect (if detected w/in 30 min, otherwise apply warm compress), and encourage the patient to then apply heat to allow fluids to dissipate
  4. elevate site above heart level
65
Q

What do you do to treat an ecchymosis?

A
  1. apply pressure after catheter/needle is removed
  2. elevate extremity above the patient’s head to maximize venous return
  3. apply cold pack to the site
  4. heme hydro
66
Q

What are the signs and symptoms of a thrombosis?

A
  1. pain at the site
  2. site warm to touch
  3. sluggish or no infusion rate
67
Q

Possible causes of phlebitis include?

A
  1. trauma to the vein w/ cannula/needle- mechanical phlebitis
  2. irritation due to type of fluid infused- chemical phlebitis
  3. introduction of pathogens related to contaminated needle/site prior to insertion-bacterial phlebitis
68
Q

If you suspect pulmonary embolism, what are the steps to take?

A
  1. call 911
  2. keep patient sitting upright
  3. give O2 by mask
  4. maintain IV site
  5. transport to hospital
69
Q

What are the signs and symptoms of a person in shock?

A
  1. dizziness
  2. tightness in chest
  3. increased HR
  4. H/A
  5. hypotension
70
Q

What is the difference between infiltration and extravasation?

A

Infiltration: seepage of non-vesicant IV fluid into surrounding subcutaneous tissues

Extravasation: infiltration of a vesicant solution in the tissues

71
Q

If you suspect a patient is experiencing infiltration, what steps to you take to help?

A
  1. stop IV/push and remove catheter/needle immediately
  2. apply pressure for at least 1 min with a few drops of rescue remedy on cotton ball- tape and hold area above heart level for 5-10 minutes
  3. if the patient is experiencing burning pain, first apply ice for an analgesic effect (if detected w/in 30 min, otherwise apply warm compress), and encourage the patient to then apply heat to allow fluids to dissipate
  4. elevate site above heart level
72
Q

When do you a filter needle?

A

Calcium gluconate

73
Q

how to prevent coring of a IV bottle

A

Use a non-coring needle, spike adapter

74
Q

what information is needed on a IV bag/syringe

A

Pt initials and DOB, date, time of preparation

75
Q

how to use the roller clamp on the IV tubing.

A

Roll down to slow/stop flow

IV Therapy (1 decks)

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