fluid/electrolyte Flashcards
if creatinine is normalish but BUN is high
dehydrated
caution about fluid with lactose
don’t give to someone with diarrhea
tips for fluid restriction
give half bt 7 am and 3 pm
-remember that ice chips, gelatin, and icecream are fluid
-need frequent mouth care
Parenteral nutrition
in CVC if hypertonic
in peripheral IV for lower osmolality
parenteral potassium
NEVER administer as a push
the body can’t conserve potassium, so its continuously excreted as long as the kidneys are working
burns a little – no more than 10 meq/hr
VADs
vascular access devises
-catheters or infusion ports for repeated access to vascular system
Central catheters are for long term stuff –> good for PN, large amts of fluid, and meds that irritate the veins
IV equipment
ASEPTIC
-VADs, tourniquet, clean gloves, dressing, IV fluid containers, tubing, EIDs
Technique for VADs
Aseptic Non-Touch Technique
-standard precautions, PPE, management of sterile field, non-touch technique, sterile supplies
When NOT to use hand veins
older adults or patients that are ambulatory
Where else not to stick someone
torso
-areas of flexion
-arm on side of masectomy or graft/fistula
-areas of infection, infiltration, or thrombosis
Line maintenance
- use ANTT to keep syst sterile and in tact
- use ANTT to change IV fluid containers, tubing, and contaminated site dressing
- help a patient with self care so system isn’t fucked with
- monitor for complications of IV therapy
Securement devices for VADs
- ASD (adhesive securement device) – sticks to skin and holds VAD in place
- ISD (integrated securement device) – combo of dressing and securement
How often to change stuff
continuous administration sets for crystalloid soln and meds = 96 hrs to 7 days
tubing for intermittent infusions = 24 hrs
blood and blood components = every 4 hrs
IV lipids = every 24 hrs
how often to change dressings
TSM (transparent semipermeable membrane) = every 7 days
gauze = every 48 hrs
MARSI = medical adhesive related skin injury
infiltration vs extravasation
infiltration = IV dislodges or vein ruptures and fluid enters subq tissue
extravasation = IV fluid has stuff that damagess the tissues
both cause coolness, paleness, and swelling of the area
