Fluid Types/IV/CVAD

Question 1

Isotonic Fluids

Answer 1

*expand intravascular compartment

Examples: 0.9% NaCl, LR

Question 2

Hypotonic Fluids

Answer 2

*contains more water than particles and shifts fluid into the interstitial compartments

Examples: 0.45% NaCl (half normal saline)

Question 3

Hypertonic Fluids

Answer 3

*contain more particles than water, shifting more fluid into the intravascular space

Examples: 3% NaCl, 10-15% Dextrose in water, 5% sodium bicarb

Question 4

If you are dehydrated what type of fluid would you give?

Answer 4

Isotonic fluids!!!

When dehydrated, you have a deficit in the intravascular space

Question 5

What two labs can indicate dehydration of they are high?

Answer 5

BUN & Hematocrit

“High and dry”

Question 6

5% Dextrose…

Answer 6

is isotonic in the bag but hypotonic in the body (once the glucose is metabolized)

Question 7

Infiltration vs Phlebitis

Answer 7

Infiltration- cool skin, swelling, pain
Phlebitis- redness, pain, heat, swelling

*apply warm compresses for both!

Question 8

Peripherally Inserted Central Catheter (PICC)

Answer 8

site: above or below anticubital fossa into basilic, cephalic, or axillary veins of dominant arm, tip of catheter in superior vena cava or brachiocephalic veins

length of stay: several days to months

nursing care: change 2-3 times/week or when wet/nonocclusive, flush with normal saline alone or normal saline and heparin lock, do not take blood pressure or drew blood from extremity with PICC line

Question 9

Tunneled Central Catheter

Answer 9

site: most commonly inserted into the internal jugular vein and advanced to superior vena cava

length of stay: long-term use, can remain in place for years

nursing care: change 2-3 times/week or when wet/nonocclusive, flush with normal saline alone or normal saline and heparin lock, anchor catheter securely, avoid chemotherapy or PN

Question 10

Non-tunneled Percutaneous Central Catheter

Answer 10

site: inserted through subclavian vein
* triple lumen: (1) infuse or draw blood samples (2) PN infusion (3)infuse or draw blood or give meds

length of stay: short-term, less than 6 weeks

nursing care: flush with normal saline alone or normal saline and heparin lock, dressing change 2-3x/week and PRN; place client in low-fowlers position, client and nurse wear a mask, alcohol and iodine used to clean site, change IV tubing q72-96 hours (per agency protocol)

Question 11

Implanted Ports

Answer 11

used for long-term therapy, surgically placed, allows increased movement and decreased care, tip of catheter is under the skin, access requires non-coring needle through the skin into the port, always cleanse site before accessing