Infusion Therapy

Question 1

Intravenous (IV) fluids – used when:

Answer 1

-Patient unable to met hydration needs orally or enterally.
-NPO status or unable to eat for whatever reason.
-Life-threatening fluid loss

Question 2

Intravenous medication – used when:

Answer 2

-A quick response is needed.
-A medication isn’t possible to deliver orally.
-Medication is irritating to muscle or subcutaneous tissue

Question 3

Purpose of Infusion Therapy:

Answer 3

-Maintain daily body fluid requirements.
-Restore previous body losses.
-Replace present body fluid losses

Question 4

Indications of Infusion Therapy

Answer 4

-Prevent or correct fluid and/or electrolyte imbalance.
-Supply nutrients.
-Maintain blood volume.
-Administer medications when rapid onset desired.
-Assist with specific patient symptoms such as nausea, vomiting or shock

Question 5

Advantages of Infusion Therapy

Answer 5

-Rapid absorption/response
-Appropriate when patient is nonresponsive to other routes.
-Total drug absorption

Question 6

Disadvantages of Infusion Therapy

Answer 6

-Vascular irritations and subsequent hazards
-Possible drug incompatibility when one or more drug added to IV solution.
-Speed shock

Question 7

IV fluid solutions (bags) should be changed every ______

Answer 7

24 hours

Question 8

Primary and secondary continuous administration sets used to administer fluids other than parenteral nutrition, lipids, blood, or blood products should be changed every _______

Answer 8

96 hours

Question 9

Propofol infusions sets should be changed every _____

Answer 9

12 hours

Question 10

Secondary medication tubing____________into a continuous primary line should also be changed every 96 hours. This is accomplished by _________________________the tubing prior to each antibiotic use.

Answer 10

“piggybacked”, “back-flushing” or “back-priming”

Question 11

equal movement of water into and out of cells

Answer 11

isotonic solution

Question 12

same concentrate of solutes as outside of the cells

Answer 12

isotonic solution

Question 13

if you give an IV with isotonic solution through the bloodstream it does not cause ________________

Answer 13

your cells to shrink or swell

Question 14

net water movement into the cells

Answer 14

hypotonic

Question 15

lower concentration of solutes in them compared to your cells

Answer 15

hypotonic solution

Question 16

examples of isotonic solution given IV

Answer 16

normal saline(0.9%), Lactated ringer’s solutions

Question 17

hypotonic solutions cause water to move into the cells making them

Answer 17

swell

Question 18

net water movement out of cells

Answer 18

hypertonic

Question 19

have higher concentration of solutes than the fluid inside your cells

Answer 19

hypertonic solution

Question 20

hypertonic solution is water moving out of the cells into the bloodstream causing the cells to

Answer 20

shrink

Question 21

examples of hypertonic solutions

Answer 21

3%-5% saline, 10% - 50% Dextrose solutions(TPN)

Question 22

example of hypotonic solutions

Answer 22

Dextrose solutions(D5W 5%), Dextrose/sodium chloride combination solutions, 1/2 normal saline, sterile water

Question 23

1000 mL bag of D5W is 5% in

Answer 23

1000 ml contains 50 grams dextrose

Question 24

for potassium chloride (KCl)

Answer 24

Never give direct push, Always dilute, Use pump

Question 25

syringe with medication is hooked up to one of the ports on the line and injected directly by the nurse. Usually done over few minutes (depending upon the medication)

Answer 25

IV Bolus (direct push)

Question 26

a small IV fluid bag with the medication added in the solution as a secondary unit and infused over a shorter period of time, or a bag containing the medicine is hooked up and delivered into a saline lock (INT)

Answer 26

Piggyback (IVPB)- secondary infusion

Question 27

be careful of giving a lot of fluids via IV to patients with

Answer 27

congestive heart failure

Question 28

used to infuse continuous or intermittent fluids or medications (main event)

Answer 28

primary infusion

Question 29

patient controlled analgesics uses

Answer 29

IV push

Question 30

For IV push: If pushing into tubing that has fluid infusing, ___________________doesn’t take the “path of least resistance and flow backwards up the line rather than into the patient”.

Answer 30

pinch off the tubing “upstream” from the injection port so that the medicine

Question 31

for IV push: If given into a saline _________________________________________

Answer 31

lock for peripheral lines or heparinized saline for central lines

Question 32

how to prepare IV fluids

Answer 32

1. wash hands, 2. open tubing, 3. close the roller clamp, 4. remove caps, 5. spike carefully(stickk spike into bag), 6. MAINTAIN asepsis, 7. prime the tubing, 8. label the tubing

Question 33

always clean port before doign this, use normal saline, does this before and after giving the med

Answer 33

flushing

Question 34

when flushing an INT use

Answer 34

positive pressure

Question 35

solution must be compatible with IV solution

Answer 35

compatibility of IV solution

Question 36

never give IV medications in the same line as

Answer 36

blood products, TPN, mannitol, dextrane, and sodium bicarbonate

Question 37

Problem: IV fluids won't run- Why?

Answer 37

tubing could be clamped, kinks, or bent IV catheter

Question 38

The number one way to prevent infection is to maintain ________________________, both peripheral and central

Answer 38

an occlusive dressing over the vascular access site(air and water tight)

Question 39

Monitor IV site every

Answer 39

2-4 hr

Question 40

Pain tenderness, erythema, vascular access site (IV site) warm to touch, swelling or edema, induration, purulence, or palpable venous cord. Can occur: With indwelling cannula

Answer 40

Phlebitis

Question 41

Edema or swelling at site or in surrounding tissue, discomfort at the vascular access site, decrease in the rate of the infusion or complete stop in flow, and failure to obtain blood return (sometimes a blood return can be obtained even if the IV is infiltrated)

Answer 41

Extravasation / Infiltration

Question 42

Must remember that the flow of the fluid maintains the patency of the intravenous line. Blood backing up into the tubing can cause clotting if not cleared. There are usually no visible signs of problems at the vascular access site – the site appears healthy.

Answer 42

Clotted IV lines

Question 43

infultation symptoms

Answer 43

pale and cool to touch

Question 44

symptoms of Phlebitis

Answer 44

warmth, streaking, hard veins

Question 45

bruise

Answer 45

Ecchymosis

Question 46

caused by inflation of harsh meds hhas damaged or destroyed tissue

Answer 46

Extravasation

Question 47

Caused by rapid infusion of solution

Answer 47

Speed shock

Question 48

Patient will complain of pain traveling up the extremity. Caused sometimes when cannula is small, and fluid infusion is fast

Answer 48

Venous spasm

Question 49

Caused by air not being cleared from tubing. Air has entered into the vascular system.

Answer 49

Air embolus