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infusion therapy Flashcards

1
Q

infusion therapy definition

A

delivery of meds in solution and fluids by parenteral route
IV most common route
IV most common invasive therapy administered to hospitalized pts

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2
Q

infusion therapy definition

A

delivery of meds in solution and fluids by parenteral route
IV most common route
IV most common invasive therapy administered to hospitalized pts

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3
Q

normal serum osmolarity in adult

A

270-300 mOsm/L

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4
Q

isotonic serum osmolarity

A

270-300

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5
Q

hypertonic serum osmolarity

A

> 300

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6
Q

hypotonic serum osmolarity

A
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7
Q

isotonic infusate

A

water doesn’t move into/out body cells

risk for fluid overload, esp older adults

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8
Q

hypertonic infusate

A

corrects fluid, electrolyte and acid-base imbalances by moving water out body cells into bloodstream
example - parenteral nutrition

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9
Q

hypotonic infusate

A

moves water into cells and expands them

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10
Q

infusion in central circulation

A

if osmolarity is >600 mOsm/L
where greater volume provides adequate hemodilation
TPN should NEVER be infused in peripheral circulation b/c can cause damage to cells and lining of vein

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11
Q

administering IV meds

A

med safety
rapid therapeutic effect
never assume IV admin is same as giving via other routes

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12
Q

vascular access device types

A 
short peripheral catheters
midline catheter
peripheral inserted central cath (PICC)
nontunneled percutaneous central venous cath (CVC)
tunneled cath
implanted port
hemodialysis cath
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13
Q

peripheral IV therapy

A

in superficial vein of dorsal surface of hand

in place for 72-96 hrs then require remove and insert at another site

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14
Q

locations not use in pats with…

A 
mastectomy
axillary lymph node dissection
lymphedema
paralysis of upper extremity
dialysis graft/fistula
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15
Q

midline cath

A 
3-8 in long, double/single lumen
inserted through vein in upper arm
used for therapies lasting 1-4 wks
do not use for vesicant drugs (meds that can break down lining of vessel ie chemo/tpn)
DO NOT USE TO DRAW BLOOD
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16
Q

central IV therapy

A

vascular access device placed in central circulation with superior vena cava
CXR used to confirm placement
OK TO GIVE VESICANT
don’t cover w/ gauze b/c can hold moisture and cannot see insertion site

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17
Q

peripherally inserted central cath (PICC)

A

18-29 in
CXR to determine placement
used for contrast injection

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18
Q

nontunneled percutaneous

A

inserted through subclavian vein in upper chest or jugular vein in neck
may require insertion in femoral vein - rate inf high
7-10 in up to 5 lumen
CXR confirm placement
IF INFECTION OCCURS, OCCURS AT INSERTION SITE INSTEAD OF VESSEL

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19
Q

tunneled central venous

A

portion lies in SQ tunnel
used for frequent and long-term infusion therapy
cuff of abx-containing material help reduce infection

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20
Q

implanted port

A

surgically created SQ pocket housing port body
placed in upper chest/extremity
flush after each use and at least once/month b/t therapies prevent clot formation in internal chamber
fill with heparin

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21
Q

hemodialysis catheter

A

DON’T TOUCH THEM
placement in both veins and arteries
large lumen to accomodate hemodialysis/pheresis procedure
cath-related bloodstream infection, vein thrombosis common problem
do not use admin other fluids/meds

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22
Q

local complication of IV therapy

A 
infiltration
phlebitis
thrombosis
thrombophlebitis
ecchymosis/hematoma
site infection
venous spasm
nerve damage
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23
Q

infilatration

A

cold skin - IV solution hanging out in tissue
edema
tx - stop infusion, elevate extremity to reabsorb, hot/cold compress

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24
Q

phlebitis

A

red, swollen, red streak along vein

warm compress to increase blood flow

25
thrombosis
redness, swelling, tender IV won't work, blood won't get through area elevate, no excessive movement, may require surgery
26
thrombophlebitis
clot | irritated
27
hematoma
bruise went through vein, blood leaking from vein into area don't leave IV in, apply ice (heat makes worse, thins blood, leak even more) elevate arm
28
normal serum osmolarity in adult
270-300 mOsm/L
29
isotonic serum osmolarity
270-300
30
hypertonic serum osmolarity
>300
31
hypotonic serum osmolarity
32
isotonic infusate
water doesn't move into/out body cells | risk for fluid overload, esp older adults
33
hypertonic infusate
corrects fluid, electrolyte and acid-base imbalances by moving water out body cells into bloodstream example - parenteral nutrition
34
hypotonic infusate
moves water into cells and expands them
35
infusion in central circulation
if osmolarity is >600 mOsm/L where greater volume provides adequate hemodilation TPN should NEVER be infused in peripheral circulation b/c can cause damage to cells and lining of vein
36
administering IV meds
med safety rapid therapeutic effect never assume IV admin is same as giving via other routes
37
vascular access device types
``` short peripheral catheters midline catheter peripheral inserted central cath (PICC) nontunneled percutaneous central venous cath (CVC) tunneled cath implanted port hemodialysis cath ```
38
peripheral IV therapy
in superficial vein of dorsal surface of hand | in place for 72-96 hrs then require remove and insert at another site
39
locations not use in pats with...
``` mastectomy axillary lymph node dissection lymphedema paralysis of upper extremity dialysis graft/fistula ```
40
midline cath
``` 3-8 in long, double/single lumen inserted through vein in upper arm used for therapies lasting 1-4 wks do not use for vesicant drugs (meds that can break down lining of vessel ie chemo/tpn) DO NOT USE TO DRAW BLOOD ```
41
central IV therapy
vascular access device placed in central circulation with superior vena cava CXR used to confirm placement OK TO GIVE VESICANT don't cover w/ gauze b/c can hold moisture and cannot see insertion site
42
peripherally inserted central cath (PICC)
18-29 in CXR to determine placement used for contrast injection
43
nontunneled percutaneous
inserted through subclavian vein in upper chest or jugular vein in neck may require insertion in femoral vein - rate inf high 7-10 in up to 5 lumen CXR confirm placement IF INFECTION OCCURS, OCCURS AT INSERTION SITE INSTEAD OF VESSEL
44
tunneled central venous
portion lies in SQ tunnel used for frequent and long-term infusion therapy cuff of abx-containing material help reduce infection
45
implanted port
surgically created SQ pocket housing port body placed in upper chest/extremity flush after each use and at least once/month b/t therapies prevent clot formation in internal chamber fill with heparin
46
hemodialysis catheter
DON'T TOUCH THEM placement in both veins and arteries large lumen to accomodate hemodialysis/pheresis procedure cath-related bloodstream infection, vein thrombosis common problem do not use admin other fluids/meds
47
local complication of IV therapy
``` infiltration phlebitis thrombosis thrombophlebitis ecchymosis/hematoma site infection venous spasm nerve damage ```
48
infilatration
cold skin - IV solution hanging out in tissue edema tx - stop infusion, elevate extremity to reabsorb, hot/cold compress
49
phlebitis
red, swollen, red streak along vein | warm compress to increase blood flow
50
thrombosis
redness, swelling, tender IV won't work, blood won't get through area elevate, no excessive movement, may require surgery
51
thrombophlebitis
clot | irritated
52
hematoma
bruise went through vein, blood leaking from vein into area don't leave IV in, apply ice (heat makes worse, thins blood, leak even more) elevate arm
53
venous spasm
irritated vessel, spasming | warm compress, wait, deep breathing
54
nerve damage
DON'T INJECT FLUID INTO NERVE
55
systemic complication of IV therapy
circulatory overload speed shock allergic reaction catheter embolism
56
circulatory overload
SOA, bounding pulse, high BP and pulse peripheral edema in lage stages SWELLING IN EYES FIRST tx - SLOW infusion rate if catch early, STOP if catch late, counter w/ diuretic, O2 d/t fluid building in lungs
57
embolism
either in heart or lung | could be lifethreatening
58
alt sites for infusion
``` intra-arterial therapy intraperitoneal infusion SQ infusion intraspinal infusion intraosseous therapy ```
59
compartment syndrome
increased tissue perfusion in confined space causing decreased flow to area tx w/ fasciotomy to relieve pain no peripheral pulse, low O2 sat, white extremity, numb/tingling

nursing (9 decks)

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