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Med/Surg > Intravenous Therapy > Flashcards

Intravenous Therapy Flashcards

1
Q

To Start an IV you must have

A

A provider’s order with type, kind, and rate of solution

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2
Q

Type of nurse that inserts and manages IV’s the best

A

ICU nurses

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3
Q

Nurses must know these to start an IV

A

Type of solution
Desired effect
Possible complications
Patient’s condition
Reason for IV

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4
Q

Inserting needle or catheter into a vein using sterile technique

A

Venipuncture

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5
Q

IV insertion site:

Extremities: hands, arms, feet, legs

A

Peripheral

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6
Q

IV insertion site:

Subclavian or internal jugular veins

A

Central

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7
Q

This IV is entered towards the IVC for chemo or potassium because they are caustic to veins

A

Central

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8
Q

IVC

A

Inferior Vena Cava

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9
Q

Fluids should be what temp?

A

Room temp and site dressed with sterile dressing

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10
Q

What peripheral site is not recommended for adults? Why?

A

The foot because of possible circulation problems

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11
Q

Use the _______ gauge cannula that can deliver the prescribed therapy at the desired rate

A

smallest

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12
Q

Use _______ gauge cannula for rapid infusion of IV fluids, viscous medications, or blood components

A

18–20 gauge

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13
Q

Use _________gauge shorter cannula (e.g., 3/4-inch) cannula for older adults and pediatric patients.

A

22–24 gauge

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14
Q

Obese patients may have veins deeper in the subcutaneous tissue and may require _______.

A

Longer IV cannulae. May consider a peripherally inserted central catheter (PICC) as an alternative

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15
Q

Macro tubing:

A

10,15,20 gtts/minute

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16
Q

Micro tubing

A

60gtts/min

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17
Q

IV fluid closest to ECF osmolality

A

Isotonic

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18
Q

IV fluid used expand EC volume (plasma)in fluid loss, dehydration & hypernatremia

A

Isotonic

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19
Q

IV fluid that does not provide nutrition-only 200 calories per liter!!

A

Isotonic

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20
Q

D5W

A

Dextrose 5% in water: no sodium! If used for long time can deplete sodium…

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21
Q

IV fluid that if used for long time can deplete sodium…

A

D5W

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22
Q

Types of Isotonic fluids

A

D5W, Lactated Ringers, and NS

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23
Q

NS –

A

0.9% Saline (normal)

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24
Q

IV fluid that is a good ECF expander but is not completely like ECF because only has Na & Cl

A

NS

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25
Q

Isotonic fluids can cause

A

Fluid overload

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26
Q

IV fluid that contains many electrolytes found ECF

A

Ringers Solution

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27
Q

Fluid used to replace ECF loss such as: burns, hypovolemia & diarrhea

A

Ringers solution

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28
Q

Ringers are not enough to replace severe loss unless it states

A

“R” which is replacement fluid

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29
Q

Solution that is the same as Ringers but with bicarbonate!

A

Lactated Ringers Solution

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30
Q

Helpful in mild metabolic acidosis

A

Ringer solution

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31
Q

IV fluid used to replace CELLULAR FLUID (water)

A

Hypotonic

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32
Q

IV fluid that can lead to intravascular depletion

A

Hypotonic

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33
Q

IV fluid given for dehydration

A

Hypotonic

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34
Q

Iv fluid given for fluid overload

A

Hypertonic

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35
Q

Macro is what type of drip?

A

Gravity

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36
Q

Micro is what type of drip?

A

Pump

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37
Q

colloid is

A

hypertonic

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38
Q

IV solution that is commonly given in the OR

A

Lactated Ringers

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39
Q

Dextrose makes any solution it is added to

A

more hyper in osmolality-

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40
Q

Dextrose quickly metabolizes usually leaving

A

hypotonic fluids

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41
Q

HYPER is ____%

A

> 0.9 saline

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42
Q

Types of hypertonic fluids

A

D5W & 0.45 NS

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43
Q

Injection given to a hypoglycemic patient

A

D50

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44
Q

TPN is always given through

A

a central line

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45
Q

TPN is what kind of solution

A

Hypertonic

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46
Q

Type of IV fluid that draws fluid into vascular space

A

Hypertonic

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47
Q

Can be seen in IV nutrition TPN when 50% Dextrose used

A

Hypertonic

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48
Q

What vein would be used for TPN?

A

IVC/ central line

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49
Q

Length of needles (range)

A

1/2 in to 2 in

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50
Q

Needle gauges

A

16, 18, 19, 21, 23, 25

51
Q

PICC

A

peripheral inserted central cath

52
Q

Central Venous Access Devices:

A

PICC(peripheral inserted central cath)
Implanted Ports
Tunneled vs Non-tunneled

53
Q

AMOUNT TO INFUSE IN ONE HOUR IS CALLED

A

DRIP RATE

54
Q

Things that can affect drip rate:

A

solution used
tubing used
temperature solution

55
Q

MACRO tubing -delivers:

A

10 per cc or 15 per cc

56
Q

Used when fluid rates are for 1000cc/8hours or less in most cases or when fluid is >100cc per hour

A

Gravity Drip

57
Q

MICRO tubing delivers=

A

60 drops a cc

58
Q

Careful delivery of <100cc per hour

A

Micro drip

59
Q

IV’s must be checked

A

HOURLY

60
Q

Syringe pumps

A

insulin or fluids

61
Q

IV dressings must be changed

A

q96h

62
Q

Signs of fluid overload

A

cough
increased BP
dyspnea

63
Q

Treatment of IV fluid overload

A

decrease IV rate, monitor VS, HOB high, MD contact

64
Q

Air embolism is caused by

A

Failure to prime IV line

65
Q

Signs of air embolism

A

dyspnea, decreased BP, weak pulse, chest pain

66
Q

Air embolism is seen more often in

A

central vein

67
Q

Treatment for air embolism

A

PLACE ON LEFT SIDE, Trendelenberg! VS, O2

68
Q

Signs of septicemia

A

Abrupt Fever, headache, backache, increased pulse, RR chills, shaking

69
Q

Treatment for septicemia

A

culture IV, antibiotics

70
Q

Clot that forms on catheter & can break loose into circulation

A

Thrombus

71
Q

Signs of thrombus

A

Redness, edema of site, tender

72
Q

Treatment for Thrombus

A

Stop IV, warm compress, restart another spot

73
Q

Treatment for infiltration or phlebitis

A

Warm compress & elevate extremity

74
Q

Before any blood transfusion, the patient must

A

sign consent

75
Q

Rh negative means the pt does not have

A

antigen in blood

76
Q

If Rh negative gets Rh+

A

pt will develop antibodies & have red blood cell destruction

77
Q

Whole Blood:

A

RBC’s, WBC’s, platelets, plasma & clotting factors

78
Q

Whole blood is administered through

A

18g angiocath

79
Q

Whole blood can only be given with what type of IV solution?

A

NS

80
Q

Packed RBC contains

A

RBC’s & 20% plasma

81
Q

Packed RBC is good for what type of patients?

A

Fluid overload patients

82
Q

Fresh frozen plasma is used to treat

A

clotting deficiency, expand volume

83
Q

Fresh frozen plasma:

one unit is to be given over

A

30 min

84
Q

Platelet transfusion contains

A

platelets, WBC’s & plasma

85
Q

Platelet transfusions are given to treat

A

Thrombocytopenia

86
Q

Platelet transfusions are given over

A

1 unit over 30 min

87
Q

Cryoprecipitate replaces

A

clotting factor

88
Q

Cryoprecipitate is given over

A

10 mins

89
Q

WBC transfusion contains

A

WBC’s & plasma

90
Q

WBC transfusion treats

A

Low granulocytes

91
Q

WBC transfusion patients must be premedicated with

A

antihistamine & Tylenol!

92
Q

Albumin comes in

A

5% & 25% in 100cc

93
Q

Albumin is

A

Plasma protein used to replace protein/fluid loss

94
Q

Albumin is given

A

1ml/min with D5W

95
Q

Normal Lab Values:

Hemoglobin

A

(M=13-18) (F=12-16)

96
Q

Normal Lab Values:

Hematocrit

A

(M=45-52) (F=37-48)

97
Q

Normal Lab Values:

WBC

A

4,300-10,800

98
Q

Normal Lab Values:

Platelets

A

150,00-450,000

99
Q

Blood products must run

A

slowly (2-5 ml/min) for 1st 15 min

100
Q

TPN infused through

A

A peripheral or central vein

101
Q

Lipids are given

A

To patients with catabolic states

102
Q

Lipids may be given

A

piggybacked into TPN in either peripheral or central veins

103
Q

Central catheter is inserted into

A

subclavian vein under sterile conditions

104
Q

Central Venous Nutrition( TPN) is Indicated when

A

glucose concentration>10%

105
Q

After Central Venous Nutrition( TPN) line insertion,

A

a CHEST XRAY MUST BE DONE before use, to insure proper placement

106
Q

IV Nutrition may be started in a peripheral vein

A

if the glucose solution concentration is not > 10%

107
Q

> 10% concentrations are hypertonic to peripheral veins and MUST BE USED IN

A

CENTRAL VEINS

108
Q

Due to the high glucose content, TPN, PN are prime mediums for

A

bacterial growth!

109
Q

1 complication of TPN=

A

Infection

110
Q

Complications related to Central Catheter

A

Pneumothorax with subclavian

Air Embolism

111
Q

Volume in IV tubing only

A

25-30 cc

112
Q

Use clamp and one way valve to prevent

A

air embolism

113
Q

When given phone consent

A

2 nurses must be present

114
Q

Platelets can clump so

A

lightly shake

115
Q

cryoprecipitate is given to what type of patients?

A

septic patients

116
Q

Reduces swelling/fluid overload. It sucks fluid back to intracellular space

A

Albumin

117
Q

During transfusion, a 2 degree raise in temp is

A

a sign of reaction

118
Q

A classic reaction to transfusion

A

hemolysis

119
Q

Low back pain is a classic sign of

A

Clumping of blood (hemolysis)

120
Q

Sometimes protein in donor blood causes

A

anaphylactic reaction

121
Q

Clinimix can be given through

A

peripheral line

122
Q

If TPN is given during the day,

A

Lipids are given at night

123
Q

If TPN is late, hang

A

D10

Med/Surg (17 decks)

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