Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NCLEX-RN® > NCLEX-RN (1) Fundamentals > Intravenous Therapy > Flashcards

Intravenous Therapy Flashcards

Review the types of IV fluids, how to put an IV in, and complications.

1
Q

What is intravenous therapy (IV therapy)?

A

It is giving fluids and other nutrients through a vein.

It is given to clients who can’t take fluids orally or when there is dehydration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the steps to insert an IV?

The nurse is using a translumination device to locate the veins.

A
  1. Select site
  2. Clean the site with disinfectant solution
  3. Apply tourniquet
  4. Insert needle
  5. Check indicator of blood return
  6. Advance catheter
  7. Pull stylette back slightly, advance catheter into vein
  8. Release tourniquet
  9. Apply gentle pressure over the vein at the catheter tip and remove the metal stylette
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the difference between a peripheral IV site and a central line?

A
  • Peripheral IV site: a short IV that goes into a vein into the arm.
  • Central line: an IV that also goes into a vein but is threaded much further in so that the tip of the catheter site is closer to the heart for quicker administration.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 3 types of IV solutions?

A
  1. hypotonic
  2. isotonic
  3. hypertonic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a hypotonic solution and what are some examples?

A

Hypotonic solutions are “more watery”. There is a lower concentration of solutes compared to body fluids.

Examples: 0.45% saline, 1/2 normal saline, D2.5W, 0.33%NS

When given, HypOtonic fluids will first go into the vascular space then will shift “Out of the vessels” and into the cells to replace cellular fluid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In what situations is a hypotonic solution given?

A
  1. Fluid replacement for those with nausea/vomiting, burns or hemorrhage for a client who has cardiac or renal disease
  2. Hypernatremia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why is a hypotonic solution given for fluid replacement for clients with cardiac or renal disease?

A

Clients with cardiac or renal disease cannot handle extra fluids too quickly.

A hypotonic solution prevents the client from receiving fluids too quickly because it goes into the vascular space and then leaves quickly to go into the cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why is a hypotonic solution given to clients with hypernatremia?

A

Because it will dilute the sodium in the blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is an isotonic solution and what are some examples?

A

Isotonic solutions have the same concentration of solutes as body fluids.

Examples: 0.9% NS, Lactated Ringers or LR, D5W, D5 1/4 NS

When given, iSotonic fluids will first go right into the vascular space and then “Stay in the vessels” to treat dehydration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In what situations is an isotonic solution given?

A

It is fluid replacement for those with nausea/vomiting, burns or hemorrhage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Who should NOT receive isotonic solutions?

A

Clients with renal or cardiac disease.

The kidneys and heart cannot handle the extra fluid. It will cause fluid volume overload.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a complication of administering too much isotonic solution?

A

It can cause fluid volume overload and increased blood pressure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is a hypertonic solution and what are some examples?

A

Hypertonic solutions have an increased concentration of solutes as compared to body fluids.

Examples: D10W, 3%NS, 5%NS, D5LR, D5NS, TPN, albumin

When given, fluids will first go into the vascular space and then pull fluids from the 3rd space to go back into the vessels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

In what situations is a hypertonic solution given?

A

When a client has too much fluid in the 3rd space such as severe edema, burns or ascites.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a complication of administering too much hypertonic solution?

A

It can cause severe fluid volume overload.

This client is usually in an ICU with frequent monitoring of blood pressure, heart rate, and central venous pressure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What substances are in D5W and D10W?

A

Glucose

  • D5W: 5% dextrose and water
  • D10W: 10% dextrose and water

Dextrose is a type of sugar.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which type of client should typically NOT receive D5W or D10W?

A

Clients with diabetes because the blood sugar is already elevated.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What substances are in lactated Ringer’s (LR)?

A

Sodium, potassium, calcium, and water.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which clients is Lactated Ringer’s NOT given to because of electrolyte overload?

A

Clients with acute kidney injury or chronic kidney disease because their potassium is already elevated.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are IV gauges?

A

They are the size of the diameter of the needle.

It is sometimes called a lumen or cannula.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Complete the sentence:

The ______the IV gauge number the _______the diameter.

A

smaller, larger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What IV gauge would be used for rapid fluid administration or blood products?

A

18 or 19 gauge lumen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What IV gauge would be used for fat emulsion (lipids)?

A

20 or 21 gauge lumen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What IV gauge would be used for standard IV fluids or IV meds?

A
  • 22 or 24 gauge lumen
  • 25 gauge lumen for very small veins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Label the parts of IV tubing:

  • drip chamber
  • extension hook
  • flow control clamp
  • piggyback set
  • piggyback Y-port
  • primary set
  • secondary Y-port
  • slide clamp
  • spike
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What does it mean to “prime the tubing”?

A

To make sure the tubing has fluid in it before it is connected to the client’s IV access and started.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is an IV piggyback or secondary tubing?

A

An IV medicine that goes through the IV tubing that is hung above the main bag of IV fluids.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the purpose of an IV filter?

A

To catch and prevent larger molecules from entering the client’s veins.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is an IV pump?

A

A machine where the IV tubing is placed to control the amount of fluids a client gets without having to calculate and count drips.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is a normal IV fluid rate for a typical client?

A

100-125 ml/hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is an IV compatibility check?

A

The check confirms that what will be administered through the IV is compatible with the main bag of fluids that is already running through the IV.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Why is IV tubing flushed before and after giving an IV medication or solution?

A

To prevent a reaction from two incompatible fluids in the IV tubing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is keep vein open (KVO) for?

A

To keep the IV fluids going through the client’s IV at a very slow rate for future use.

The IV pump is set at 20 mL/hour.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Label the common veins for IV insertion on the inner arm:

  • accessory cephalic vein
  • basilic vein
  • cephalic vein
  • median cubital vein
  • median vein of forearm
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Label the common veins for IV insertion on the dorsal surface of the hand:

  • basilic vein
  • cephalic vein
  • dorsal venous arch
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What areas should be avoided for IV venipuncture?

A
  1. Edematous extremity
  2. An arm that is weak, traumatized or paralyzed
  3. The arm that is on the same side as a mastectomy
  4. An arm that has an AV fistula or shunt for dialysis
  5. A skin area that is infected
37
Q

How many milliliters of normal saline should be used to flush an IV site before and after using it and before the start of a shift?

A

1-2 mL of normal saline

38
Q

Why are small veins not used for IV insertion?

A

Because the IV medication or fluid is too harsh on the vein and can cause trauma.

39
Q

Why are IVs NOT usually placed in the inner elbow?

A

Because it’s too easy for the IV to get dislodged.

40
Q

How should an IV be anchored/secured?

A

By looping the tubing and securing with tape.

41
Q

What can be used for an IV with restless or active clients when there is a risk of the IV coming out?

A

Use an armboard or splint with a restless/active client to secure the IV.

42
Q

How often should an IV cannula be removed and restarted in another vein?

A

Every 72-96 hours to prevent infection.

43
Q

What is an air embolism?

(Immediate Complication)

A

It’s when air goes into the client’s IV.

44
Q

How is an air embolism prevented from occurring?

A

By priming the tubing with IV fluids before using it.

Always monitor the tubing for air bubbles.

45
Q

What are the signs and symptoms of an air embolism?

(Immediate Complication)

A

Due to decreased oxygen:

  • tachycardia
  • chest pain and dyspnea
  • hypotension
  • cyanosis
  • decreased LOC
46
Q

What are the interventions if an air embolism is suspected?

(Immediate Complication)

A

Turn the client on the left side with the head of the bed in the Trendelenburg position to trap the air embolism in the right atrium.

47
Q

What is a catheter embolism?

(Immediate Complication)

A

It’s when the catheter tip breaks off from the client’s IV and goes into the bloodstream.

48
Q

How is a catheter embolism prevented from occurring?

A

Remove the catheter slowly to prevent breaking.

After IV removal, always inspect the tip to assure it hasn’t broken off.

49
Q

What are the signs and symptoms of a catheter embolism?

(Immediate Complication)

A

Du to decreased oxygen:

  • decreased BP
  • pain along the vein
  • weak, rapid pulse
  • cyanosis of nail beds
  • loss of consciousness
50
Q

What are the interventions if a catheter embolism is suspected?

(Immediate Complication)

A
  • place a tourniquet as proximal as possible to the IV site on the affected limb
  • prepare for x-ray and surgery to remove catheter.
51
Q

What is IV circulatory overload?

(Immediate Complication)

A

When IV fluids are administered too rapidly.

It is especially harmful in clients with renal, heart or liver failure.

52
Q

How is IV circulatory overload prevented from occurring?

A

By using IV fluids cautiously in clients with fluid retention problems such as kidney disease, cardiac disease, and liver disease:

  • assess for fluid volume overload at least every 2 hours
  • make sure the correct amount of fluids is going in the IV
53
Q

What are the signs and symptoms of circulatory overload?

(Immediate Complication)

A

Due to fluids backing up into the vascular space and lungs:

  • increased BP
  • JVD
  • tachypnea
  • dyspnea
  • moist cough and crackles
54
Q

What are the interventions if IV circulatory overload from IV fluids is suspected?

(Immediate Complication)

A
  • stop the fluids or put at KVO rate
  • elevate the HOB
  • apply oxygen
  • anticipate chest x-ray and diuretics
55
Q

What is IV electrolyte overload?

(Immediate Complication)

A

When electrolytes are received too quickly causing electrolyte imbalances.

The most dangerous electrolyte is potassium which can cause dysrhythmias.

56
Q

What are the signs and symptoms of electrolyte overload?

(Immediate Complication)

A

Occur because electrolytes control cell and muscle function:

  • Calcium and Magnesium imbalances: can cause seizures, coma or dysrhythmias
  • Potassium imbalances can cause dysrhythmias
  • Sodium imbalances can cause a coma
57
Q

What are the interventions if electrolyte overload from IV fluids is suspected?

(Immediate Complication)

A

Stop the fluids and call the HCP.

58
Q

Why is infection a potential complication of IV therapy?

A

Because an IV cannula pierces the skin allowing bacteria to enter.

59
Q

Is IV insertion a sterile or non-sterile procedure?

A

It’s a sterile procedure, yet clean gloves are worn for insertion.

Don’t touch the skin where the IV needle enters the skin.

60
Q

How is infection from an IV prevented?

A
  • change IV tubing and site at least every 96 hours
  • change IV dressing if soiled
  • label the IV bag and tubing with date and time
  • change fluids at least every 24 hours
61
Q

What are the steps taken if a client does get a possible infection from an IV site?

A
  1. Remove IV and place in sterile container for culture
  2. Get blood cultures
  3. Restart IV in opposite arm
62
Q

What is IV infiltration?

A

When IV fluid seeped out of the vein and into the tissue.

It is usually caused by the IV moving and getting dislodged.

63
Q

How is IV infiltration prevented?

A
  • Avoid IVs over areas that bend (inner elbow)
  • Use an armboard for active clients
64
Q

What are the interventions if infiltration has occurred?

A
  • remove the IV immediately
  • elevate arm
  • depending on what the fluid was the HCP may order cold or warm compresses
65
Q

What is phlebitis and thrombophlebitis?

A
  • phlebitis: inflammation of the vein usually caused by an IV med or infection
  • thrombophlebitis: blood clot
66
Q

How are phlebitis and thrombophlebitis prevented?

A
  • Avoid small veins
  • Don’t put IV on the inner elbow
  • Use an armboard
67
Q

What are the interventions if phlebitis occurs?

A
  • Stop IV med that is causing problem and remove it
  • Notify HCP
  • Start an IV in the opposite arm
  • Give antibiotics if from infection
  • Warm/moist compresses to dilate vein and promote circulation
68
Q

What is extravasation and a vesicant?

A

Extravasation: tissue damage usually caused by a very harsh IV fluid or IV meds seeping into the surrounding tissues.

Vesicant: the substance that causes extravasation.

69
Q

What are the interventions if extravasation has occurred?

A

Remove the IV, notify the HCP.

70
Q

What is a central venous access device (CVAD)?

Also known as a central venous catheter, central venous line or central line.

A

An IV catheter that goes right into a very large vein so larger amounts of fluids and medications can be given or it’s used for measuring central venous pressure.

It is for long term use.

71
Q

What are the common sites for a CVAD?

A
  • internal jugular vein
  • subclavian (chest)
  • femoral vein (groin)
  • veins in the arms (called PICC lines)
72
Q

What is a major complication that can occur if the CVAD is not inserted in the correct place?

(Immediate Complication)

A

The CVAD catheter can puncture the pleural space and cause a pneumothorax (collapsed lung).

73
Q

How is placement of a CVAD verified?

A

X-ray

74
Q

What are the 3 main types of CVADs?

A
  1. Central venous catheter or Peripherally inserted central line (PICC line)
  2. Tunneled central venous device
  3. Implantable port
75
Q

What type of CVAD is this?

A

Implanted port CVAD

76
Q

What type of CVAD is this?

A

Peripherally inserted central catheter

77
Q

What position should the client be in for central insertion, tubing changes, and line removal for a CVAD?

A

Trendelenburg and bearing down/Valsalva maneuver.

This position is to increase pressure in the central veins while the IV system is open. An air embolism can occur if not done.

78
Q

How are blood clots prevented with CVADs?

A

Always flush with heparin or normal saline to prevent blood clots from forming on the tip of the catheter.

79
Q

Why should the tubing always be clamped for a CVAD?

A

To prevent air embolisms.

80
Q

How often should the tubing be replaced for a CVAD or any IV?

A

Replace the tubing every 24 hours.

This is to prevent infections from old tubing.

81
Q

What is used to clean the insertion site of a central line?

A

Chlorhexadine and cover with a sterile dressing.

82
Q

What is worn by both the nurse and client during a sterile dressing change of a central line?

A

A mask.

83
Q

What medication is given through the central line if a there is a suspected blood clot stuck to the tip of the tubing?

A

Alteplase, a thrombolytic.

Alteplase will dissolve the clot so the central line can be used.

84
Q

What are the steps for getting a blood culture through a central line?

A
  1. Turn infusions off for at least 1 minute
  2. Clean the cap with alcohol
  3. Use proximal lumen (the biggest lumen)
  4. Get first blood sample and send to lab
  5. Clean cap again with alcohol
  6. Flush with 10 mL of normal saline

Don’t flush with normal saline before getting the blood sample.

85
Q

What are the steps for getting a blood lab sample through a central line?

A
  1. Turn infusions off for at least 1 minute
  2. Clean the cap with alcohol
  3. Use proximal lumen (the biggest lumen)
  4. Flush with 5-10 mL of normal saline
  5. Aspirate 5 mL and discard
  6. Clean cap again with alcohol
  7. Withdraw blood into speciman tubes
  8. Clean cap again with alcohol
  9. Flush with 10 mL of normal saline
86
Q

What is an epidural catheter?

A

An IV catheter placed in the epidural space for the administration of pain meds.

87
Q

Why is a skeleton or spine abnormality a contraindication for an epidural catheter?

A

Skeleton or spine abnormalities: unable to get the catheter into the correct area

88
Q

Why are bleeding disorders or use of anticoagulants a contraindication for an epidural catheter?

A

Bleeding disorders or use of anticoagulants with epidural catheter: insertion can cause bleeding that is difficult to control.

NCLEX-RN (1) Fundamentals (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions