IV Flashcards
The most common electrolytes in the body
Sodium, potassium, calcium, bicarbonate, chloride, magnesium, phosphate
Elecytolye
An element or compound that, when dissolved or dissociated in water or solvent, separates into ions
Why must we add electrolytes to fluids
In order to create an isotonic solution for the body
Regulation of body fluids occurs by
Intake, output, hormonally
Fluids and solutes move through membrane by 4 processes
Osmosis, diffusions, filtaration, carrier mediated transport
Fluid output occurs where
Fluid lost through, skin, lungs, GI tract
Insensible loss (20-25 mLs per hour)
Sensible water loss (varies greatly)
Fluid intake regularted by
Osmoreceptors
Usual Fluid intake per day
2200-2700 mLs per day
Hormonal regulation of fluids
ADH
Renin-Angiotensin aldosterone mech (released by adrenal cortex by falling sodium levels)
Atrial natrietic peptides (respond to low fluid circulating blood volume)
Everytime someone has fluids they have electrolytes checked every _____
48 hours
Prolonged and severe compromises in electrolyte balance can result in
irreversible chronic health problems
Interventions to fluid imbalance include?
Enteral fluid replacement
Restriction of fluids
Parental replacement of fluids/electrolytes
two main categories of Iv theerapy
Crystaloid and colliodM
Most common category of IV thereapy
Crystaloid
Cyrstaloid solutions
Glucose, sodium cholrid and lactated ringer solutions
Vary in tonicity
Cross semipermeable membranes
Colloid solutions
Remain suspended in intervascular space to incrase vascular pressure/vascular volume in critical situations
Contain proteins and starch
Crystaloids divideed based onto tonicity into
Isotonic, hypertonic, hypotonic
Isotonic crystalloid solutions
Same tonicity as blood
Fill same fluid volume space as blood
The fluid goes equally through inter and extracellular spaces
Most common 0.9 NaCl solution
2nd most common Desxtroce 5% in water
3rd Ringers Lactate
.9% NacL is
Isotonic
Anything more than 0.9% NaCl would be
Hypertonic
Anything less than 0.9% NaCl would be
Hypotonic
How often are bags changed and tubing changed
Depends on hospital policy
Things a nurse must be aware of when caring for a patient with an IV
Safety alerts for electrolytes
NaCl is NEVER given by direct intravenous infusion
IV pumps/volume controlled devices - ensure prescribed rate of infusion
- Must be used for meds requiring preseise rates of admin
Antifreeflow safeguard preventing bolus infusion in event of machine malfunction and IS required
- Manufactured recommendation for procedure should ALWAYs be followed and checked
What to check on IV bags
Expiry date, look for punctures, look for crystalization
How is the equipment chosen
Size of the bag is chosen based on how long it will be hanging for
Pump used if necessary, only pole if using gravity
What is significant abuot IV access
There is a BIG difference bw and IV access point and a peripherally inserted central line
Roller clamp
Regulates rate at which IV runs by gravity
Number of drops/min is controlled
Drip chamber
Small space allowing drips to fall
to determine drop factor (number of drops/mL)
Port
Where secondary tubing meets the primary
Lower port
For delivering IB push meds OR when we want to connect ANOTHER tubing that is going to run and shut the other one off
Luer lock
Connects tubing to IV infusion device
Drop factor
Number of drops that exist in a mL (every IV package will have this in the right upper corner)
IV drip Rate formula
Volume to be infused (mls/hr) / 60 minutes/hr
x the drop factor = IV drip rate
i.e.
75mLs/hr / 60 min/hr x 20 gtts/mL (drop factor)
=25 drops per minute
Basic instructions for using IV line
Choose the correct IV solution and tubing. Prime the line.
Label the infusion bag and tubing
Obtain a “service ready” pump.
Load the tubing into the pump.
Enter the patient ID and select the correct profile – e.g., “Med Surg”
Program the pump to infuse solution using the “Guardrails.”
Be able to respond to a patient side or pump side occlusion alertW
WHy should patient with IV avoid raising arms for long periods of time
it affects flow rate based on pressure provided by raising a lowering arm
Infiltration
when intravenous fluids enter the surrounding space around the venipuncture site. See your text for infiltration scale.
Phlebitis
is inflammation of the vein, Indicators always include erythema. Risk factors include catheter material, chemical irritation of additives or drugs given intravenously, rate of medication administration, skill of insertion, and anatomical location of catheter. See your text for the phlebitis scoring scale
Interventions for IV complications
Pain meds, improve circulation to site
Warmth will often bring pain release
Sometimes Phlebitis patients need IV antibtiotics
IV catheter can be accessed intermittantly advantages
Reduces the risk of ptfluid volume excess
increases mobility, safety, and comfort
Patency
The condition of the vein to remain open
2nd year nursing students cannot flush PICC lines, so what must we check
Patients chartws to know if it’s a PICC line or IV line
What must be ensured before attatching syringe to vascular access device?
NO AIR IN SYRNINGE
