iv 2 Flashcards
what do you heaer with fluid over load when administering IV therapy
you hear crackles while you are auscultating the lungs
when the infusing blood through a CVC and the volume is to large, fast and cold it can cause
cardiac dysrhythmias
what is autologous transfusion
blood that is collected from a patient and later reinfused into the same patient
plasma transfusion is given when
you have been burned badly , have liver failure, or a severe infection
red blood cells
carry oxygen and help to get rid of carbon dioxide and other waist products
platelets and clotting factors
this part of the blood helps stop bleeding, including internal bleeding that you can not see
what kind of solution can you only use with blood products?
normal saline
hypertonic
this type of solutions pull fluids
isotonic
fluid that replaces intravascular fluid
hypotonic solutions nursing considerations
monitor circulatory overload
hypertonic indicated
dehydration, hyperglycemia (excess glucose in the blood stream)
what type of intravenous solution do you use for cellular dehydration?
hypotonic
If the nurse discovers the I.V. solution has infused too rapidly or too slowly, what does the nurse do?
Reset the rate
What interventions and considerations should be completed or observed when performing intravenous therapy on older adults?
-Avoid flexion areas and areas with bruising
-Avoid spiderweb veins
-Avoid hard sclerosed veins
-Use small gauge and short length needle device to effectively deliver ordered therapy
If the nurse attempts to flush an intravenous catheter and meets resistance, what can happen if the flush attempt is not stopped?
It can cause rupture of the catheter or mobilization of an occlusive clot, blood clot, and it can cause an embolism.
List blood transfusion reaction symptoms.
-Back or chest pain
-fever
-Chills
-Decreased blood pressure
-Urticaria
-Wheezing
-Dyspnea
-Coughing
-Allergic reaction
-headaches
What three areas will the LPN find scope of practice and guidelines for the performance of I.V. therapy?
-Kansas nurse practice act
-Facility policies and procedures
-IV standards
Can all LPNs perform some level of I.V. therapy? What types of classes are available for LPN I.V. certification?
All LPN can do some level of therapy, not start but can monitor, hang bags of basic IV fluids. Discontinue less than 3 inch
With IV certification- LPN can do all IV therapy
how can you get an IV certificate?
1- Nursing program with IV certificate
2- stand alone class that does certification for IV
3- grandfathered in with one week certification class
What should be assessed when assessing I.V. therapy?
IV site all the way to the tubing, container, IV fluids, IV site from any rash warmth, cool, to touch, intake and output, monitor infusion rate, patient response to therapy or AE
What are symptoms of fluid volume overload?
edema, headache, crackles in the lungs, weight gain, neck pain distinction,
if a client exhibits fluid over load symptoms, what actions should the nurse take? AKA circulatory overload
slow rate down, elevate head of the bed, oxygen, notify the doctor, and vitals
When is basic Iv tubing changed?
Basic IV tubing - major fluids- 96 HRS
Discuss valves in blood vessels.
epithelial folds
What is the most commonly used peripheral catheter?
over the needle catheter
When can the lower extremities of a client be cannulated?
in infants ONLY, never IN ADULTS
What is the main complication of an intraosseous catheter if it remains in place longer than 24 hours?
Infection in the bone AKA Osteomyelitis
What is a potential complication of inserting a central line venous access device?
Pneumothorax because its right by the lung
How many insertion attempts per nurse when trying to start an I.V.?
2 per NURSE
What does a sharp, shock-like like, or ‘zinging’ pain up the arm indicate during an I.V. cannulation attempt indicate?
Nerve damage- change the site
How often is a central venous access device GAUZE dressing changed?
48hrs
How often is a central venous access device TRANSPERANT dressing changed?
5-7 days
What is a priority when infusing I.V. therapy using an electronic infusion pump?
Priority is monitoring the IV SITE
If an I.V. solution is discovered to have been hanging longer than 24 hours, what should the nurse do?
The nurse has to change the Fluid bag
PRBC- Packet red blood cells- give when patient?
anemia, blood loss, low hemoglobin, fluid replacement, and if client is symptomatic, hypotension and dyspnea. There is not enough oxygen in the blood because of the hemoglobin not being enough
give Granulocytes-when patient
white blood cells, given when an infection is to strong, and body is not responding to antibiotics
Plasma is
is the portion of the blood that contains albumin, fibrinogen, coagulation factors
give plasma when patient?
fluid replacement, hypertension, coagulation deficits, and it can be infused as fast as the client can tolerate.
Albumin is
protein, help with poor wound healing, increases osmotic pressure, and third spacing ( too much fluid in the tissues) will move the excess fluids from the tissues to the vessels.
