IV Access Week One

Question 1

What is the purpose of intravenous therapy

Answer 1

3 Objectives:
- Restore & Replace Intravascular volume
- Administer medications & or emergency pharmacological treatment
- Maintain venous access in emergency situations

Question 2

What is IV therapy used for

Answer 2

1. IV cannulation is used to gain access to the body’s circulation
   Indications:
   A: Administer fluids, to keep a vein open
   B: Administer drugs, i.e. Morphine Sulfate
   C: Obtain specimens for laboratory determinations
   - Route of choice for fluid replacement is through a peripheral vein in an extremity

Question 3

Layers of veins

Answer 3

Outer: tunica adventitia
Middle: tunica media
Inner: tunica intima

Question 4

Macro Drip Sets: what sets and what used for

Answer 4

• 10, 15, 20 gtt/ml
• Are the most commonly utilized admin. Sets
• Effective for TKVO & large fluid admin (bolus)

Question 5

Micro drip sets: what they are used for and what set is used?

Answer 5

• Always 60 gtts/ml
• They are used To deliver medications over long periods of time
• Assist in the precise measurement of medications
• they are to control the amount of fluid – I.e. pediatric pt’s
• To control fluid overload in certain patients – elderly/CHF

Question 6

What does #gtts/ml mean

Answer 6

For example: 10gtts/ml – means 10 drops to get one ml of fluid
Same for micro sets 60 drops = 1ml of solution

Question 7

What is a Buretrol

Answer 7

A Buretrol (micro set: 60gtts/ml) is an IV device used to control fluid delivery, especially in pediatric or geriatric care. It has a chamber that limits the amount of fluid flowing to the patient, preventing fluid overload and allowing precise dosing of medication.

Question 8

What Catheter would you use per PT

Answer 8

Adult:
14g/16g/18g/20g
Elderly Pt.
18g/20g/or 22g
Pediatric Pt. (young)
22g/ 24g

Question 9

What are crystalloids

Answer 9

Dissolving crystals such as SALTS and SUGARS in water crates crystalloid solutions
Contain NO PROTEINS

They Remain in the intravascular space for only a short time before diffusing across the capillary walls into the tissue.

Examples: Normal Saline & Lactated Ringers are primary EMS fluids

Question 10

What are colloids

Answer 10

They are Contain Large Molecules such as PROTEIN.

They Do not pass through the capillary membrane as readily as crystalloids

They are Referred to as volume expanders, plasma substitutes, plasma, packed red blood cells and whole blood.
Plasmanate, Dextran, Hetastarch

Question 11

What are hypotonic solutions

Answer 11

Hypotonic solutions have a lower concentration of solutes than the body’s cells, causing water to move into cells, which can make them swell.(cytolysis)
Ex: 0.45% Sodium Chloride (½ Normal Saline)

Question 12

What are hypertonic solutions

Answer 12

Hypertonic solutions have a higher concentration of solutes, drawing water out of cells, which can make them shrink.(plasmolysis)
Ex: 3% sodium chloride

Question 13

What are isotonic solutions

Answer 13

• Isotonic solutions have the same concentration of solutes as body cells, so there is no net movement of water, keeping cells stable.
Ex: 0.9% Sodium Chloride (Normal Saline)

Question 14

Drugs PCP can Monitor without an Escort:

Answer 14

NS/Ringers/D5W/Potassium Chloride/Thiamine & multivitamins/saline locks/ heperin locks

Question 15

Drugs a PCP needs a Escort Required for

Answer 15

Blood products/ medication being infused/IV pumps/ central lines/ jugular lines

Question 16

What is the difference between distal and proximal

Answer 16

• Distal would be below the IV, closer to the hand.
• Proximal would be above the IV, closer to the elbow and body.

Question 17

Contraindicated Locations for IV

Answer 17

1. Presence of an AV Fistula
2. Anticipated locations of surgery
3. Veins that are firm or sclerosed
4. Evidence of phlebitis or thrombosis
5. Mastectomy
6. Lymph Node Removal

Question 18

What is infiltration and its S&S

Answer 18

• Infiltration is when IV fluid or medication unintentionally enters the surrounding tissue instead of the vein

1. Coolness of skin around IV site
2. Swelling at the IV site, with or without pain
3. Sluggish or absent flow rate

Question 19

What is phlebitis

Answer 19

Inflammation of the vein caused by injury to the vessel wall

Signs and Symptoms:
Pain
Swelling
Redness
Tenderness

Treatment:
Use of an appropriate size catheter to canulate the vein

Question 20

What is a air embolism and its S&S

Answer 20

An air embolism is a blockage of blood flow caused by air bubbles entering the bloodstream, which can travel to the heart, lungs, or brain and lead to serious complications.

Signs and symptoms
-Hypotension
-Cyanosis
-Weak and rapid pulse
-Loss of consciousness

Question 21

What is the definition of flow rate

Answer 21

The period of time (in minutes) over which the fluid is to be infused. (Drops per minute)

Question 22

What is the definition of drop factor

Answer 22

The number of drops per mL that infusion set delivers (drop factor)

Question 23

IV Fluid therapy AUXILIARY MD conditions

Answer 23

IV cannulation: more than or equal to 2 years old
0.9% NaCl fluid bolus: more than or equal to 2 years old and have to be hypotensive

Question 24

IV Fluid therapy AUXILIARY MD Contraindications

Answer 24

IV cannulation: suspected fracture proximal to the access site

0.9% NaCl fluid bolus: fluid overload

Question 25

IV Fluid therapy AUXILIARY MD treatment

Answer 25

0.9% NaCl fluid bolus:
Age: 2-12 Yr old 12+
Infusion: 20ml/kg 20ml/kg
Reassess every: 100ml 250ml
Max volume: 2000ml 2000ml