IV and Topical Meds

Question 1

What is a central venous catheter?

Answer 1

Inserted by a physician, goes into bog blood vessels in our body (aka femoral veins, jugular, subclavian). Has 3 lumens and used in patients critically ill who need to administer large volumes of meds.

Question 2

What is peripherally inserted central catheters?

Answer 2

Used for IV nutrition, long term antibiotics. Most common. In basal or cephalic veins.

Question 3

What is an implanted central venous catheter?

Answer 3

Used for patients with chemotherapy with a special needle that’s surgically inserted into the subclavian vein.

Question 4

What is tunnelled central venous catheter?

Answer 4

It’s surgically inserted with multiple lumens in the subclavian vein.

Question 5

Advantages/disadvantages of IV meds?

Answer 5

A- fast acting, medication less irritable to surrounding tissues, avoids first pass effect so it gives high concentrated dose

D- effect is quick so don’t make mistakes, risk for anaphylaxis, once it is in it can’t be taken out, any medication incompatibilities

Question 6

What is phlebitis?

Answer 6

Vascular irritation of veins that causes redness, warmth, edema, and pain.

Question 7

What is infiltration?

Answer 7

Extravasation of meds that result in tissue damage around IV site. Causes edema, cool skin, pain.

Question 8

What is rapid adverse reaction (anaphylaxis)

Answer 8

Allergic reaction. Signs are hives, rash, swelling, wheezing.

Question 9

What is speed shock?

Answer 9

Systemic reaction to substance that’s rapidly injected into blood. Similar symptoms to anaphylaxis.

Question 10

How do we assess patency of IV line?

Answer 10

Flush saline lock with NS 3 mL. Should feel no resistance, edema, pain.

Question 11

How to check compatibility?

Answer 11

Use nursing central or IV drug reference manual to make sure med is compatible with IV bag prior to administration.

Question 12

What is a bolus (small volume) injection?

Answer 12

Concentrated dose of medication that’s manually pushed directly into vein.

Question 13

What does tandem (concurrent) mean?

Answer 13

Both lines will infuse into patient at same time. On gravity line you set them at the same height and on pump you push concurrent setting.

Question 14

What does piggyback mean?

Answer 14

Secondary line is infusing and primary line is on hold. On gravity the small bag is placed higher than the main IV bag.

Question 15

What is skin application meds?

Answer 15

Applied to skin/mucous membranes to achieve local effect like transdermal patches.

Question 16

What is the criteria for choosing a site for patches?

Answer 16

Apply patch to area of skin that’s intact and free of hair to achieve a local effect. Assess the site that’s irritated/dry then apply the cream or whatever it is.

Question 17

How to apply steroid cream?

Answer 17

Apply gloves, clean/assess skin, apply thin layer, document.

Question 18

How to apply transdermal patches and characteristics?

Answer 18

Remove previous patches, indicates where you put patch on MAR, make sure it sticks appropriately, use least number of patches possible, keep patches in same area if multiple, don’t overlap, rotate patch site for better absorption/less irritation, document on MAR if more than 1 patch.

Question 19

What position to insert rectal meds?

Answer 19

Left side lying position.

Question 20

How to insert nasal meds?

Answer 20

Use gloves, assess nares, blow nose before, don’t blow immediately after (15-20 min) because it gets ride of med.

Spray- patient sit, compress spray with patients inhalation
Drops- patient in side lying (stay in post in for 5 min after)

Question 21

How to administer ophthalmic meds?

Answer 21

Administer drops before ointment to same eye (drops absorb quicker), clean eyes before (in to out because we don’t want to drag bacteria into lacrimal duct). If more than 1 med to be given in same eye than wait 5 minutes before administering the next.

Eye drops- gloves, head back, hold dropper 1-2 cm above eye, pull down conjunctival sac, close eye after administering
Eye ointment- apply thin stream from inner to outer canthus and pull down lid, don’t touch end of container to eye, patient close eye after

Question 22

How to administer ear meds?

Answer 22

Want solution to be at room temperature (warm with hands, cold will experience vertigo).

Ear drop- pull pinnna up/back, i still drops, have patient remain in position for 2-3 minutes, apply cotton ball for 15 min if needed

Ear irrigation- affected ear down, want gravity to move foreign object out, straighten ear canal