IV cert Flashcards
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,
what actions should the nurse take? with fluid overload
slow rate down, elevate head of the bed, oxygen, notify the doctor, and vitals
Basic IV tubing change
major fluids- 96 HRS
valves in blood vessels are
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, never utilize in an adult- does require a physician’s order
What is the main complication of an intraosseous catheter if it remains in place longer than 24 hours?
nfection 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,
if there is two nurses its 4 tries all together
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 dressing changed?
Gauze- 48 hrs
Transparent dressing- 5 to 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 administered when?
anemia, blood loss, low hemoglobin, fluid replacement, and if the client is symptomatic, hypotension and dyspnea.
PRBC- Packet red blood cells is what?
There is not enough oxygen in the blood because of the hemoglobin not being enough
Granulocytes
white blood cells, given when an infection is to strong, and body is not responding to antibiotics
Plasma
is the portion of the blood that contains albumin, fibrinogen, coagulation factors. given for fluid replacement, hypertension, coagulation deficits, and it can be infused as fast as the client can tolerate.
Platelets
help with clotting of the blood, if count is low.
Albumin
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.
To much fluid in the vessel - fluid overload
hypervolemia
Isotonic
-Solutions NS (0.9%), D5W, LR, colloids
-Indications expands blood vessel compartment
-Contraindications Do not administer D5W with ICP
-Adverse Effects: fluid overload
Hypertonic
-Indications : Dehydration, hyperglycemia
-Contraindications : Increased ICP from stroke, trauma, or neurosurgery; risk for third-spacing (burns, trauma, low serum protein from malnutrition or liver disease)
Hypotonic Solutions
-Indications: Postoperatively to pull fluids from tissues; reduces edema, stabilizes blood pressure, hyponatremia, and regulates urine output
-Contraindications: Impaired heart or kidney function; DKA
-Nursing Considerations: Monitor for circulatory overload
piggy back tubing is
is always above the primary solution
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.
If the nurse discovers the I.V. solution has infused too rapidly or too slowly, what does the nurse do?
Reset the rate
A nurse is preparing an I.V. piggyback of antibiotic. Which is the best method for a client with a history of CHF?
Intermittent infusion via saline lock
A client has swelling at the site, reports pain and the rate is slowing. What complication does the nurse suspect?
Thrombus formation
A client has chills, fever, headache, and anxiety with PRBC infusion. What is an action after stopping the PRBCs?
Administer PRN acetaminophen by mouth
When attaching an I.V. piggyback to a primary I.V., the nurse should hang the I.V. piggyback _____ the primary bag.
Higher than
What local complications associated with infusion therapy does the nurse monitor the client for?
Phlebitis, occlusion, and infiltration
The client’s I.V. has coolness of skin, taut skin, swelling and absence of blood in tubing are signs and symptoms of?
Infiltration
The nurse must assess the client receiving I.V. therapy and document at least every four hours on what?
The condition of the insertion site
While spiking the intravenous solution bag, the nurse should remember to:
Keep the fingers behind the flange to protect the sterility of the spike
The healthcare provider prescribed Lactate Ringers. The nurse knows this fluid will:
Stay in the vascular space
What should be considered when selecting a peripheral vascular access device?
Ordered therapy, client’s clinical status, and age
A midline catheter should not be used to administer which solution?
Total parenteral nutrition
When inserting an intermittent infusion device, the LPN must flush the it with:
Normal saline prior to attachment to catheter
