IV concepts Flashcards
Delivery of medications in solutions and fluids by parenteral route
____________ _______ most common route
Intravenous (IV) therapy
Maintain fluid balance (or correct)
Maintain electrolyte or acid-base balance (or correct)
Administer medication
Replace blood or blood products
uses for infusion therapy
MOST PEOPLE WILL ALWAYS HAVE A ______ in the hospital
SALINE LOCK
_____________ ________ ____ __________ nurses to initiate and maintain infusion therapy
Teams promote cost savings, patient satisfaction and outcomes
RN generalist inserts peripheral IV lines, and is accountable for all aspects of infusion therapy and delegation of associated tasks
may not have a ___________ if you’re at a small hospital
Specialized team of infusion
team
What are the types of IV solutions (including parenteral nutrition)?
isotonic
hypertonic
hypotonic
What is the normal serum osmolarity of adults?
270 to 300 mOsm/L
___________ = Fluids >300 mOsm/L
Hypertonic
______ = Fluids <270 mOsm/L
Hypotonic
____________ of IV Fluids indicates whether the IV solution will cause shift of fluid into the cell or out of the cell.
Osmolarity
Water does not move into or out of body’s cells
Risk for fluid overload, especially older adults
isotonic infusate
__________ _________ are good for patients who have FVD, or are coming in for surgery and need maintenance IV fluids
isotonic infusate
What are isotonic IV fluids?
lactated ringers -fluid resuscitation -often used for surgery
normal saline (0.9%) -fluid resuscitation -this is the fluid that is used with blood products
what should you do for patients receiving isotonic fluids?
Document baseline data. Before infusion, assess the patient’s vital signs, edema status, lung sounds, and heart sounds. Continue monitoring during and after the infusion.
Observe for signs of fluid overload. Look for signs of hypervolemia such as hypertension, bounding pulse, pulmonary crackles, dyspnea, shortness of breath, peripheral edema, jugular venous distention, and extra heart sounds.
Monitor manifestations of continued hypovolemia. Look for signs that indicate continued hypovolemia such as, decreased urine output, poor skin turgor, tachycardia, weak pulse, and hypotension.
Prevent hypervolemia. Patients being treated for hypovolemia can quickly develop fluid overload following rapid or over infusion of isotonic IV fluids.
raise HOB so fluids circulate better
if they have edema, elevate the legs
watch if you patient is having more than 80 cc per hour
Elevate the head of the bed at 35 to 45 degrees. Unless contraindicated, position the client in semi-Fowler’s position.
Elevate the patient’s legs. If edema is present, elevate the legs of the patient to promote venous return.
Educate patients and families. Teach patients and families to recognize signs and symptoms of fluid volume overload. Instruct patients to notify their nurse if they have trouble breathing or notice any swelling.
Close monitoring for patients with heart failure. Because isotonic fluids expand the intravascular space, patients with hypertension and heart failure should be carefully monitored for signs of fluid overload.
Document baseline data. Before infusion, assess the patient’s vital signs, edema status, lung sounds, and heart sounds. Continue monitoring during and after the infusion.
Observe for signs of fluid overload. Look for signs of hypervolemia such as hypertension, bounding pulse, pulmonary crackles, dyspnea, shortness of breath, peripheral edema, jugular venous distention, and extra heart sounds.
Monitor manifestations of continued hypovolemia. Look for signs that indicate continued hypovolemia such as, decreased urine output, poor skin turgor, tachycardia, weak pulse, and hypotension.
Prevent hypervolemia. Patients being treated for hypovolemia can quickly develop fluid overload following rapid or over infusion of isotonic IV fluids.
raise HOB so fluids circulate better
if they have edema, elevate the legs
watch if you patient is having more than 80 cc per hour
Elevate the head of the bed at 35 to 45 degrees. Unless contraindicated, position the client in semi-Fowler’s position.
Elevate the patient’s legs. If edema is present, elevate the legs of the patient to promote venous return.
Educate patients and families. Teach patients and families to recognize signs and symptoms of fluid volume overload. Instruct patients to notify their nurse if they have trouble breathing or notice any swelling.
Close monitoring for patients with heart failure. Because isotonic fluids expand the intravascular space, patients with hypertension and heart failure should be carefully monitored for signs of fluid overload.
things to watch out for if your patient is receiving isotonic fluids
Decreased concentration of dissolved solutes in intravascular fluids (than in cells)
Water moves into cell
hypotonic infusate
Treat hypernatremia and intracellular dehydration
hypotonic IV fluids
Monitor closely for hypovolemia, hypotension, confusion
considerations for hypotonic fluids
What are the hypotonic fluids?
0.45% sodium chloride
Too much fluid can shift into cells- Can cause _______ ________= life threatening
this occurs with ___________ _______
cerebral edema
hypotonic fluids
document baseline data
do not administer in contraindicated conditions
risk for increased intracranial pressure
watch for FVD -confusion in older adults
warning on excessive infusion
do not administer along with blood products
considerations for patients receiving hypotonic fluids
___________ ___________may exacerbate existing hypovolemia and hypotension causing cardiovascular collapse. Avoid use in patients with liver disease, trauma, or burns.
Hypotonic solutions
Should not be given to patients with risk for IICP as the fluid shift may cause cerebral edema
hypotonic solutions
Monitor for manifestations of fluid volume deficit. Signs and symptoms include confusion in older adults. Instruct patients to inform the nurse if they feel dizzy.
hypotonic solutions
Warning on excessive infusion. Excessive infusion of ______ IV fluids can lead to intravascular fluid depletion, decreased blood pressure, cellular edema, and cell damage
hypotonic
Do not administer along with blood products. Most ______solutions can cause hemolysis of red blood cells especially during rapid infusion of the solution.
hypotonic
Corrects fluid, electrolyte, and acid–base imbalances by moving water out of body’s cells
Parenteral nutrition is example
hypertonic infusate
What are the hypertonic IV fluids?
3% normal saline
Used to treat severe hyponatremia and cerebral edema
hypertonic IV fluids
Monitor closely for hypernatremia and hypervolemia.
hypertonic fluid considerations
IS NOT GIVEN A LOT REALLY
IS NOT GIVEN ON THE MED SURG FLOOR
hypertonic iv fluids