IV Final Flashcards
When should a peripheral line IV dressing be changed?
-When the catheter is removed. -No longer intact. -Soiled. -Clean techniques.
When should a central line IV dressing be changed?
-Changed weekly. -When no longer intact. -Soiled.
When should blood tubing and a blood bag be changed?
After each unit of blood or every 4 hours.
What types of medications and solutions should be administered using an IV pump?
-Heparin -Nitroglycerin -Theophylline -TPN -Lipids
What are important nursing considerations/actions in preventing nosocomial infections from vascular access?
-Use aseptic techniques. -Hand hygiene. -Cleaning patients skin appropriately. -Use proper IV site dressings. -Use catheter securement devices.
What should be done if any steps are compromised while spiking an IV bag?
Dispose of compromised supplies, get new supplies, and start over.
What information needs to be placed on a time strip?
Patients name, RM#, my initials, date, time, mL/hr, gtts/min.
What are the compartments for body fluids and what is the distribution of water in those compartments?
-Extracellular: Interstitial fluid Intravascular fluid -Intracellular compartment: fluids within the cell.
Who has the highest percentage of water?
Slender, young, male
What are the functions of water in the body?
-Maintains blood volume. -Assists digestion of food through hydrolysis. -Transports material to and from cells. -Serves as an aqueous medium for cellular metabolism. -Regulates body temp. -Serves as a medium for the excretion of waste. -Acts as a solvent in which solutes are available for cell function.
What are electrolytes?
-Sodium: cation (+) -Potassium: cation (+) -Magnesium: cation (+) -Calcium: cation (+) -Chloride: anion (-) -Phosphate: anion (-)
When dissolved in water or other solvent____ dissociate into + and - charged ions.
electrolytes
What is the major cation in the ECF?
Sodium
What is the major cation in the ICF?
Potassium
How much fluid is required each day for an adult?
2-3 L/day or 30 mL/ kg
What are sources of fluid intake?
-Liquids by mouth -Food ingested -Metabolic waste
What are routes of fluid loss?
-Urine -Feces -Perspiration -Respiration
What are some ways that we monitor fluid status?
-Input and output -Daily weight -Lab tests: Specific gravity, Serum electrolytes (lytes), Serum or urine osmolality
The movement of water, ions, and lipid-soluble molecules randomly in all directions from an area of high concentration to an area of low concentration. Does not require energy. As long as there’s no force opposing them they will distribute evenly.
Diffusion
Is the passage of water from an area of lower particle concentration toward one with a higher particle concentration across a semipermeable membrane. Does not require energy. This process tends to equalize the concentration of two solutions. Governs the movement of fluids between ICF and the ECF compartments.
Osmosis
Ions (electrolytes) move from an area of low concentration to an area of high concentration. Uses energy in the form of ATP. The sodium-potasium pump uses active transport to move sodium from the cell to the ECF.
Active trasport
What is the process of fluid/electrolyte regulation?
Regulation of body water is maintained through exogenous sources, such as the intake of food and fluids, and endogenous sources that are produced within the body through chemical oxidation process.
The endogenous sources of balancing electrolytes and fluids use various body systems. What are the body systems?
Cardiovascular, lymphatic, renal, respiratory, nervous, and endocrine systems.
What is the role of the pituitary gland in fluid/electrolyte regulation?
Pituitary gland stores ADH.
When body fluids become more concentrated ___ is released causing the renal cells to reabsorb water.
ADH
If body fluids become to diluted ____ levels will decrease.
ADH
What is the role of the adrenal glands in fluid/electrolyte regulation?
Adrenal glands produce aldosterone.
_____ circulates to the kidneys, where it causes resorption of sodium and water in isotonic proportion in the distal renal tubules.
Aldosterone
Removing sodium and water from the renal tubules and retuning it to the blood increases the volume of the ____?
ECF
_____ also contributes to electrolyte and acid-base balance by increasing urinary excretion of potassium and hydrogen ions.
Aldosterone
What is the role of the parathyroid gland in dliid/electrolyte regulation?
Parathyroid glands produce parathyroid hormone, which regulates calcium metabolism in the blood; increases calcium levels; increases calcium absorption from intestine and kidney tubules.
What is the role of the kidney in fluid/electrolyte regulation?
Kidneys filter waste products of metabolism that collect in the bloodstream and excrete the waste to the external environment as urine.
What is an acid?
A pH of less than 7.35 is acidic. Acids release hydrogen (H+) ions. The more H+ ions that are present, the more acidic is the solution. The lungs and kidneys excrete acids.
What is a base?
A pH of more than 7.45 is basic. Bases accept hydrogen ions. The less H+ ions that are present, the more basic the solution.
What is pH?
pH is the degree of acidity in blood and other body fluids. The pH scale goes from 1.0 (very acidic) to 14.0 (very alkaline or basic).
What is the normal range for pH?
The normal range of adult arterial blood is 7.35 to 7.45.
What is osmolality?
The total number of solute particles per kilogram of water/solute. Most commonly used system of fluid measurement. Expressed as milliosmols per kg or mOsm/kg.
What is osmolarity?
The concentration of solute particles contained in a unit of solvent. Expressed as milliosmols per liter or mOsm/L.
What is normal serum osmolality?
The average serum osmolality is 290 mOsm. Normal saline is between 240-340 mOsm/kg.
The same concentration of non-permeant particles as normal blood. Close or equal to that of serum.
Isotonic Solution
What is the osmolality of an isotonic solution?
290 mOsm + or - 50 mOsm.
_____ are administered to the intravascular space and will stay in the intravascular space.
Isotonic solutions
Examples of isotonic solutions?
-LR: 310 mOsm -0.9% NaCL: 308 mOsm -D5W: 252.52 mOsm -Plasmalyte 148: 296 mOsm
These fluids are used to expand the ECF compartment?
Isotonic solutions
What are isotonic solutions used to treat?
Fluid loss, mild dehydration, hypernatremia, and KVO.
What does a patient need to be monitored for while administrating an isotonic solution?
Fluid overload, elevated blood glucose, hypokalemia.
Who should not receive D5W?
Patients at risk for ICP (increased intracranial pressure) because in that instance some patients can get hyponatremic encephalopathy which causes the brain to swell.
Less than that of serum 240 mOsm or less; low solute concentration.
Hypotonic solution
____ will shift from the intravascular compartment into the ICC and interstitial space because the fluid will go from an area of low concentration to an area of high concentration.
Hypotonic solution
Examples of hypotonic solutions?
-D5W (when it is metabolized) -1/2 normal saline 154 mOsm -Normosol R: 112 mOsm
What are hypotonic solutions used to treat?
Severely dehydrated patients in whom dehydration is at the cellular level.
Which patients should hypotonic solutions not be used in?
-Patients who have hypotension (will cause BP to drop further) -Patient with increased cranial pressure. -Patient at risk for 3rd space fluid shifts (burns, trauma, low serum protein levels caused by malnutrition or liver disease) -Sterile water is never used as an IV flush only as a diluent.
_____ hydrate cells and can deplete the circulatory system.
Hypotonic solutions
Greater than that of serum; 340 mOsm or more; high solute content.
Hypertonic solution
When ____ are administered fluids are pulled from the intracellular space into the intravascular space causing cells to shrink and the intravascular space will become more concentrated.
Hypertonic solution
Examples of hypertonic solutions?
-D10% to D70%: 505 mOsm and up -2.225% to 5% NaCl: 685.30 -D5 in 1/2 NS: 391 mOsm -D5 NS: 560 mOsm
____ are used to shift water out of the ICC tissues into the intravascular space.
Hypertonic solutions
What are hypertonic solutions used for?
Patients who have a severe sodium deficit and water intoxication.
Which patients should hypertonic solutions not be used for?
-May cause hypertonic circulatory overload. -May be contraindicated in patients with cardiac or renal disease because of the increased risk of congestive heart failure and pulmonary edema.
____ need to be administered slowly to prevent circulatory overload?
Hypertonic solution
What are the signs and symptoms of fluid deficit?
-Dry mucous membranes -Cracked lips -Hypotension -Oliguria -Dizziness -Decreased skin turgor -Increased specific gravity -Temp and resp increase -Pulse increase first them decreases
What are the signs and symptoms of fluid overload (Hypovolemia)?
-Hypertension -Short of breath -Crackles in lungs -Edema -Tachycardia- bounding pulse -Decreased hematocrit -Decreased specific gravity
What is this?
Primary pump set
What is open and closed?
Convertible pin
What are these?
Extension set
What is this?
Dial-A-Flow
What is this?
Volume control set
What is this?
In line IV filter
What is this?
Gravity blood tubing-straight set
What are these?
PRN or Intermittent Devices
What is this?
Secondary set
