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Nurs 321 > IV initiation > Flashcards

IV initiation Flashcards

1
Q

Short peripheral catheter

A

what we seen most in practice

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2
Q

midline peripheral catheter

A

in between of PIV and PICC
- allows for better flow rate and more hemodilution
- usually inserted in median cubital vein and resides at level of armpit

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3
Q

vein condition for IV insertion

A

should be straight, bouncy, and nicely palpable

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4
Q

vein collapse

A

will occur if patient is hypotensive or hypovolemic

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5
Q

Infant vein selection

A

if under 18 months then go for scalp veins due to the increased body fat

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6
Q

Elder patient vein selection

A

use BP cuff for vein dilation
- avoid metacarpal veins due to fragility

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7
Q

considerations for patients on anticoagulants

A
  • will bleed more so hold gauze for longer
  • will bruise more
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8
Q

stroke considerations

A

will have decreased circulation and increased chance of phlebitis

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9
Q

first choice for IV insertion

A

cephalic vein
- at wrist, on thumb side

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10
Q

go 8-10 cm above wrist

A
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11
Q

cephalic vein

A
  • close to radial nerve
  • first choice
  • on thumb side
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12
Q

antecubital fossa vein

A

close to tendons of bicep, brachial artery, and median nerve
- inner elbow

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13
Q

palm side of wrist vein

A

close to median nerve
- on inside of thumb

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14
Q

metacarpal veins

A

easily visualized but small and fragile
- mostly avoid

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15
Q

feet veins

A

MUST require doctor order if inserting IV in foot

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16
Q

basilic vein

A

on pinky side
- large vein but difficult to start

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17
Q

median cubital and basilic vein

A

second option if cephalic not useable

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18
Q

median antebrachial

A

not ideal because lots of nerves nearby
- pinky side close to wrist; between cephalic and basilic
- commonly used in bloodwork

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19
Q

strategies for vein distention

A
  • position extremity lower than heart
  • tourniquet
  • clench fist
  • warm compress
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20
Q

gauge

A

the SMALLER the number the BIGGER the needle

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21
Q

most common gauge

A

20-24

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22
Q

irritants gauge

A

22-24

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23
Q

16 gauge

A

gray

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24
Q

18 gauge

A

green

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25
Q

20 gauge

A

pink

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26
Q

22 gauge

A

blue

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27
Q

24 gauge

A

yellow

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28
Q

26 gauge

A

violet

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29
Q

lab typically draws from … and use a gauge size of…

A

16 (grey) or 22 (blue) gauge at median cubital vein

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30
Q

once site is prepped you cannot..

A

re-palpate vein

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31
Q

drying the site

A

must not touch, let dry on own

32
Q

for hairy patients site prep

A

use clippers, do not shave

33
Q

direct venipuncture

A

appropriate for small gauge needles; most commonly done
- approach directly over vein

34
Q

indirect venipuncture

A

can be used for all vein sites
- enter skin slightly adjacent to vein and insert into side of vein

35
Q

PLAT

A

pause
lower
advance
thread

36
Q

adult patient monitoring post insertion

A

every 4 hours

37
Q

critically ill patient monitoring post insertion

A

every 1-2 hours

38
Q

pediatric patient monitoring post insertion

A

every hour

39
Q

mechanoreceptors

A

feel palpation of vein

40
Q

thermoreceptors

A

sense temperature

41
Q

chemoreceptors

A

process osmotic changes in blood

42
Q

venipuncture for phlebotomy

A

similar to IV
- insert needle and attach tube to other end of needle

43
Q

purpose of phlebotomy

A

-diagnostic testing
- blood donation
- therapeutic reasons

44
Q

tunica adventitia

A

outter most layer
- connective tissue

45
Q

tunica media

A

middle layer
- muscular and elastic tissue

46
Q

tunica intima

A

inner layer
- endothelium layer

47
Q

Evacuated tube system

A

most direct and efficient method
- closed system

48
Q

Syringe system for blood collection

A

not preferred but useful for patients with small or difficult veins

49
Q

butterfly system

A

used for small or difficult veins
- 23 gauge usually used

50
Q

tube size selection criteria

A

age, amount of blood required, vein condition

51
Q

tubes for blood collection

A

color coded and help determine order drawn in
- made of unbreakable plastic

52
Q

additives in tubes for blood collection

A

anticoagulants, oxalates, citrates, EDTA, heparin

53
Q

purpose of anticoagulants in blood collection tubes

A

extend metabolism and life span of RBCs

54
Q

Oxalates, citrates, EDTA function

A

anticoagulants
- remove calcium and form calcium salts

55
Q

oxalate

A

decreases calcium and regulates it

56
Q

EDTA

A

decreases calcium and decreases platelet aggregation
-used for CBC

57
Q

citrate

A

prevents high acid levels
- for coagulation study

58
Q

heparin

A

prevents clotting by inhibiting conversion of prothrombin to thrombin and fibrinogen to fibrin

59
Q

assessment data impacting blood collection

A

diet, stress, age, weight

60
Q

first vein choice for phlebotomy

A

median cubital vein

61
Q

second vein choice for phlebotomy

A

cephalic vein

62
Q

order of collection when collecting multiple tubes of blood

A

blood culture –> coagulation tubes –> serum tube –> heparin tube –> EDTA tube –> oxalate tube

63
Q

yellow tube

A

blood culture
- invert 8 to 10 times

64
Q

blue tube

A

coagulation citrate
- invert 3 to 4 times

65
Q

red tube

A

serum
- do not invert

66
Q

red/gray tube

A

clot activator
- invert 5 times

67
Q

green/gray tube

A

plasma separator
- invert 8 to 10 times

68
Q

green tube

A

heparin
- invert 8 to 10 times

69
Q

pink/purple tube

A

EDTA
- invert 8 to 10 times

70
Q

gray tube

A

oxalate
- invert 8 to 10 times

71
Q

discard method for drawing blood from CVAD

A

discarding first aspiration of blood to ensure no meds interfere with results

72
Q

hematoma complication of phlebotomy and treatment

A

most common complication
- rapid swelling
- hold pressure over site for 2 min
- cold compress

73
Q

Iatrogenic anemia complication of phlebotomy

A

will cause decreased Hct and Hgb due to large and frequent blood sampling

74
Q

cephalic and basilic blood flow

A

45-95ml/min

75
Q

subclavian vein blood flow

A

150-300ml/min

76
Q

gauge size for blood

A

18-20

Nurs 321 (7 decks)

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