IV Medication Flashcards

1
Q

How to calculate drops per minute for
gravity flow devices using the 2 step
method?

A

Calculate how many mL per hour need to be administered, then multiply that answer by the drop factor and divide by 60 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the formula for the 1 step method to determine the amount of drops per minute?

A

Amount of fluid multiplied by drop factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the things that an IV order must contain?

A

-Solution,
-Rate,
-Route,
-Time Frame

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What supplies are needed to start an IV?

A

-Gloves
-tape
-dressing (tegaderm)
-drip set,
-gauze,
-tourniquet,
-alcohol prep,
-IV catheter,
-saline flush,
-connector tubing,
-IV
fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When can an IV in the foot be placed on an adult patient?

A

When there are doctor’s orders for it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are important things to review for a patient’s assessment prior to IV insertion?

A

Physical findings (i.e. mastectomy or
fistula), lab values, age, mobility, skin,
allergies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the 4 parts of an IV catheter?

A

-Stylet,
-catheter,
-flash chamber,
-safety device

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the 5 hand veins?

A

-digital veins,
-metacarpal veins,
-dorsal veins,
-cephalic veins,
-basilic veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the characteristics of a good vein?

A

-Superficial,
-smooth,
-bouncy,
-no pulsation,
-not close to a joint,
-skin is normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why is it important to have a smooth vein when inserting an IV?

A

Lumpy veins have more valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What can hard veins be an indicator of?

A

Sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some vein dilation techniques to use when starting an IV?

A

-Tapping,
-rubbing,
-moist heat,
-gravity,
-fist clenching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which hand should you use to anchor a vein?

A

Non-dominant hand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How should the bevel of the needle be positioned for insertion?

A

Bevel should be up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the steps of preparation for IV catheter insertion?

A

-Prep all supplies,
-identify the patients with 3 identifiers, -position the patient and yourself,
-find vessel,
-use alcohol wipe to prep area,
-position the angiocatheter,
-anchor the vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Where should a tourniquet be placed in reference to the IV site?

A

6 inches above site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the diameter of the swab site that should be wiped with prep before IV
insertion?

A

Around 3 inches in diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When can a site be touched after prepping the IV site with Chlorhexidine?

A

NEVER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is an indicator that the needle has entered the vessel?

A

flashback in hub and “flash chamber”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

State 4 techniques that can be used to advance the cannula

A

-One-step technique,
-pushing cannula off stylet
- “floating” cannula into vein,
-two-handed technique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What should be on the label of an IV dressing?

A

-date,
-time,
-initial,
-size of catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What should be done after advancing the IV catheter?

A

-hold IV catheter steady,
-remove stylet,
-attach T-connector or tubing,
-anchor IV with tape,
-cover IV with transparent dressing, -Label IV dressing,
-Flush IV tubing and catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What needs to be documented following IV insertion?

A

-time/date of insertion,
-location of site,
-gauge/length/type of catheter,
-Number of attempts & complications, -type of dressing,
-States IV site,
-client response to procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are indications that IV catheter insertion is unsuccessful?

A

-loss of blood return,
-severe pain,
-vein puffs up during flushing (infiltrates),
-no blood return

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What may have happened if there is a loss of blood return?

A

It may have pierced through
the vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What may have happened if the patient is in severe pain following IV insertion?

A

-The IV may be in surrounding tissue or
-it may have pierced a nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What may have happened if there is no blood return after inserting an IV?

A

The needle may have missed the vein

28
Q

Why should an IV not be placed in a pulsating vessel?

A

The vessel may be an artery

29
Q

How many IV attempts can be done before someone else needs to be brought in to start the IV?

30
Q

What could be the cause of redness,
swelling, and warmth at the IV insertion
site?

31
Q

What could be the issue if there is swelling, but it is cool around the IV site?

A

infiltration

32
Q

What could be the issue if:
-the IV site has no redness,
-no swelling,
-is dry,
-but patient has SOB,
-puffy feet,
-and palpitations?

A

Hypervolemia: (aka “fluid overload”)
Condition where you have too much fluid volume in your body. It can be caused by several conditions such as heart failure, kidney failure, cirrhosis, or pregnancy.

33
Q

What could be the issue if the IV site has:
-redness,
-patient has chills but feels hot
-and patient states that he/she feels yucky?

A

IV infection

34
Q

What does extravasation refer to?

A

The leakage of injected drugs from blood
vessels causing damage to the surrounding tissues

35
Q

Signs and Symptoms of extravasation? (3)

A

-pain,
-stinging or burning sensations,
-edema around the intravenous (IV)
injection site

36
Q

What action should be taken with an IV site that is not WNL?

A

Discontinue the IV and relocate

37
Q

Why might IV insertion/IV therapy be needed?

A

-antibiotic administration,
-hydration,
-med administration

38
Q

What is compatibility when referring to medications?

A

The chemical stability of two or more
medications when administered together

39
Q

What are the 3 types of incompatibility?

A

-Physical,
-chemical,
-therapeutic

40
Q

What does a med look like if it has a physical incompatibility?

A

Precipitation/hazy

41
Q

What happens if there is a chemical incompatibility?

A

Drug decomposition

42
Q

What happens when there is
a therapeutic incompatibility?

A

Undesirable pharmacologic activities

43
Q

Why is it important to learn
how to calculate IV flow rates manually?

A

In case of IV pump malfunctions or IV pumps are not available

44
Q

Why are IV drip factors important?

A

-Important when working with IV line; -helps telling us the rate that a medication will be administered into the patient

45
Q

Macrodrip?

A

Big drops:
-60 gtt/mL
Is used to infuse large volumes or to infuse fluids quickly

46
Q

Microdrip?

A

Small drops:
- Need to check package
~ 10 gtt/LI, 15 gtt/mL, or 20 gtt/mL
Typically used to deliver precise amounts of medication in small drops to children and infants

47
Q

How do you calculate Gravity IV Drip
Rates?

A

(Number of mL to infuse/ Number of
minutes) × Tubing drop factor (gtt on bag) = gtts/minute

48
Q

How do you calculate IV Drips for Infusion Pumps?

A

Total number of mL ordered/ Number of hours to run = Rate in mL/hour

49
Q

How do you determine how many Hours an IV will run?

A

Num of mL ordered/Num mL per hour = Number of hours to run

50
Q

What is the Drip rate?

A

How fast a medication is going in (infusing)
gtt/min (gtt = drops)
*it’s always a whole number

51
Q

What is the Drop factor?

A

The size of the tubing
*The number of drops it takes to make up 1 ml using the particular tubing gtt/ml

52
Q

How do you find the Drip rate ?

A

Drop factor X flow rate

53
Q

What is MICRO tubing?

A

Micro = less than 100
*usually only 60gtt per ml

54
Q

What are the exceptions when using micro tubing?

A

-giving blood
-Viscous fluid
*you must use MACRO
tubing!!

55
Q

What is MACRO tubing?

A

When the flow rate is 100 or
more:
3 sizes: 10, 15 20 gtt/ml

56
Q

What determines the tubing size?

A

The flow rate

57
Q

What is the formula for drops per minute?

A

mL/min X drop factor

58
Q

State IV Medication advantages

A

-Direct access to circulatory system
-instant action
-Instant drug action and drug termination
-Rapid treatment
-Better control of rate
-Great for those with Gl tract limitations
-Good for meds that irritate gastric mucosa

59
Q

State IV Medication disadvantages/ complications

A

-Reconstitution errors: recommeded
volume of diluent
-Venous Spasm
-Drug incompatibilities
-Impaired drug absorption
-Speed Shock
-Chemical phlebitis
-Extravasation of vesicants
-Air embolism

60
Q

What are the IV Cannulations sites to
avoid?

A

-Legs, ankles, and feet
-Sclerosed or thrombosed veins
-Veins that are knotted or tortuous
-Veins below an infiltrated site or areas of phlebitis
-Areas of inflammation, disease, bruising, or breakdown
-Veins of surgically compromised or injured extremities
-Dominant hands (if possible) and
extremities with AV shunts for dialysis

61
Q

What does IV Cannulations and
Phlebotomy heavily relies on?

A

feel/touch not sight

62
Q

Where do IV Cannulations start ?

A

Low and work proximally
- inner wrist is sensitive
- AC is last option!

63
Q

IV Therapy:
-Where?
-Length?
-Absorption?

A

-Within the vein (peripheral or central)
-short to long term
-Fastest delivery method

64
Q

State IV Therapy Advantages

A

-replace fluid
-transfuse blood
-deliver meds
-correct electrolyte imbalances

65
Q

State IV Therapy Disadvantages

A

-adverse reactions
-incompatible
-infections (local or systemic):
-damage
-fluid overload
-overdose
-hinderance (annoying)
-potentiate/worsen electrolyte
imbalances

66
Q

What is the FORMULA FOR CALCULATING DROPS
PER MINUTE (gtts/min):

A

Drops per minute (gtts/min)=
(Total infusion volume × drop factor)/
total time of infusion in minutes

67
Q

What is the FORMULA FOR INFUSION TIME (IN HOURS)?

A

infusion time (hour) =
total volume to infuse(mL) / millilitres per hour being infused(mI/hour)