IV theory

Question 1

Assessment of pt recieving IV fluids

Answer 1

Infiltration– swelling coolness pallor discomfort. If occurs stop infusion and apply warm compress

Ensure fluid level half full

If clot in tubing do not flush–remove
Change injection caps for lumen hubs on central venous cath every 72 h/per policy
Ck site hourly

Question 2

Fluid needs of healthy adult

Answer 2

8-10 glasses q day, 2k-2.5k ml q day

Question 3

Risks for dehydration

Answer 3

Causes– GI fluid loss, diuretics diabete hemmorage sweating fever draining wounds burns, fluid shifts (third spacing)

Question 4

S/s fluid overload/hypervolemia

Answer 4

htn, tachycardia, full/bounding peripheral pulses, ^ resp rate, cough, dyspnea (difficult or labored breathing) orthopnea (difficulty breathing when supine) moist crackles, wheezes, weight gain, distended neck veins, ^ CVP, dependent edema, rapid bounding pulse
Lab vals– will see a decrease in the following: in serum osmolarity, hematocrit, and urine specific gravity.

Question 5

s/s dehydration

Answer 5

fatigue, altered mentation, postural hypotension, tachycardia,weak/thready peripheral pulse, weight loss, flat neck veins, decreased central venous pressure, dry skin, poor turgor, decreased urine output
lab vals- will see ^’s in serum osmolarity, hematocrit, and urine specific gravity.

Question 6

Isotonic solutions- types and actions

Answer 6

Expands blood vol/replaces abn losses. Used in hypotensive hypovolemic supports blood pressure r/t increasing vascular volume

0. 9% NaCl (normal saline) restores intravascular volume, replaces extracellular fluid, replaces sodium losses
   - lactated ringers (LR) replaces fluid losses maintains intravascular volume

Question 7

hypotonic solutions– types and actions pg 109

Answer 7

0.2% and 0.45% sodium chloride: useful in conditions of cellular dehydration provides electrolytes/water
has lower osmolarity than serum
-water is rapidly pulled from the vascular compartment into the interstitial/intracellular compartments, can be given to ppl with ^ Na

Question 8

hypertonic solutions- types and actions pg 109

Answer 8

-d5/0.45 NS and D5/0.9 NS and TPN: has potential to pull fluid from the intracellular and interstitial compartments into the intravascular compartment,

has a higher osmolarity than the serum and can cause celular dehydration and vascular overload.

Question 9

Technique for admin dangerous meds

Answer 9

Burette–pedi

Question 10

What parts of IV system (tubing, bag, spike, ect) should be sterile?

Answer 10

Spike, inside all tubing, port

Question 11

appropriate tubing for glass containers

Answer 11

vented- secondary or primary

Question 12

microdrop tubing

Answer 12

delivers 60 drops/ml. (used with heparin, pedi, potent meds)

Question 13

macrodrop tubing

Answer 13

delivers 10,15, or 20 drops/ml

Question 14

safe admin of IV fluids to pedi pt

Answer 14

Burette

Question 15

flushing central lines

Answer 15

m

Question 16

flushing saline locks

Answer 16

Don’t draw blood from peripheral cath
Changed every 72-96 h
Don’t change for pedi unless indicates per policy

Question 17

flushing heparin locks

Answer 17

Sash method used w picc

Iv push an bolus w sash method

Question 18

IV pump settings/ selection of catheter

Answer 18

ml/hr

27 gauge 5/8 inch to 14 gauge 2.5in

Question 19

s/s of IV,central line infections

Answer 19

m

Question 20

Technique of central line and PICC dressing changes

Answer 20

Cephallic/basilica veins of antecubital space
Flush w saline hep after each use of daily if not in use
Gauze/transparent semipermeable membranes are the two types dressings most often used

Question 21

Safe use of central lines

Answer 21

Used w meds that irritate vein walls or large vol
Usually inserted subclavian jugular vein
Long term access or emergencies
Ie chemo, tpn
Tunneled central venous cath– types are Hickman broviac groshong

Question 22

s/s phlebitis

Answer 22

Red warmth swelling burning pain

If occurs, disc and apply warm compress

Question 23

What is rubber injection portal used for?

Answer 23

route to push meds

Question 24

Non-volumetric IV controllers

Answer 24

aka the manual/primitive controller. Monitors only the gravity infusion rate by counting the drops that drip through chamber.

Question 25

Ex of syringe pump

Answer 25

self-admin pain meds.

Question 26

If you are admin with glass bottle, what type of tubing will you use?

Answer 26

vented

Question 27

Burotroll/burette

Answer 27

used in pedi pts to prevent fluid overload. The nurse fills drip tube by the hr and closes off bag to avoid chance overload.

Question 28

Before nurse admin IV therapy, he/she should ask the following…

Answer 28

Does tx law delegate this function to nurse?
Does written policy of the institution through which I am employed permit nurse with my level of education/experience to admin IV therapy? Does institution/agency policy limit the types of fluids and meds that I may administer? Is order written by a hcp for a specific pt?

Question 29

S/a pulm edema

Answer 29

Dyspraxia cough anxiety rales rhinchi cardiac dysrythmias thready pulse frothy sputum

Question 30

S/a air embolism

Answer 30

Palpitations 
Cp
Sob
Cyanosis 
Hypotension 
Weak thready pulse