IV Theory Flashcards
What is the purpose of IV therapy?
- Fluids (ex. dehydration, cerebral edema)
- Medications (ex. morphine)
- Glucose (ex. nutrition, NPO)
- Electrolytes (ex. post-surgery)
- Volume expanders (separate from blood, ex. albumin)
- Blood (ex. blood transfusions)
What are the principles of IV therapy?
- Surgical asepsis (port of entry, need for sterility)
- Gravity (pulls downward, higher bag flows first)
- Fluid dynamics (viscosity, negative pressure, patency)
- Infection control (solution growth for micoorganisms, esp. sugars)
- Assessments (ex. phlebitis, anaphylaxis)
- Accurate documentation (ex. indication of hydration status)
- Clotting (occurs when exposed to air, stops moving, etc.)
What are peripheral lines used for?
- Short term
- Intermittent
- Hospital or home
What are central lines used for?
- Irritating meds
- Hyperosmotic fluid
- Emergency meds/fluid
- Short or long term
What is isotonic solutions?
- Same as blood plasma
- Does not change isotonic pressure of plasma
What is hypotonic solutions?
- Lower osmolarity than blood plasma, decreases serum osmolarity
- Water moves out of blood into the intracellular space
What are hypotonic solutions used for?
Treats dehydration
What are isotonic solutions used for?
Increases circulatory volume (ex. hypotension, hypovolemia)
What is hypertonic solutions?
- Higher osmolarity than blood
- Fluid is pulled from cells into vascular system
- Seen in cerebral edema
What are some examples of isotonic IV solutions?
- Normal saline (0.9%)
- 2/3, 1/3
- Lactated ringers (RL or LR)
- D5W is isotonic in bag but becomes hypotonic in the blood
What are some examples of hypotonic IV solutions?
- 0.25% N/S
- 0.45% N/S
What are some examples of hypertonic IV solutions?
- D5 NaCl
- D5 in LR
- D10W
What is an IV example of a blood volume expander?
- Albumin
- Dextran
Define: Osmosis
the movement of water molecules or other solvents across a semipermeable membrane from an area of low concentration (less solutes) to an area of high concentration (more solutes)
What is the relationship between osmosis and cells?
Cell membranes are completely permeable to water, therefore, the environment the cell is exposed to can have a dramatic effect on the cell.
What are hypertonic solutions?
contain a high concentration of solute relative to another solution. When a cell is placed in a hypertonic solution, the water diffuses out of the cell, causing the cell to shrivel.
What are hypotonic solutions?
contain a low concentration of solute relative to another solution. When a cell is placed in a hypotonic solution, the water diffuses into the cell, causing the cell to swell and possibly explode.
What are isotonic solutions?
contain the same concentration of solute as an another solution. When a cell is placed in an isotonic solution, the water diffuses into and out of the cell at the same rate. The fluid that surrounds the body cells is isotonic.
How do we assess an IV system?
- Systematic fashion
- Insertion site to IV solution
- Condition of insertion site and IV dressing
- Position of pt’s extremity
- Patency of IV (is there blood backflow?)
- Tubing: check for air, kinks or position
- Clamps: open and connections secure
- Drip chamber and IV solution (check height)
What do we check for in IV bags?
- Right solution
- Right volume
- Expiry dates
- Sediment
- Leaks
What are some guidelines for IV care?
- Promote asepsis
- Reduce risks for infection
- Safety concerns
- Pt education (increased pain, cool feeling, limited activity, bleeding)
- IV tubing= changed q 96 hours
- Primary IV bag= q 24 hours
- Assessment q 4 hours
What are some developmental considerations with IV’s?
- Pediatric fluid rates based on pt weight
- Patient teaching on skin integrity; activity restrictions; therapeutic play; communication regarding IV
