IV Therapy

Question 1

Blood Transfusions procedure

Answer 1

1 only prim w NS (has 2 filters)
2 start admin w/in 30minof p/u fr blood bank
3 2 nurse double check
4 RN stay w pt for first 15min
5 VS: before, after, 15 min, hrly, finish (5x)
6 must finish PRBC in 4 hr
7 can do 2 units of tandem w order
8 can do 2 units on same tubing set

Question 2

only prime BLOOD tubing with

Answer 2

NS only!

Question 3

can you administer med in a line that is for infusing blood?

Answer 3

NO

-if admin of meds IV is necessary, then either start another IV or do it before/after the blood transfusion

Question 4

Blood transfusion prerequirements

Answer 4

• order
• content
• in Ca, pt’s guide to transfusions
• type + screen vs type + cross
• possible PRN of diphenhydramine + APAP prior to infusion
• blood band on pt
• ask pt hx of transfusion + rxn

Question 5

blood transfusion equipment

Answer 5

-20 gauge or large catheter like 18 gauge

-

Question 6

if pt has hx of transfusion + reaction of minor hives or itchiness…

Answer 6

then dr might order PRN diphenhydramine + Tylenol/APAP

Question 7

most common (90%) rxn is ____

Answer 7

Febrile Non-Hemolytic

-temp incr 1.8F esp 30 min after

Question 8

how to prevent Febrile Non-Hemolytic?

Answer 8

leukocyte-reduced blood

Question 9

if Febrile Non-Hemolytic occurs?

Answer 9

• stop infusion
• notify MD
• infuse NS 0.9 thru new tubing
• save blood + old blood tubing for blood bank so they can run a test

Question 10

blood tubing vs piggyback

Answer 10

blood tubing is at the same height as saline

-blood tubing has an extra filter to filter out any clots

Question 11

infiltration

Answer 11

• non vesicant gets into tissues
• -think forearm peripheral IV infusing NS
• swelling, cold, edematous, spongy

Question 12

infiltration

treatment

Answer 12

stop, elevate, encourage ROM, apple cold/warm compress

Question 13

extravasation

Answer 13

• VESICANT med gets into tissues

- -think dextrose D10, epinephrine, K, Cl

Question 14

extravasation

treatment

Answer 14

• stop
• withdraw as much of fluid
• leave IV to infuse antidote
• also pot’l for addtl subQ antidote if applicable
• start IV in new arm
• notify MD
• follow hospital protocol

Question 15

infiltration/extravasation

s/s

Answer 15

• pallor
• local swelling at site
• decr skin temp
• damp dressing
• slow infusion
• med not working