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iv therapy Flashcards

1
Q

distribution of fluid

A

intracellular

extracellular (interstitial
intravascualr)
(trans-cellular)

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2
Q

extracellular and intracellular fluids contain

A

O2
dissolved nutrients
extractor products of metabolism
charged particles called ions (electrolytes)

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3
Q

electrolytes

A 
sodium 
chloride 
magnesium
potassium
phosphate
bicarbonate
calcium
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4
Q

movement of body fluids

A

osmosis
diffusion
filtration
carrier mediated transport

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5
Q

fluid replacement

A

enteral replacement (oral, NG tubes, g tubes)

parental replacement (isotonic)
(hyper tonic)
(hypotonic)

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6
Q

isotonic

A

same osmolity as body cells
used fro extracellular volume replacement
expands body fluid without causing a fluid shift

0.9 saline
lactated ringer
5 % dextrose in water
2/3 and 1/3 dextrose and NaCl

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7
Q

hypotonic

A

Osmotic pressure is lower than plasma
Moves fluid into cells causing them to enlarge
Hydrates cells while reducing fluid in circulatory system
Based on specific fluid & electrolyte imbalance
0.45% NaCl (half normal saline)
0.33% NaCl (one-third normal saline

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8
Q

hypertonic

A

Osmolality greater than body fluids
Pulls fluid from cells causing them to shrink
Based on specific fluid & electrolyte imbalance
5% Dextrose in normal saline (D5NS)
5% Dextrose in o.45% NaCl (D5 1/2NS)
5% Dextrose in lactated Ringer’s (D5LR)
D10W

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9
Q

factors influencing flow rate

A 
position of forearm 
position and patency of tubing
height of infusion and bottle/container 
possible leakage or fluid infiltration 
relationship of size of angiocath to vein
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10
Q

advantages of iv therapy

A

fluid and electrolyte management
tpn administering
perfred route of medications

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11
Q

disadvantages of iv therapy

A

infection

hypovelimia if not monitored closely

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12
Q

maintain of iv therapy and client assessment

A 
Assessment Focus:
Type of fluid being infused and TBA
Drip chamber level & Rate of flow (every hour)
Patency of system
Appearance of infusion site 
Response of client (assessments)
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13
Q

infiltration

A

needle becomes dislodged and fluid flows into the interstitial fluids

Localized swelling, coolness, pallor and discomfort at IV site

Stop infusion and remove catheter

Warm compress to site-promotes comfort, vasodilation, facilitating absorption of fluid

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14
Q

phlebitis

A

Due to chemical irritation or chemical injury (eg KCL, IV antibiotics)

Redness, edema at IV site and burning pain along course of vein

If phlebitis detected d/c infusion & apply warm compresses as ordered.

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15
Q

potential complications

A

incorrect flow can result in

hypovelimia
hypervolemia
inadequate medications administer

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16
Q

heath teaching

A

Avoid sudden twisting or turning movements of extremity with IV site
Avoid stretching or placing tension on tubing
Try to keep tubing from dangling below level of needle
Notify nurse if flow rate suddenly changes, stops, solution empty, blood in tubing, discomfort, swelling
Saline Lock similar

17
Q

input and output

A

intake includes all liquids taken by mouth (e.g., gelatin, ice cream, soup, juice, and water) or through nasogastric or jejunostomy feeding tubes, intravenous fluids , and blood or its components.

Output includes urine, diarrhea, vomitus, gastric suction, and drainage from postsurgical wounds or other tubes Daily intake should equal output plus 500 mL (to cover for insensible fluid losses).

18
Q

recording intake and output

A

Recording intake and output is essential for obtaining an accurate database to evaluate hydration status. This information helps maintain an ongoing evaluation of the patient’s hydration status to prevent severe imbalances.

19
Q

serum levels

A

serum osmolality is 285 to 295 mmol/kg. With dehydration, the serum osmolality will be higher than normal.

20
Q

Possible nursing diagnoses for patients with fluid, electrolyte, and acid–base alterations

A
  • Actual or risk of deficient fluid volume
  • Actual or risk of excess fluid volume
  • Decreased cardiac output
  • Impaired gas exchange
  • Acute confusion
  • Impaired oral mucous membrane
  • Actual or risk of impaired skin integrity
  • Impaired mobility
21
Q

Crystalloids

A

most commonly and include dextrose, sodium chloride, and lactated Ringer’s solutions These solutions contain solutes that mix, dissolve, and cross semipermeable membranes.

22
Q

Colloids

A

protein or starch, which does not cross semipermeable membranes and therefore remains suspended and distributed in the extracellular space, primarily the intravascular

Colloids have been used to increase the osmotic pressure in the intravascular space to increase vascular volume in critical situations.

Colloids are either semi-synthetic, such as dextran, pentastarch, or hetastarch, or human plasma derivatives, such as albumin, plasma proteins, or blood.

23
Q

Vascular access devices (VADs)

A

catheters, cannulas, or infusion ports designed for repeated access to the vascular system.

These devices include peripheral vascular access devices (PVADs) and central vascular access devices (CVADs) and allow for parenteral fluid and electrolyte replacement, parenteral nutrition, and administration of medications.

24
Q

CVAD

A

venous access device with a tip that terminates in a great vessel, preferably in the lower third of the superior vena cava; however, the upper right atrium is an acceptable site.

The most common insertion sites are the internal jugular and subclavian veins; the right internal jugular vein is considered the best option

25
Q

Skin-tunnelled catheters STC

A

are tunnelled from the entry site, subcutaneously, to the preferred vein, where the catheter is inserted and advanced into the superior vena cava

26
Q

complications associated with CVADs

A 
pneumothorax, 
arterial puncture, 
hemorrhage, 
cardiac tamponade, 
air embolus, 
hemothorax, 
nerve injury, 
hydrothorax, 
infection, 
catheter 
occlusion,
phlebitis.
27
Q

Microdrip

A

60 gtt/ml

28
Q

Macrodrip

A

15 gtt/mL or 10 gtt/ml

29
Q

transfusion reactions

A

mild response (e.g., faintness, dizziness) to severe anaphylactic shock or acute intravascular hemolysis

30
Q

Autologous transfusion

A

The blood for an autologous transfusion can be obtained by preoperative donation up to 5 weeks before the planned surgery (e.g., heart, orthopedic, plastic, or gynecological).

Patients can donate several units of their own blood, depending on the type of surgery and the ability of the patient to maintain an acceptable hematocrit.

31
Q

blood salvaging

A

The blood that has been salvaged is then reinfused during the surgery.

Blood can also be salvaged postoperatively from mediastinal and chest tube drainage and after joint and spinal surgery.

32
Q

blood cathered sizing for adults

A

A large catheter, such as 18 to 22 gauge, is recommended for adults

unless rapid infusion is required (16–18 gauge)

33
Q

Acute intravascular hemolytic

A

Chills, fever, low back pain, flushing, tachycardia, tachypnea, hypotension, hemoglobinuria, hemoglobinemia, sudden oliguria (acute kidney injury), circulatory shock, cardiac arrest, death

34
Q

Febrile nonhemolytic

A

Sudden shaking chills (rigors),
fever (rise in temperature 0.5°C [1°F] or more from start), headache,
flushing, anxiety,
muscle pain

35
Q

Mild allergic

A

Flushing, itching, urticaria (hives)

36
Q

Anaphylactic

A 
Anxiety,
 urticaria, 
dyspnea, 
wheezing progressing to cyanosis, 
severe hypotension, 
circulatory shock, 
possible cardiac arrest
37
Q

Blood Products for Transfusion

A 
Whole blood
Red blood cells
Autologous red blood cells
Platelets
Plasma
Albumin
Clotting factors & cryoprecipitate
38
Q

TPN Complications

A

Pneumothorax
Catheter occlusion
Infection
Hyper and hypo glycemia

found final (3 decks)

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