IV therapy Flashcards
what are some different purposes of IV therapy
-maintenance or replacement of fluids and electrolytes
-provide glucose and nutrition
-access route to administer meds intravenously
-venous access to administer blood products
-venous access for emergencies
are peripheral IVs for short or long term use
short term use
how often should peripheral IVs be changed
change Q96 hours or according to agency’s policy
what does IID stand for
intermittent infusion device
if peripheral IV is capped how often do you flush and assess site
-flush Q8 to check patency
-assess site at least Q8
when talking about IV gauges the larger the number…
the smaller the needle size
which gauge is most common for peripheral IVs
20
what is 16 or 18 gauge large bore used for
trauma/surgery
both require a large vein
what is the smallest gauge we generally use for adults
22
used for fragile veins, older adults, amd slower infusions, can still give blood products
what is 24 gauge used for
slow flow rates, pediatric and elderly
when pushing IV meds, what should you remember to check for?
-allergies
-compatibilities (do the meds get along)
-dilution (some meds need reconstituted/diluted)
-rate of adminstration (slow or fast?)
IVP meds
what port do you clean before pushing the med through it?
the port closest to the patient
clean with alcohol and connect syringe
IVP meds
what port do you clean before pushing the med through it?
the port closest to the patient
clean with alcohol and connect syringe
IVP meds
administer drug at ____ with constant flow
recommended rate
IVP meds
how do you flush a peripheral IV
SAS method (saline, admin, saline)
use 3-5ml
where should you never administer IVP or IVPB meds
TPN or PCA line
when are central venous catheters used
long term therapy or tissue toxic meds
describe central venous catheters
-can be inserted at bedside as a sterile procedure (PICC)
-some are implanted surgically (port)
-single or multiple lumens
-site can be used immediately after insertion
describe a PICC line
-can be inserted by a specially trained nurse
-placement verfiied with chest xray
-follow CVC admin guidelines
describe nursing and nursing assistant care for PICC
- no BP in arm with PICC
- no venipunctures from the arm with the PICC
describe implanted ports
-surgically implanted
-assure initial placement with Xray
-assess site
-access port with noncoring needle
-use CVC admin guidelines
-generally seen with chemotherapy, can be used for years
-when not accessed, low risk for infection
what are the CVC use guidelines
- verify placement prior to initial use (xray)
- assess site
- use 10ml flush and syringe
- assure blood return before asministration
what do you do if blood return is absent prior to administration according to CVC use guidelines
-check clamps/connections
-flush 10ml
-reposition patient/ask pt to cough
-hold therapy
-obtain an order for declotting agent
-confirm proper line placement: xray
IVP meds via central line
remember to check for…
-allergies
-compatibilities
-dilution
-rate of administration
IVP meds via central line
what port do you clean
port closest to patient
IVP meds via central line
do you check for blood return
yeppers
IVP meds via central line
administer drug at ____ with constant flow
recommended rate
IVP meds via central line
describe SAS with central line
-saline, admin, saline
-10ml peripheral flush
-may need heparin in port (sash) (super rare)
IVPB
which infusion is lower
primary
IVPB
which infusion gets hung higher
secondary
describe primary infusion
something running continuously
IVPB
what should you akways check
compatibility
a patient came to the ER after a car accident. what type of IV should the nurse start?
A. 18g peripheral
B. 22g peripheral
C. port-a-cath
D. PICC line
A. 18g
a large bore IV like an 18 would be ideal for a trauma pt. a central line or implanted port are not warrented in this case
before giving an IVP med through a central line which step should the nurse take?
A. apply tourniquet
B. hang normal saline bolus
C. check for blood return
D. start peripheral IV
C. check for blood return
always check for blood return with central lines as part of checking patency
IV fluids
crystalloids
clear fluids
saline, LR, D5W
IV fluids
colloids
fluids that cannot see through (TPN, blood)
IV fluids
tonicity
homeostasis serum = other body fluids
how similar it is to body composition
IV fluids
isotonic
-same toncity as body fluids
-osmolality close to that of ECF and does not cause cells to swell or shrink
-good for basic hydration and add fluid volume
IV fluids
hypotonic
-fluid shifts out of blood, cells swell
-exert less osmotic pressure than ECF
-used to replace cellular fluid
-used short term, usually for DKA
-mainly seen in ICU
IV fluids
hypertonic
-pull fluid into vasular system, cells shrink
-osmotic pressure greater than that of ECF
-used in hyponatremia and cerebral edema
-usually seen in ICU
name some types of isotonic solutions
-normal saline (0.9% NaCl)
-5% dextrose in water (D5W)
-lactated ringers
name a type of hypotonic solution
0.45% NaCl
