Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Module 2 (Skills) > IV Therapy > Flashcards

IV Therapy Flashcards

1
Q

In older adults, what is not a good predictor of fluid deficits?

A

diminished skin turgor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why does the patient experience cold, clammy skin in hypovolemia?

A

adrenalin shunts blood flow away from periphery to vial organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the danger signs for fluid deficit (HYPOVOLEMIA)? - 8

A
  • restlessness (1st clue), confusion … coma
  • cold, clammy skin
  • decrease skin turgor (tenting)
  • weak, rapid heart rate
  • rapid respirations: hypoxia
  • orthostatic hypotension: fall precaution
  • Oliguria: decrease urine output due to poor perfusion to kidneys (concentrated)
  • decrease cap refill, flat jug veins, weight loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How can a pulmonary edema occur with dyspnea/tachypnea?

A

Left ventricle overloads - pumping declines - fluid backs up in the lungs - hydrostatic pressure pushes fluid out of pulmonary vessels and into interstitial and alveolar areas - pulmonary edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the danger signs of fluid excess? (HYPERVOLEMIA)

A
  • HA, confusion
  • peripheral edema
  • jugular vein distension
  • Extra heart sound (S3)
  • bounding pulse, increase bp
  • dyspnea, tachypnea, crackles
  • pink frothy sputum = pulmonary edema
  • weight gain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a hallmark of pulmonary edema in hypervolemia?

A

pink, frothy sputum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Fluid imbalances are more prominent in what age group?

A

young and the old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Nursing Management of a fluid imbalance

A
  • Assess for S/S of imbalance (At - risk)
  • Give IV fluids and meds as ordered (if deficit)
    ~ If excess, then restricted fluids
    ~ If deficit, give isotonic and oral fluids
  • O2 Therapy for both
  • Fall precautions
  • Daily weight Accurate
  • I&O accuracy
  • Elevate edematous extremities
  • Encourage fluids if at a deficit = monitor at-risks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When patients have GI losses, hemorrhage, overuse of diuretics, inadequate fluid intake, and third space shifting, what are they at risk for?

A

Fluid deficit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When patients have of heart failure, renal failure, excess isotonic or hypotonic fluids, SIADH, or long-term steroids, what are they at risk of?

A

Fluid excess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hypovolemic Shock occurs when
- Common signs

A

40% more of intravascular volume is lost
- loss of LOC, cardiac output, urine below 10mL/h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Treatment of hypovolemic shock

A
  • fluid replacement NS, LR to expand volume; blood transfusion; vasopressor
  • lower HOB to slow declining bp
  • 2 large bore IV catheters
  • O2 therapy
  • monitor VS and LOC
  • lung sounds for crackles (fluid buildup in lungs = f;uid overload)
  • indwelling catheter possible for output
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Vasopressor

A

group of medicines that contract (tighten) blood vessels and raise bp
- used to treat severely low bp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why does the body decrease in BP during hypovolemia?

A

~Heart baroreceptors notice a decrease in fluid volume and **posterior pituitary secretes VP
- VP increases vasoconstriction and water absorption from filtration
~ Glomerulus activate RAAS
- increase in angiotensin 2, aldosterone, vasoconstriction, VP, drinking
- aldosterone increases sodium retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the difference between hypovolemia and dehydration?

A

Dehydration is water loss alone
Hypovolemia is the volume (water and concentration) lost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

In summary, hypovolemia is when ____________ fluid is __________; this results in decreased tissue __________.

A

Extracellular; reduced: perfusion
- produced by salt and water loss from the extracellular fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the 5 signs of dehydration?

A
  • feeling thirsty
  • dark yellow and strong-smelling pee
  • peeing little, and fewer than 4 times a day
  • feeling dizzy and tired
  • dry mouth, lips, and eyes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Dehydration

A

water loss alone with Na concentration goes high
- pure water loss from total (only 1/3 of ECF)
ALWAYS HYPERNATREMIC - high sodium
Treat with free water administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

IV Therapy
Where?
Length?
Absorption?

A

within the vein (peripheral or central)
short to long term
Fastest delivery method

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

IV Therapy Advantages

A
  • replace fluid
  • transfuse blood
  • deliver meds
  • correct electrolyte imbalances
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

IV Therapy Disadvantages

A
  • adverse reactions
  • incompatible
  • infections (local or systemic)
    -damage
    -fluid overload
    -overdose
  • hinderance (annoying)
  • potentiate/worsen electrolyte imbalances
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Larger insoluble molecules, such as gelatin or blood
Faster action for volume expansion and high osmotic pressures
are termed as

A

Colloids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Small molecules, inexpensive mineral salts, and water-soluble molecules are termed as

A

crystalloids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Isotonic Solutions Types

A

D5W - 5% Dextrose in Water
NS - 0.9% Sodium Chloride
LR - Lactated Ringers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Hypertonic Solutions include

A

D5 1/2 NS - 5% Dextrose 0.45% Sodium Chloride
D5NS - 5% Dextrose 0.9% Sodium Chloride
D5LR - 5% Dextrose Lactated Ringers
D10W - 10% Dextrose in Water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What isotonic solution can metabolize into a hypnotic solution?

A

D5W
use with caution bc once metabolized becomes hypotonic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Isotonic solutions do what in the body?

A

remain in the intravascular compartment and don’t pull fluid from other compartments
- replace volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What solution is used for issues with hypovolemia, resuscitation, shock, burn injuries, DKA, alkalosis, hypercalcemia, and mild sodium deficits?

A

Normal Saline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the only solution that can be given with blood or blood products?

A

Normal Saline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

This fluid should not be used in patients with renal disabilities. Why?

A

Lactated Ringers, because contain potassium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is used for acute blood loss and is a volume expander?

A

Lactated Ringers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What solution do you not want to give if the patient has a renal disability?

A

Lactated Ringers, because contains Na, K, Ca, Cl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Hypotonic solutions have

A

osmolarity lower than serum osmolarity
- use cautiously for at risk of intracranial pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

When a pt receives hypotonic solutions, fluid shifts where?

A

shifts out of the blood vessels and into cells/interstitial spaces with high osmolarity
- cells swell
- hydrate cells while reducing fluid in the circulatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Hypotonic Solutions Types

A

1/2, 1/3, 1/4 NS, and D2.5W

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What percentage of body fluid is water?

A

60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What “nutrient” is more important than other nutrients?

A

water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are the purposes of water in the body? - 5

A
  • transports nutrients and O2 to cells
  • removes waste
  • medium of electrolyte chemical reactions and digestion
  • regulate body temp
  • lubricates joints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Fluids in the body are affected by

A

-age
-gender
- body fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What gender has more body fluid and why?

A

men; more muscle mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What gender has a greater percentage of fat?

A

women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

______ people have less fluid than those who are thin because fat cells contain little water

A

obese

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

The highest amount of water is found in

A

muscle, skin, and blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the most accurate way to measure fluid status in a person?

A

Daily weight
Not I&Os

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Filtration

A

movement of fluid across cell membrane due to hydrostatic pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Diffusion

A

movement of solutes (substances) from higher to lower concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Osmosis

A

movement of fluid (water) from areas of more fluid to areas of less fluid
- liquid through membrane from less concentrated to more concentrated one

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What are the 3 mechanisms/processes that control fluid and solute movement to prevent dangerous changes?

A

Filtration
Diffusion
Osmosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Hydrostatic pressure is generated by the ___________ system. How?

A

cardiovascular
- blood is pumped through the body’s blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

In diffusion, what moves
**Fish swimming with the current

A

solutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

During osmosis, the body is attempting

A

homeostasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What do these abbreviations mean?
DS
OF

A

In diffusion, solutes move
Osmosis, fluid moves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is the purpose of a semi-permeable membrane in osmosis?

A

a type of biological or synthetic, a polymeric membrane that will allow certain molecules or ions to pass through it by osmosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What does osmotic balance mean?

A

the control of water and electrolyte balance in the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Osmoregulation

A

active regulation of osmotic pressure of bodily fluids to maintain the homeostasis of the body’s water content
- keeps fluids from becoming too dilute or too concentrated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Hydrostatic =

A

pushing force fluid out of capillaries
exerted by pumping of heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Normal movement of fluids through the capillary wall into the tissues depends on two forces:

A

Hydrostatic and oncotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Capillaries get ________ the further away it gets from the heart.

A

smaller

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Oncotic pressure

A

pulling force - pulls fluids from the tissue into capillaries
- exerted by non-diffusible plasma proteins - albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

When hydrostatic pressure is greater than oncotic pressure, then

A

fluid will leave the capillaries, visa versa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

On the arterial end of ________ pressure is higher than _________ pressure (as blood leaves the aorta into the arteriole end of capillaries (squeeze) from arteries pushes some fluid out; as blood passing to venules (protein back in)

A

hydrostatic; oncotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Third Spacing

A

Condition where fluid accumulates in a pocket that is not serving a purpose
- can occur anywhere

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Ascites

A

fluid in abdominal cavity peritonitis/pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Third spacing occurs as a result of

A

increased permeability of the capillary membrane
or decreased plasma colloid osmotic pressure. (oncotic pressure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Main causes of edema

A
  • Long periods of standing or sitting (usually in feet, ankles, and lower legs)
  • Venous insufficiency
  • Chronic lung diseases
  • Congestive heart failure
  • Pregnancy
  • Low protein, starvation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Edema can occur from

A

intestinal obstruction
heart failure - no pushing fluid = build up of hydrostatic pressure
peritonitis
liver failure
starvation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Of the 60% of lean body weight (water), what fraction is intracellular, extracellular, and blood plasma?

A

Intracellular 2/3
Extracellular 1/3
Blood Plasma 5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Extracellular

A

interstitial fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Edema

A

an accumulation of interstitial fluid within tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Hydrothorax

A

collection of extravascular fluid in pleural cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Hydropericardium

A

collection of extravascular fluid in pericardial cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Hydroperitoneum / Ascites

A

collection of extravascular fluid in peritoneal cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Anasarca

A

severe, generalized edema marked by profound swelling of SubQ tissue and increase fluid in cavities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What nursing interventions can you do for edema

A

Daily weight
I&Os

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

If your patient has significant weight gain, then they are _____________ water.

A

retaining

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

If they have gained 2 lbs over night, I&O is good, then what nursing intervention would you do?

A

Lung and cardiac assessment
VS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

The patient has gained 2 lbs overnight and I&O is good. After doing a respiratory and cardiac assessment, the nurse discovers crackles.
-What can the nurse interpret from these findings?
- What should the nurse do?

A
  • Build up of fluid in the lungs
  • O2 Therapy, elevate HOB, TCDB (possibly stop fluid if retaining)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Active Transport included what electrolytes?

A

Sodium and Potassium

79
Q

Explain Active Transport

A

sodium and potassium use ATP to move in/out of cells - sodium-potassium pump

80
Q

Na and K use ATP to move in/out of cells in a form of active transport called

A

sodium-potassium pump

81
Q

What energy is used to move electrolytes through the sodium-potassium pump?

A

ATP

82
Q

ICF is fluid ________ the cells

A

inside (intracellular 2/3)

83
Q

ECF is fluid _________ the cells

A

outside (Extracellular 1/3)

84
Q

What are the 3 different types of ECF?

A

Intravascular
Interstitial
Transcellular

85
Q

Intravascular

A

found in the vascular system that consists of arteries, veins, and capillary networks
- whole blood volume includes RBC, WBC, plasma, and platelets.

86
Q

Interstitial

A

fluid between cells – “third space”

87
Q

Transcellular

A

cerebral spinal fluid, synovial fluid, peritoneal and pleural fluid
– only ALLOWS some things if it serves a purpose

88
Q

Each of the fluid compartments is separated by a selective _________ __________ that permits mvmt of water and solutes

A

permeable membrane

89
Q

What molecules move freely between permeable membranes into other compartments?

A

small (urea and water)

90
Q

What molecules do not cross readily between permeable membranes into other compartments?

A

Larger (protein)

91
Q

Osmolality is measured in

A

milliOsmois/ kg

92
Q

Osmolarity is measured in

A

milliOsmois/ Liter

93
Q

Osmolality is used to assess

A

body’s state of water balance
-urine

94
Q

What is the only difference between Osmolality and Osmolarity?

A

Osmolality = kg
Osmolarity = L

95
Q

High osmolality

A

water deficit

96
Q

Low osmolality

A

water excess

97
Q

Normal osmolarity

A

270-300 mOsm/L

98
Q

Osmole

A

The concentration of solution measured

99
Q

Normal serum osmolality

A

275-295 mOsm/kg

100
Q

High Osmolarity of urine

A

concentrated urine (less liquid and more particles)
- dehydrated

101
Q

Low Osmolarity of urine

A

diluted urine (more liquid and fewer particles)

102
Q

Isotonic Fluid Concentration
Shifts?

A
  • equal to match I-so-perfect
  • same solute concentration
  • No fluid shifts occur bc of equally concentrated
103
Q

Hypotonic Fluid Concentration

A
  • less concentrated (fewer solutes/more solvents)
  • fluid pulled/moved from the bloodstream (veins) into the cells
    = SWELL
104
Q

What is the mnemonic for Hypotonic solutions?

A

Hippo / Hypo It’s off to the cells we go

105
Q

Hypertonic Fluid Concentrations

A

more concentrated than other solutions
- fluid pulled from cell into bloodstream
= shrink

106
Q

Mnemonic for Hypertonic

A

hyper = energy; makes cells skinny; fluid escaping from cells

107
Q

What organs maintains fluid balance?

A

kidneys and lymphatic system

108
Q

How does the lymphatic system help maintain fluid balance?

A
  • collecting excess fluid and particulate matter from tissues
  • depositing them in the bloodstream
  • defend the body against infection by supplying disease-fighting cells (lymphocytes)
109
Q

What hormones are used to maintain fluid balance?

A
  • ADH (Anti-diuretic hormone)
  • RASS (Renin - Angiotensin - Aldosterone System)
  • Aldosterone
  • ANP (Atrial Natriuretic Peptide)
    THIRST
110
Q

Main Purpose of kidneys

A

regulate fluid/electrolyte balance by adjusting urine volume and the excretion of electrolytes
- remove excess water
- Na and K filtered or reabsorbed

111
Q

If loss of 1 -2 % fluid, then kidney …
Leads to …

A

reabsorbs more water
= concentrated urine

112
Q

What are the 7 functions of the kidneys?

A

A - control ACID-base balance
W - control WATER balance
E - maintain ELECTROLYTE balance
T - remove TOXINS and waste
B - control BLOOD PRESSURE
E - produce ERYTHROPOIETIN
D - activate vitamin D

113
Q

An anti-diuretic hormone is produced by and stored

A
  • produced by hypothalamus
  • stored in pituitary
114
Q

ADH purpose

A
  • restores blood volume
    = reduce diuresis
    = increase water retention
    = vasoconstrictors
115
Q

ADH is usually made by the body naturally, but what is the medication form of ADH?

A

Vasopressin (Desmopressin)
- usually IV and critical dosage
- Don’t stop if getting a blood draw

116
Q

What control the excretion of fluid?

A

nephrons

117
Q

Diuretic

A

removes water

118
Q

Antidiuretic

A

retain water

119
Q

Diuresis

A

amount of urine

120
Q

When the body becomes hypotensive or does not have enough water, what does the body do?

A

Brain will release ADH to kidneys for reabsorbed liquids
- release less water
- constrict the veins
- increase bp

121
Q

SIADH

A

Syndrome of Inappropriate ADH

122
Q

If the body is dehydrate, deficit of water, then ADH ____________ .

A

Increases
- water is absorbed/conserved for
= concentrated urine

123
Q

If the body is hydrated (excess water), then ADH is

A

released and less water is absorbed
= urine diluted

124
Q

What is the RAAS

A
  • ECF low
  • Renin produces angiotensinogen
  • Produces angiotensin 1
  • Converts to angiotensin 2 = massive vasoconstriction
  • A2 stimulates release of aldosterone
  • retention of water and sodium
  • aldosterone and vasoconstriction = increase of bp
125
Q

When is RAAS activated?

A

decrease of Extracellular fluid

126
Q

Hormone Order for RAAS

A

Renin
Angiotensinogen
Angiotensin 1
Angiotensin 2
Aldosterone

127
Q

RAAS ultimate goal

A

increase volume of fluid (aldosterone) and bp

128
Q

What does Aldosterone do in the body?
Released if?

A
  • water regulator
  • kidneys to retain Na and water
  • released if low Na and K high
129
Q

Where is aldosterone made?

A

adrenal cortex
- keep Na and release K from the body

130
Q

Too much aldosterone can cause

A

high bp
build up of fluid

131
Q

Atrial Natriuretic Peptide (ANP) purpose

A
  • stops RAAS
  • decrease bp by vasodilation
  • reduces fluid volume by increasing secretion of Na and water = lowers bp
132
Q

Role of ANP

A

cardiac hormone
- lower bp and to control electrolyte homeostasis

133
Q

When is ANP secreted from the heart?

A

sodium levels and bp are increased

134
Q

ANP and BNP are secreted from

A

cardiac atria and ventricles

135
Q

BNP acts ________ to reduce ventricular fibrosis

A

locally

136
Q

High BNP means

A

heart can’t pump the way it should
- greater than 100

137
Q

The higher the BNP, the more likely

A

heart failure is present and severity

138
Q

What diet does someone with high blood pressure eat?

A

low sodium

139
Q

What is the simplest method of maintaining fluid balance?

A

Thirst
- result of smallest loss of fluid or high salty foods
= drying of mucous membranes in mouth
- regulated hypothalamus

140
Q

What depletes electrolytes?

A

Vomit
Pee
Poop
Sweat

141
Q

Where fluids flow

A

electrolytes go

142
Q

Hypovolemia

A

fluid volume deficit of isotonic in ECF

143
Q

Hypovolemia is caused by

A

Abnormal
- fluid loss
- fever, excess perspiration (sweat)
- hemorrhage
- vomiting, diarrhea
- GI suction (NG tube)
- Decreased fluid intake
Diuretics
Chronic diseases: heart failure, diabetes
Third-space fluid shifts ( burns, liver dysfunctions, trauma )

144
Q

Clinical Manifestations of Hypovolemia

A

develop quickly, severity depends on the degree of fluid loss
= Decreased vascular volume

145
Q

Hypovolemia is/isn’t the same as dehydration.

A

Is not

146
Q

What is the difference between hypovolemia and dehydration?

A

Hypovolemia is water loss and electrolytes concentration is the same
but dehydration is just loss of water causing sodium to rise

147
Q

With volume loss or excess need to ** monitor** what?

A

electrolytes

148
Q

Hypovolemia is common among what age groups

A

very young and very old

149
Q

During dehydration, water shifts …

A

water shifts out of cells and into ECF and cells shrink

150
Q

Hypervolemia is caused by

A

abnormal retention of water and sodium in same proportions which they normally exist in ECF

151
Q

Hypervolemia is fluid volume

A

excess

152
Q

Hypervolemia is caused by

A

Isotonic fluid overload (ECF increase in interstitial/intravascular compartments)
excess sodium intake
heart failure, renal failure, liver cirrhosis

153
Q

Hypervolemia treatment involves

A

underlying cause and remove fluid w/o causing changes in electrolytes or osmolality of ECF

154
Q

Hypertonic solutions move fluid from

A

from interstitial space to expand extracellular space
- cells shrink

155
Q

Hypertonic solutions are ordered for what type of pts?
Why?

A

postoperative pts
- reduce risk of edema, stabilize bp, and regulate urine output

156
Q

IV Cannulations start where

A

low and work proximally
- inner wrist is sensitive
- AC is last option!

157
Q

IV Cannulations and Phlebotomy relies heavily on

A

feel/touch not sight

158
Q

IV Cannulations sites to avoid

A

Legs, ankles, and feet
Sclerosed or thrombosed veins
Veins that are knotted or tortuous
Veins below an infiltrated site or areas of phlebitis
Areas of inflammation, disease, bruising, or breakdown
Veins of surgically compromised or injured extremities
Dominant hands (if possible) and extremities with AV shunts for dialysis

159
Q

Considerations for selecting a vein

A

condition of the vein (fragile?)
reason for IV
what solutions or meds used (irritating)

160
Q

Vein Evaluation what do you do and look for?

A

PALPATE
- suitable: round, firm, and elastic
engorged with tourniquet

161
Q

14-16 g needles are used for

A

trauma or surgery when needing rapid infusion

162
Q

18 g needle is used for

A

surgery, receiving blood or caustic meds

163
Q

In normal everyday IV catheter, what needle gauge would you use?

A

20 -22 g

164
Q

24 g

A

most common in peds
used on adult with fragile veins

165
Q

What are the different types of IV catheter insertion devices

A

Nexiva Winged
Insyte Autoguard

166
Q

Complications of IV Therapy

A
  • a fluid overload of the circulatory system (stress on heart)
  • infection (redness, irritation, and pain)
  • phlebitis (irritation to vein mechanical:tube itself or chemical: medication)
  • infiltration: fluid seeps into tissue like 3rd spacing (swollen, cold
  • extravasation: infiltration of caustic meds and eats away tissue
167
Q

Intermittent (INT)

A

scheduled dose daily or several times a day

168
Q

Continuous

A

IV solutions are constant
-used for hydration, electrolyte replacement

169
Q

Bolus/Push

A

specific amount in a specific time frame

170
Q

Nurse Responsibilities for IV

A

Assess patency, irritation, and infection (once per shift)
Know the medication
Assess for adverse effects
Teach the patient

171
Q

IV Medication advantages

A

Direct access to circulatory system  instant action
Instant drug action and drug termination
Rapid treatment
Better control of rate
Great for those with GI tract limitations
Good for meds that irritate gastric mucosa

172
Q

IV Medication disadvantages/complications

A

Reconstitution errors: recommeded volume of diluent
Venous Spasm
Drug incompatibilities
Impaired drug absorption
Speed Shock
Chemical phlebitis
Extravasation of vesicants
Air embolism

173
Q

Venous Spasm

A

sudden, brief, tightening of the muscle cells inside the blood vessel walls.

174
Q

Speed shock

A

from too much medication in too short a period of time
-It could result in systemic reactions depending on the drug.
-Make sure you administer all medications at the recommended rate

175
Q

Chemical phlebitis

A

inflammatory damage to the lining of blood vessels with chemical irritation

176
Q

Air embolism

A

when air enters the central veins and becomes trapped in the blood

177
Q

What are the causes of air embolisms?

A

Solution runs dry, air in tubing, loose connections, improper removal of CVAD, poor technique with dressing or tubing changes

178
Q

S/S of air embolism

A

Dyspnea, tachypnea,
lightheadedness,
palpitations,
drop in BP,
weakness,
cyanosis, expiratory wheezes

179
Q

Air embolism Interventions

A

Stay witht pt and Call for help
- Position the patient in Trendelenburg on their left side
- Administer oxygen
- Monitor vital signs
- Have emergency equipment ready

180
Q

S/S of extravasation

A

Pain or burning at IV site
Skin tightness at site
Blanching and coolness of skin
Dependent edema

181
Q

Prevention of extravasation

A

Dilute meds as recommended
Avoid use of high pressure pumps
Assess & monitor IV site
Teach patient what to report

182
Q

Extravasation

A

vesicant drugs can result in tissue necrosis or the formation of blisters when infused into the tissue surrounding a vein.
= lead to permanent damage and even death.

183
Q

Which device is the safest for the administration of vesicant drugs?

A

CVADs

184
Q

Causes of venous spasms

A

Viscous solutions
Too rapid administration
Cold or irritating solutions

185
Q

S/S of venous spasms

A

Sharp pain radiating up the arm with the IV site

186
Q

Prevention Techniques of venous spasms

A

Dilute meds as recommended
Admin solutions and meds at room temperature
Admin at the recommended rate
Restart questionable IVs
Consider a warm compress during infusion

187
Q

Causes of chemical phlebitis

A

Too rapid infusion
Presence of particulate matter in solution
Improper dilution or reconstitution when preparing meds
Administration of irritating meds

188
Q

Prevention of chemical phlebitis

A

Use an in-line filter for meds that do not reconstitute completely
Increase the volume of dilution
CVAD or larger peripheral veins for IV site
Slow the rate of infusion
Restart any questionable IVs

189
Q

IV Push Administration procedure

A
  • 7 rights, Verify Patient and allergy status
  • Scan patient’s arm band and med vial and verify with eMAR (3rd check)
  • Hand hygiene & don clean gloves
  • Remove alcohol permeated cap from IV lumen
  • clean needleless connector access with alcohol pad for 15 sec
  • Purge air from a sterile saline flush syringe = attach syringe = flush lumen and IV catheter with 9 mL = remove syringe
  • Clean needleless connector access = attach medication syringe = administer med at recommended rate = remove syringe
  • Clean needless connector access = attach post saline flush syringe
  • flush slowlyfor the first 2-3 mL
    then vigorously for total of 9 mL
  • Remove flush syringe = clamp lumen= attach new alcohol permeated cap
190
Q

Formula for gtts/minute for gravity infusion

A

mL*drop factor/mins

191
Q

What do you do with tubing before attaching primary or secondary tubing?

A

clamp and Prime

192
Q

How to prevent venous spasms

A

warm fluids to room temperature so they’re not cold.

193
Q

How to prevent air embolisms?

A

Always ensure you purge air from syringes and prime tubing, and secure all connections properly.

Module 2 (Skills) (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions