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IV Therapy Flashcards

1
Q

examples of isotonic solutions

A

0.9% sodium chloride
Lactated Ringers
D5% and water

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2
Q

isotonic solutions may put the patient at risk of…

A

Fluid volume overload

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3
Q

s/s of FVO

A

high BP, bounding pulses, edema, SOB, crackles

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4
Q

which has more rapid blood flow: peripheral or central?

A

central

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5
Q

most typical place for a short peripheral IV

A

forearm, can be in the hand

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6
Q

what gauge has the fastest flow rate?

A

the largest

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7
Q

18 gauge IVs are usually only used in..

A

surgery

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8
Q

how often should you assess the IV site

A

q4h

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9
Q

when would a patient be put on intermittent lock or saline lock?

A

if they are at risk of FVO or no longer need as much fluid

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10
Q

what does an occlusive dressing mean?

A

no lifted/peeling edges, completely closed off

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11
Q

what is a midline catheter?

A

still peripheral, but much longer catheter than a short

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12
Q

how long can a midline cath be left in?

A

up to 4 weeks

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13
Q

do solutions going into short peripheral IVs have to be compatible? why?

A

yes, slower blood flow

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14
Q

do solutions going into midline caths have to be compatible? why?

A

yes, slower blood flow

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15
Q

where is a PICC line located?

A

usually in upper arm - cath in superior vena cava or right atrium

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16
Q

what is a biopatch?

A

decreases risk of infection by releasing CHG around the insertion site

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17
Q

anytime you are preparing to give a med, you MUST check for…

A

blood return!

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18
Q

thrombophlebitis

A

clot that inflames the vein - why we flush with 20 after drawing blood

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19
Q

DVT

A

appears swollen, red - need to call doctor
why we flush with 20 after drawing blood

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20
Q

how to prevent CLABSI’s/CRBSI’s

A

scrub hub for 15-30 seconds

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21
Q

PICC line indications

A

chemo, long term antibiotics,

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22
Q

PICC line contraindications

A

paraplegic (uses arms to move around), weight lifters, anyone who uses their arm muscles an excessive amount

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23
Q

what type of catheter would be best for a long-term chemo patient who can’t tolerate frequent needle sticks?

A

port

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24
Q

non-tunneled catheter indications

A

emergency situations

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25
where does a non-tunneled catheter go?
chest straight into the superior vena cava/right atrium
26
how often should a port be flushed
at least once a month between courses of therapy
27
when hanging a glass IV container, make sure you...
open air vent so it can flow
28
how long can a closed IV system be used
96 hours/4 days
29
if you are opening/closing an IV frequently, ex) in between rounds of antibiotics, how often should the lines be changed
q24h
30
how often does blood tubing need to be changed?
q4h
31
each unit of blood must be given within...
4 hours
32
blood can only be infused with..
normal saline
33
if you have a 1 liter bag, how much should you program the pump for?
900-950 mls
34
KVO
keep vein open - prevents clots
35
if you have a 250 ml secondary bag, how much should you program the bag for?
250 mls
36
if the IV pump is alarming for a downstream occlusion, what should you check?
that they are not sitting on it, not kinked, clotted, clamp is closed, etc
37
if the IV pump is alarming for an upstream occlusion, what should you check
roller clamp on secondary line
38
patent
clear, working well, no clots
39
how do we keep lines patent?
FLUSH
40
what is an intermittent lock
pt not receiving fluids, but need IV access for push meds or in case of emergency
41
altepase
PRN drug, for PICC or central lines only, dissolves clots in long catheters
42
after a central line is put in, what is needed before you use it?
chest x-ray to confirm placement
43
FVO interventions
slow IV rate, notify MD, elevate HOB, apply oxygen, monitor vitals, diuretics
44
what is speed shock?
a toxic reaction from a drug being pushed too quickly
45
s/s of speed shock
flushed face, irregular pulses, light headedness, dizziness, chest tightness
46
speed shock interventions
discontinue drug infusion, hang isotonic to KVO, monitor vitals, notify MD
47
speed shock prevention
use infusion pump properly, use correct infusion rate
48
what is infiltration
leakage of IV solution into the extravascular tissue
49
s/s of infiltration
fluid leaking from puncture, edema around site (look underneath arm), IV rate slowed/stopped, pump alarms for downstream occlusion, cool skin, burning, tenderness, discomfort, taut, stretched skin
50
infiltration interventions
stop infusion and remove IV, elevate extremity, apply warm/cool compress, insert new cath in opposite extremity
51
what is phlebitis
inflammation of the vein
52
s/s of phlebitis
defined red streak or generalized erythema, vein becomes hard & cordlike, patient may report pain at IV site
53
causes of phlebitis
wrong size catheter, catheter not secured properly, catheter remained in too long, certain fluid irritates the vein
54
how do we prevent phlebitis?
monitor, choose smallest size catheter possible, avoid sites of joint flexion, rotate IV sites, make sure catheter is properly secured
55
s/s of thrombosis
slow/stopped infusion, pump may detect a downstream occlusion, swollen extremity, site is tender & red
56
causes of thrombosis
catheter too large for vein, multiple venipuncture attempts, venous stasis, hypercoagulative state
57
venous stasis
blood moving slowly - low blood pressure, hypovolemia
58
thrombosis interventions
stop infusion and remove cath, elevate extremity, apply cool compress
59
thrombosis prevention
choose smallest size catheter, choose a large vein, properly secure the catheter, ensure adequate hydration
60
what is thrombophlebitis?
a blood clot and inflamed vein
61
what is extravasation
leakage of a harmful fluid/medication into the extravascular tissue
62
s/s of extravasation
infiltration, blistering, tissue sloughing, necrosis
63
extravasation interventions
stop infusion, may need surgical intervention, aspirate the drug and administer antidote
64
CRBSI
catheter related bloodstream infection
65
causes of CRBSIs
break of sterile field on insertion, inadequate hand hygiene, in there for too long
66
s/s of a systemic CRBSIs
chills, fever, headache, nausea
67
s/s of a localized CRBSI
redness/painful on area, blistering, pus, area is inflamed/warm
68
CRBSI treatment
systemic: check other options - might not be from cath obtain blood cultures to treat with appropriate antibiotics, remove IV, replace all bags & tubing
69
what is a lumen occlusion
a total/partial block of the catheter
70
causes of lumen occlusions
blood clots, not flushing immediately after giving a push medication
71
s/s of a lumen occlusion
infusion stops, pump alarms for a downstream occlusion, increased resistance to flushing/push meds, inability/difficulty to draw blood
72
treatment for a lumen occlusion
alteplase
73
alteplase
dissolves the clot - for use in central lines ONLY
74
lumen occlusion prevention
flush hard with a pulsing pattern - dislodges anything, clears the catheter well; flush before and after each medication administered; flush immediately after infusing meds

Med Surg (13 decks)

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