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Med Surg > IV Therapy > Flashcards

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
Q

where does a non-tunneled catheter go?

A

chest straight into the superior vena cava/right atrium

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26
Q

how often should a port be flushed

A

at least once a month between courses of therapy

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27
Q

when hanging a glass IV container, make sure you…

A

open air vent so it can flow

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28
Q

how long can a closed IV system be used

A

96 hours/4 days

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29
Q

if you are opening/closing an IV frequently, ex) in between rounds of antibiotics, how often should the lines be changed

A

q24h

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30
Q

how often does blood tubing need to be changed?

A

q4h

31
Q

each unit of blood must be given within…

A

4 hours

32
Q

blood can only be infused with..

A

normal saline

33
Q

if you have a 1 liter bag, how much should you program the pump for?

A

900-950 mls

34
Q

KVO

A

keep vein open - prevents clots

35
Q

if you have a 250 ml secondary bag, how much should you program the bag for?

A

250 mls

36
Q

if the IV pump is alarming for a downstream occlusion, what should you check?

A

that they are not sitting on it, not kinked, clotted, clamp is closed, etc

37
Q

if the IV pump is alarming for an upstream occlusion, what should you check

A

roller clamp on secondary line

38
Q

patent

A

clear, working well, no clots

39
Q

how do we keep lines patent?

A

FLUSH

40
Q

what is an intermittent lock

A

pt not receiving fluids, but need IV access for push meds or in case of emergency

41
Q

altepase

A

PRN drug, for PICC or central lines only, dissolves clots in long catheters

42
Q

after a central line is put in, what is needed before you use it?

A

chest x-ray to confirm placement

43
Q

FVO interventions

A

slow IV rate, notify MD, elevate HOB, apply oxygen, monitor vitals, diuretics

44
Q

what is speed shock?

A

a toxic reaction from a drug being pushed too quickly

45
Q

s/s of speed shock

A

flushed face, irregular pulses, light headedness, dizziness, chest tightness

46
Q

speed shock interventions

A

discontinue drug infusion, hang isotonic to KVO, monitor vitals, notify MD

47
Q

speed shock prevention

A

use infusion pump properly, use correct infusion rate

48
Q

what is infiltration

A

leakage of IV solution into the extravascular tissue

49
Q

s/s of infiltration

A

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
Q

infiltration interventions

A

stop infusion and remove IV, elevate extremity, apply warm/cool compress, insert new cath in opposite extremity

51
Q

what is phlebitis

A

inflammation of the vein

52
Q

s/s of phlebitis

A

defined red streak or generalized erythema, vein becomes hard & cordlike, patient may report pain at IV site

53
Q

causes of phlebitis

A

wrong size catheter, catheter not secured properly, catheter remained in too long, certain fluid irritates the vein

54
Q

how do we prevent phlebitis?

A

monitor, choose smallest size catheter possible, avoid sites of joint flexion, rotate IV sites, make sure catheter is properly secured

55
Q

s/s of thrombosis

A

slow/stopped infusion, pump may detect a downstream occlusion, swollen extremity, site is tender & red

56
Q

causes of thrombosis

A

catheter too large for vein, multiple venipuncture attempts, venous stasis, hypercoagulative state

57
Q

venous stasis

A

blood moving slowly - low blood pressure, hypovolemia

58
Q

thrombosis interventions

A

stop infusion and remove cath, elevate extremity, apply cool compress

59
Q

thrombosis prevention

A

choose smallest size catheter, choose a large vein, properly secure the catheter, ensure adequate hydration

60
Q

what is thrombophlebitis?

A

a blood clot and inflamed vein

61
Q

what is extravasation

A

leakage of a harmful fluid/medication into the extravascular tissue

62
Q

s/s of extravasation

A

infiltration, blistering, tissue sloughing, necrosis

63
Q

extravasation interventions

A

stop infusion, may need surgical intervention, aspirate the drug and administer antidote

64
Q

CRBSI

A

catheter related bloodstream infection

65
Q

causes of CRBSIs

A

break of sterile field on insertion, inadequate hand hygiene, in there for too long

66
Q

s/s of a systemic CRBSIs

A

chills, fever, headache, nausea

67
Q

s/s of a localized CRBSI

A

redness/painful on area, blistering, pus, area is inflamed/warm

68
Q

CRBSI treatment

A

systemic: check other options - might not be from cath
obtain blood cultures to treat with appropriate antibiotics, remove IV, replace all bags & tubing

69
Q

what is a lumen occlusion

A

a total/partial block of the catheter

70
Q

causes of lumen occlusions

A

blood clots, not flushing immediately after giving a push medication

71
Q

s/s of a lumen occlusion

A

infusion stops, pump alarms for a downstream occlusion, increased resistance to flushing/push meds, inability/difficulty to draw blood

72
Q

treatment for a lumen occlusion

A

alteplase

73
Q

alteplase

A

dissolves the clot - for use in central lines ONLY

74
Q

lumen occlusion prevention

A

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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