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IV Therapy Flashcards

1
Q

What is the equation for normotension in peds patients

A

Age x 2 + 90

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2
Q

What is the equation for hypotension in peds?

A

Age x 2 + 70

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3
Q

What are the 2 indications for IV Therapy

A

Potential med administration
and the need for fluid therapy

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4
Q

What is the use of a secondary set in medication administration in the context of IV

A

It allows for a slow administration of drugs

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5
Q

Define Macrodrip

A

comes in (10/15/20 Drops per mL) sets, runs drips faster
10 drops=1ml of fluid

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6
Q

Define Microdrip

A

Microdrip 60 drops per ml of fluid
Runs drips slower
Allows more control
Recommended for Peds (2-12)

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7
Q

Define Crystalloid solution

A

Homogenous
Dilution of mineralized salts

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8
Q

What are 3 examples of a Crystalloid solution that we use as PCPs

A

Ringers Lactate
Saline
D-10

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9
Q

Define Colloid solution

A

Heterogenous and Difficult to store

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10
Q

What is an example of a colloid solution?

A

Blood

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11
Q

Define Hypotonic Solution

A

A solution that has a higher osmotic pressure external of the vasculature which causes fluid to fill the cells

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12
Q

Define Isotonic solution

A

It doesn’t draw fluid in or out, just provides body with extra volume
Ex - Saline

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13
Q

Define Hypertonic solution

A

Draw more fluid from the cells in to vasculature
These solutions are Used for cerebral Edema
and Used in partner with hyperventilation

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14
Q

What is TKVO on a 10-set macro drip typically in adults?

A

1 drop every 6-12 seconds or 5 drops per minute or 30-60ml/hr

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15
Q

What is TKVO on a Microdrip for Peds?

A

1 drop every 4 seconds with Microdrip

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16
Q

When cannulating what should you avoid?

A
  • Fracture
  • Hematomas
  • AV graft/fistula
  • history of mastectomy
  • Infection/swelling
  • decreased sensation
  • sclerosed or thrombosed veins
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17
Q

What are 2 indications for the use of a Buretrol?

A
  1. Pediatrics
  2. D10W
    or other slow admin of meds
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18
Q

When would you use a pressure infuser?

A
  • rapid delivery of fluid is required
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19
Q

Some local complications of IV administration

A
  • pain and irritation
  • infiltration and extravasation
  • hematoma formation
  • venous spasm or vessel collapse
  • Phlebitis
  • thrombosis and thrombophlebitis
  • cellulitis
  • nerve, tendon, ligament and limb damage
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20
Q

What are 3 causes of Infiltration?

A
  1. Dislodgement of catheter or needle cannula during venipuncture
  2. Puncture of vein wall during venipuncture
  3. High delivery rate or pressure
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21
Q

What are the signs and symptoms of infiltration

A
  • cool site around the IV
  • Swelling at IV site
  • Sluggish or absent flow
  • infusion flows when pressure is applied to vein above tip of cannula
  • no backflow of blood into IV tubing when clamp is fully opened, and solution container is lowered below IV site
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22
Q

What are 4 systemic complications that can occur

A
  • sepsis (infection)
  • Hypersensitivity reactions
  • Pulmonary Edema
  • Emboli
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23
Q

Signs and Symptoms of Air Embolism

A
  • hypotension
  • Cyanosis
  • weak rapid pulse
  • loss of consciousness
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24
Q

How to manage an Air embolism

A
  • close the tubing
  • transport pt semi-prone on left side (keep head down)
  • Check tubing for leaks
  • administer high concentration O2
  • notify medical direction
  • CPR if needed
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25
Q

Paramedics are permitted to transport pts on these 4 types of IV therapy without an escort

A
  • Peripheral IV
  • TKVO or prescribed rate no greater than 2ml/kg/hr to max of 200ml/hr
  • drugs within your certification level
  • normal saline, D5W, Ringers, Thiamine, multivitamins
  • Pt has to be 18+ to be transported with KCL
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26
Q

What percentage of total body weight is interstitial fluid

A

40-60%

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27
Q

What is an example of Intravascular fluid

A

Blood Plasma

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28
Q

What is an example of interstitial fluid

A

CSF

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29
Q

What % of total body weight is body fluids in an infant

30
Q

What % of total body weight is body fluids in a child

31
Q

What % of total body weight is body fluids in an adult

32
Q

What % of total body weight is body fluids in an infant Obese/Elderly

33
Q

Define Edema

A

Fluid that accumulates in interstitial spaces

34
Q

4 things that interstitial space fluid depends on

A
  1. capillary hydrostatic pressure
  2. Oncototic pressure by blood plasma proteins (pulls fluid back into capillaries)
  3. Capillary permeability
  4. Lymphatic channels (collects fluid forced from capillaries by blood hydrostatic pressure and returns it into circulation)
35
Q

What are the 2 type of clinical manifestations of edema +?

A

Localized, and generalized

36
Q

What are some characteristics of a gernalized edema

A
  • more widespread
  • dependant on the body part
  • pitting
  • symptom from undelying illness
37
Q

What is a way to check for dehydration?

A

Tenting of the skin

38
Q

3 classes of dehydration and definitionso

A

Isotonic - excessive loss of sodium and water in equal amounts
Hypernatrermia - loss of water in excess of sodium
Hyponatremic - loss of sodium in excess of water

39
Q

How often do you reassess when running a fluid bolas

A

every 250 ml of fluid

40
Q

What are signs and symptoms of fluid overload

A

Crackle in the lungs, and localized edema

41
Q

What is the chief cation in ICF?

42
Q

What is the chief anion in ICF

43
Q

What is the chief cation of ECF?

44
Q

What is the chief anion of ECF?

45
Q

Where would you find large amounts of Bicarb ions? In ICF or ECF?

46
Q

What is the role of sodium in the body

A
  • helps maintain water balance
  • helps with transmission in muscles and nerve fibres
47
Q

What organ is key in regulating sodium?

A

The renal system and the kidneys

48
Q

What are the 2 hormones that regulate sodium levels and helps maintain the balance of water and sodium in the body

A

Aldosterone and ADH

49
Q

When would aldosterone be secreted

A

If ECF Na was decreased, the aldosterone would cause an increase in sodium

50
Q

Why would you see an increase in ADH in the body?

A

to help secrete water and NA

51
Q

What would cause sodium loss in the body that would result in excess water?

A
  • Medications
  • Diarrhea
  • Renal, liver, or hear disease (CHF)
52
Q

What would cause water gain in excess of sodium

A
  • Hypotonic fluid excess
  • Compulsive Water Drinking

May also be adrenal insufficiency (low aldosterone)

53
Q

What would cause excess sodium in the body in relation to water

A
  • diet
  • Hypertonic saline IV solutions
54
Q

What would cause excessive water loss

A
  • extensive burns
  • hyperglycemia
  • diabetes insipidus
55
Q

What is potassium vital for in the body

A
  • regulating the normal electricity of the heart
  • nerve and skeletal function and metabolic processes
56
Q

Sodium and Potassium work in ________________ of each other

57
Q

When aldosterone is released, the kidneys may…..

A

eliminate more potassium, and not recognize the fact that there may already be a lack of potassium in the body

58
Q

Acidosis = hyper or hypokalemia

A

Hyperkalemia

59
Q

Alkalosis = hyper or hypokalemia

A

hypokalemia

60
Q

True or False - the body reatians potassium well

61
Q
  • Muscle Dysfunction (decreased reflexes)
  • Muscle weakness
  • Malaise
  • Constipation
  • decreased myocardial muscle contraction (hypotension)
  • Conduction problems
  • Vomitting

These are symptoms of what?

A

Hypokalemia

62
Q

Causes of Hyperkalemia

A
  • cell injury
  • Acidosis
  • poor elimination
  • excess intake
63
Q

What is Calcium essential for in the body

A
  • neuromuscular transmission
  • cell membrane permeability
  • contraction of cardiac, smooth and skeletal muscles
  • hormone secretion
  • formation and structure of teeth and bones
  • blood clotting process
64
Q

How is calcium regulated by the GI tract

A
  • absorbed by the GI tract
  • Requires vitamin D
65
Q

How is calcium regulated by the Renal system

A
  • filtered by the glomerulus and reabsorbed in the tubules
  • stone formation can occur
66
Q

How is calcium regulated by the Endocrine system

A
  • parathyroid releases PTH to increase calcium concentration
  • Calcitonin acts to move calcium from plasma to bone (decreases blood calcium levels)
67
Q

What are some causes of hypocalcemia

A
  • decreased intake or increased excretion
  • parathyroid problem
  • vitamin d deficency - inadequate exposure to UV light
  • Hydrofluoric (HF) burn
68
Q

Signs and symptoms of Hypocalcemia - What does “CATS” go numb mean?

A

C – Convulsions (seizures)
A – Arrhythmias (irregular heartbeats)
T – Tetany (muscle cramps, spasms, or twitching)
S – Stridor and spasms (laryngospasm or bronchospasm)
The “go numb” refers to paresthesia (numbness and tingling), which often occurs in the lips, fingers, and toes due to increased neuromuscular excitability.

69
Q

Causes of Hypercalcemia

A
  • Excessive intake or absorption
  • increased vitamin D
  • Altered GI metabolism
  • Medications
  • Metabolic - Hyperparathyroid and bone tumours
70
Q

Bones, groans, stones and mental ovetones
- Bone pain - abnormal bone growth
- decreased peristalsis - GI Symptoms
- Renal Stones
- Personality changes
confusion, altered LOC, Lethargic, psychosis, depression, memory loss
- Cardiac dysrhytmias, short QT, heartblock, bradycardia

What are all these symptoms of?

A

Hypercalemia

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