IV Therapy

Question 1

Hypertonic solution

Answer 1

Greater concentration than body fluid. D10W. Pull fluid into the vessels. Fluids flow to a high concentration

Question 2

Hypotonic solution

Answer 2

Less concentrated than body fluid. 0.45% NaCl. Pulls fluid into the tissue

Question 3

IV flow rate

Answer 3

Total solution/# of hours to run= ml/h

Total volume x drop factor/ minutes= gtt/min

Question 4

Caustic solution

Answer 4

Sodium bicarb. Damaging to veins. Need big veins. If long term therapy need big vein.

Question 5

Isotonic solution

Answer 5

Same concentration as the fluid of the person you’re putting it into. Not appropriate for those in shock or elyte imbalances. 0.9% NaCl, D5W

Question 6

Infiltration

Answer 6

Fluid comes out of the vessel and into the tissue. SnS- cool skin, swelling, pain, dec in flow rate. Tourniquet trick to check dripping. Discontinue IV, warm compress, elevate arm, start new IV above/proximal to site or other arm.

Question 7

Extravasation of IV

Answer 7

Vesicant is medication or IV solution that causes blisters and tissue sloughing. Meds- gentamicin, penicillin, vancomycin, Dilantin, antineoplastics (vincas get warm compress rest get cool) , calcium, potassium, epinephrine. Pull out IV and aspirate.

Question 8

Phlebitis, thrombophlebitis

Answer 8

Redness, warm, tender, swelling, leukocytosis. D/c IV, warm compress, restart IV at new site

Question 9

Hematoma

Answer 9

Assess- ecchymosis, swelling, leakage of blood. D/c IV, apply pressure, ice bag 24h, restart IV in other arm

Question 10

Clotting of IV

Answer 10

Assess- dec flow rate, back flow of blood into tubing. D/c, do not irrigate, milk, inc flow rate or hang solution higher, do not aspirate cannula, inject Urokinase

Question 11

PICC line

Answer 11

Placed in SVC or brachial cephalon vein. Midline between AC and clavicle. Stay up to 6 mo. Comp- pneumothorax, dysrhythmias, thrombophlebitis, nerve or tendon damage, resp distress, embolism. Imp- change dressing 2-3x/wk when wet or nonocclusive. Flush w/ 2ml NS followed by 5 ml heparin (100 u/ml) into each lumen. No BP.

Question 12

MLC (midline catheter)

Answer 12

Enlarges 2 gauges and elongates 2.5 cm after insertion. Takes 2 hrs. Placed b/n AC and clavicle. In place 1-8 wks. Comp- thrombosis, phlebitis, air embolism, infection, vascular perforation. Flush with NS and heparin q12h or after meds

Question 13

Percutaneous central catheter

Answer 13

Triple lumen. Insertion- placed supine head low, turn head away from procedure, valsalva maneuver, abx ointment and transparent sterile dressing, verify w/ xray. Lure lock. Distal- blood draws. Middle- TPN or Reg IV infusion. Proximal- blood transfusions or meds. Change site q4wks. Tubing changed q24h. Flush w/ heparin BID, after infusion, specimen withdrawal, d/c. Dressing change 2-3x/wk