IV Therapy Flashcards
1
Q
Large Volumes
A
- Continuous
- Over 3 hours
- Example 100mL/hr
2
Q
Fluid bolus
A
- Patient is dehydrated; has N/V, hypotension
- Short period of time
- Less than 1 hour
3
Q
Meds mixed in large bags of fluids
A
- K+Cl (potassium chloride)
- Vitamins
- TPN
4
Q
IVPB
A
- Small amount of solution (25-100mL)
- Contains a medication that is “piggybacking” onto the main line
- Intermittent
- Aren’t ran continuously
5
Q
IVP
A
- Meds are pushed directly into the vein
- Need to: verify compatibility, know if it needs to be diluted and what to dilute in, how fast to push the meds
- Typically narcotics
- NEVER push K+
6
Q
Vascular Access Devices
A
- Short Peripheral Catheter
- Midline Catheter
- Peripherally Inserted Central Catheter (PICC)
- Nontunneled Percutaneous Central Venous Catheter (CVC)
- Tunneled Catheters
- Implanted Ports
- Hemodialysis Catheters
7
Q
Delegation
A
- UAP/CNA CANNOT administer IV fluids, meds, or blood
- LPN CAN administer IV fluids, IVPB medication
- LPN CANNOT do IVP, or narcotics (PCA)
- IVP medications MUST BE given by RN
- Blood products MUST BE started, initiated, and followed up by a RN
8
Q
Autoguard IV catheter
A
- Yellow is mellow 24g
- Blue is for you 22g
- Pink you seeee 20g
- Green is mean 18g
- The larger the # the smaller the diameter
- 14-16g is very large (surgery, trauma)
- Standard surgery = 18g
- Most therapy is given with 20g
- 22g used when the patient veins cant support a 20g
- 24g-26g used on children and elderly
- Anytime a patient says its tingling, you are in the nerve and need to get the IV out
- Stay away from hand if they have a lot of action
- Move from distal to proximal, may even need to move to other arm
9
Q
AccuVein
A
Used when having a hard time finding a good vein
10
Q
Midline Placement
A
- Basilic Vein (PREFERRED)
- Tip no further than axilla vein
- Used most often without the ultrasound
- Ultrasound allows to go to deeper veins
- Allows for demodulation of fluids
- Mixed solutions
- May be called a mini-stick
11
Q
PICC
A
- Double lumen = 2 ports
- Triple lumen = 3 ports
- Basilic or cephalic
- Placed above the AC
- Sterile dressing needs to be changed every 7 days
- Can be left in for several months
- No BP on that arm
- DO NOT USE until placement is confirmed by x-ray
- Flushed every shift 10cc
- Can infuse TPN
- Can be used to draw blood, need to change the caps with each blood draw
12
Q
CVC Non-tunneled
A
- Greater risk for infection
- Tip is in the superior vena cava (SVC)
- Used for less than 6 weeks
- Don’t typically see at home
- Placement confirmed by x-ray
- Sterile dressing change every 7 days
- Have patient take a deep great and hold when removing
- Will need to apply sterile dressing after CVC is removed
- May be placed in trandelenburg during insertion
- sutured in place
- Can be removed by nursing staff
13
Q
CVC Tunneled
A
- Point of entry is not directly in the vein
- Cuff is coated by antibiotic solution
- Sutured in place
- Cuff gets inflated to help keep it in place
- Used for longer periods of time
- Requires surgery for insertion and removal
- Inserted by physician or advanced practice nurses
14
Q
Complications of CVC
A
- Pneumothorax: air being introduced into the pleural cavity causing the lung to deflate
- Hemothorax: Blood being introduced into the pleural cavity
- Hydrothorax: Fluid and air being introduced into the pleural cavity
- COPD patients are at a higher risk for pneumothorax, hemothorax, and hydrothorax
- Air embolism: bubble of air, acts like a clot/stroke
- Arterial Puncture: hitting the artery
- Catheter migration/dislodgment
- Catheter rupture
- Lumen occlusion: opening of end of cannula is obstructed by clot or web of clot
- Central Line-Related Bloodstream Infections (CLRBI): purulent draining around the site, needs to be d/c & sent down to lab, may need to also culture the site
15
Q
Port a Cath
A
- Must use a Huber needle
- Cancer patients
- Strict sterile technique when accessed
- Can be double lumen or single lumen
- Come in various sizes
- Placed in upper chest wall, possible upper extremity
- Designed to not “core”, designed to slice through and when removed, the material will self-close
16
Q
Huber Needle
A
- 45 degree angle needle
- Needed to access a port a cath
17
Q
Isotonic IV Fluids
A
- Be careful on patients who are at risk for overload (renal & cardiac patients)
- Usually used with burn patients
- No push into or pull out of the cells
- D5W
- NS: should be the only thing used when giving blood products. Need to prime the tubing for blood products with NS
- LR: contains k+
18
Q
Hypotonic IV Fluids
A
- Pushes fluid into the cells
- Puts patients at risk for phlebitis & infiltration
- Moving into the cells & expanding them
- Use cautiously with burns
- 1/2 NS
19
Q
Hypertonic
A
- Pulls fluid out of the cells
- Monitor blood sugar levels
- D5 1/2 NS
- D5 NS
- D10W
20
Q
IV Fluids
A
- Be sure to check the date on the fluids
- Make sure the bag is not leaking
- If it doesn’t look right, don’t hang it
- IV solutions should be changed every 24 hours
