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IV Therapy Flashcards

1
Q

Infiltration and Extravasation

A

Infiltration- IV fluid escapes the vein in to surrounding tissue
Extravastion- a vesicant fl/med causes necrosis or tissue damage

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2
Q

S/S Infiltration/Extravasation

A

Swelling, pallor, COOL skin, skin blanched/taut, leaking from insertion site

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3
Q

Causes of I&E

A

Dislodged catheter, vessel wall penetrated by catheter, fragile or poor vein condition, mutiple IV attempts

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4
Q

Interventions for I&E

A

Discontinue infusion,, cool compress, elevate extremity, restart IV at different site,
Extravasation- attempt to aspirate residual drug, cool compress,

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5
Q

Phlebitis

A

Inflammation of the inner lining of the vein.

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6
Q

S/S Phlebitis

A

Pain, Inflammation, tenderness, redness, WARMTH (infection), edema above insertion site,

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7
Q

Causes of Phlebitis

A

Trauma from cath, chemical trauma from solution, contamination (bacterial)

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8
Q

Interventions for Phlebitis

A

Discontinue IV, apply warm moist compress, restart IV in opposite extremity

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9
Q

Thrombus

A

Blood clot in a vessel that causes interruption of blood flow

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10
Q

S/S of a Thrombus

A

Pain, inflammation, tenderness, localized redness, warmth, mild edema above insertion site.

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11
Q

Causes of Thrombus

A

Trauma from cath or needle

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12
Q

Interventions for Thrombus

A

Do not rub or massage area, discontinue IV, apply warm moist compress, restart IV in opposite extremity

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13
Q

Embolus

A

Clot/Air or foreign matter formed in circulatory system and CARRIED to the point of obstruction by the blood stream.
(E-Bus= Emergency Bus MOVES Fast)

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14
Q

S/S Embolus

A

Depending on location: dyspnea, sudden pain

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15
Q

Causes of Embolus

A

Air enters vein through infusion line, thrombus dislodges from insertion site and travels
-Nitrogen in air can dissolve quickly quickly in pts blood, as little as 10 mL can cause death.

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16
Q

Intervention of Embolus

A

Report sudden pain or difficulty breathing,

Prevention: Monitor site regularly, do not allow air to enter infusion line

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17
Q

Infection

A

Infection at insertion site increases risk for bacterial systemic infection due to colonization of the site migrating through catheter in to circulation

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18
Q

S/S Infection

A

Fever, Chills, malaise, pain, swelling, induration ( loss of elasticity, hardened mass) redness, inflammation or pus at site

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19
Q

Causes of Infection

A

Poor sterile technique on insertion, caring for insertion site, contaminated solution,

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20
Q

Interventions for Infection

A

Discontinue Infusion, notify provider,

Prevention: sterile technique when initiating IV, change dressing/tubing according to policy

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21
Q

Hematoma

A

Formation/Induration from blood escaping into tissue at venipuncture site.

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22
Q

S/S of Hematoma

A

Ecchymosis, site swelling, discomfort, inability to advance cath, resistance during flushing,

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23
Q

Causes of Hematoma

A

Poor venipuncture technique where cannula passes through vein, opening flow clamp for infusion before tourniquet is removed, cannula to large for vessel, pressure of tourniquet to fragile for skin

24
Q

Interventions for Hematoma

A

Remove cath, apply pressure with 2x2 gauze, elevate extremity, apply cold compress.

25
Tourniquet Use
-decreases venous blood return to aid in IV insertion -Apply tighly but no to much to impede arterial blood flow -Do not leave on longer 2-4 minutes This will prevent nerve injury
26
IV Site
- Antecubital is NOT a good site. its an area of flexion. - Immobilizion pt arm limits ROM and ADLs - damage at Antercubital eliminates vein sites at lower parts of extremity. - Use Antecub for blood sampling, NOT IVs
27
18 gauge
-Pt is receiving large quantites of fluids/blood/blood products quickly (trauma, transfusions, CT scan c dye, requires large vein)
28
14 and 16 gauge
14- grey 16- orange - used in high risk surgical procedures - requires large vein
29
20 gauge
- most commonly used - suitable for non emergent blood transfusions - pink color
30
22 gauge
- older adults - for slow speed infusions - blue color
31
Midline Catheters
1-4 week IV therapy
32
Peripheral Catheters
- Up to 7 days of therapy | - good for 72-96 hours (with no sx infiltration,phlebitis,contamination)
33
PICC
up to 1 year of therapy
34
IV solutions
-Hang Lipid-containing solutions no longer than 24 hrs - Hang lipid ONLY emulsion for no longer than 12 hours - Hang blood and blood products no longer than 4 hours - Parentarel solutions do not hang longer than 24 hours at room temp
35
IV tubing
- Replace tubing for blood/products or lipid containing solutions every 24 hours - Replace tubing for propofol q6-12hrs - Replace tubing for dextrose and aminoacids without lipids q 72 hrs - Replace any other tubing 96 hours
36
Air in blood stream
Through cut IV tubing, unprimed infusion sets, ports, injection caps, drip chamber with too little fluid, vented infusion containers that completely empty.
37
Preventing Air in to pt
- close roller clamp before spiking bag - hang bag before priming line - fill drip chamber 1/3 - 1/2 full before priming - use roller clamp to control flow rate. (invert ports before fluid reaches them, then tap to fill c fluid)
38
Hair at IV site
- do NOT shave - clip the hair with scissors, if excess. - allows better cleaning, adherence, visualization, reduces discomfort when discontinuing IV
39
Cleansing agent to air dry
- 30 sec chlorhexidine - 60 sec for alcohol - 2-3 min povidone-iodine - allows agent to reduce microbial count - do NOT fan or blow on skin - if combination, allow alcohol to dry before adding povidone-iodine (ETOH negates povidone effects) - do NOT wipe away povidone with alcohol (povidone effects last longer than ETOH)
40
Lidocane
-10 sec for effects
41
IV bag
-position/hang 36 inches above IV site
42
Backpriming Secondary Tubing
-ensures none of the med is wasted or lost
43
Discontinuing IV
- do NOT use alcohol swab - causes stinging - vasodialation leads to increase post-removal bleeding
44
IV Catheter
- inspect catheter for damage after removal - check for the tip (if broken, can become embolus) - can become damaged if needle is reinserted, excessive pressure or improper angle when removing - infection at IV site could warrant culture at cath tip
45
Inserting IV
- stabilize/anchor vein below IV site - place thumb over vein and pull distally 2-3 inches - insert at 10-30 degrees - secure cath with transparent dressing (avoiding the hub) - dressing protects while allowing visualization and allows tubing to be changed. - gauze can be used under hub to elevate to decrease exertion on pt skin - secure with tape chevron (covers cath hub, NOT insertion site
46
Proper Technique inserting IV cath
A: Insert needle bevel up 30-40 degrees B: Advance in to vein until flashback. C: Advance cath off needle (blood may ooze from cath) D: Dispose of needle and connect plastic cap to catheter.
47
Hypotonic
- Moves fluid from vascular space to intracellular space. - The osmotic pressure gradient draws water into the cells from the ECF causing the cells to swell (think Hippo). - For Hypertonic dehydration and water replacement
48
Hypotonic Solutions
* 0.45% sodium chloride (half NS) * .33% sodium chloride * 2.5% dextrose in water.
49
Hypertonic
• Draws water from the intracellular space and increases extracellullar causing cells to shrink. • Shifts ECF from the interstitial fluid to the plasma For hypotonic dehydration, replace electrolytes, circulatory insufficency and shock
50
Hypertonic Solutions
* 5% Dextrose in 0.45% NS * 5% Dextrose in .9% NS * 5% Dextrose in LR * D10W * Colloids (albumin 25%, plasma protein fraction, dextran and hetastarch)
51
Isotonic
``` " I so happy" Compatible body fluid For fluid floss, dehydration NS, D5W, LR Water for fluid overload ```
52
Chain of infection
agent leaves its reservoir or host through a portal of exit, is conveyed by some mode of transmission, and enters through an appropriate portal of entry to infect a susceptible host.
53
Osmolality
osmolar concentration in 1 kg of water. Refers to fluid inside the body
54
Osmolarity
Osmolar concentration in 1 L of water | Refers to water out side of the body
55
Piggyback Set
* short tubing (30-36 inches) * standard drop factor of 10-20/mL * used to deliver 50-100 mLs
56
Volume controlled set
* AKA metered-volume chamber set * designed for intermittent administration of measured volumes of fluid with a calibrated chamber * Most chambers hold 100-150 mL solution * Frequently used for pediatric patients and critically ill patients when small, well-controlled amounts of medication are needed
57
Catheter Colors
* Blue: 24-gauge * Yellow: 22-gauge * Pink: 20 gauge * Green: 18-gauge * Gray: 16-gauge

IV Exam (1 decks)

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