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IV Exam > IV Therapy > Flashcards

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
Q

Tourniquet Use

A

-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
Q

IV Site

A
  • 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
Q

18 gauge

A

-Pt is receiving large quantites of fluids/blood/blood products quickly (trauma, transfusions, CT scan c dye, requires large vein)

28
Q

14 and 16 gauge

A

14- grey 16- orange

  • used in high risk surgical procedures
  • requires large vein
29
Q

20 gauge

A
  • most commonly used
  • suitable for non emergent blood transfusions
  • pink color
30
Q

22 gauge

A
  • older adults
  • for slow speed infusions
  • blue color
31
Q

Midline Catheters

A

1-4 week IV therapy

32
Q

Peripheral Catheters

A
  • Up to 7 days of therapy

- good for 72-96 hours (with no sx infiltration,phlebitis,contamination)

33
Q

PICC

A

up to 1 year of therapy

34
Q

IV solutions

A

-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
Q

IV tubing

A
  • 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
Q

Air in blood stream

A

Through cut IV tubing, unprimed infusion sets, ports, injection caps, drip chamber with too little fluid, vented infusion containers that completely empty.

37
Q

Preventing Air in to pt

A
  • 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
Q

Hair at IV site

A
  • do NOT shave
  • clip the hair with scissors, if excess.
  • allows better cleaning, adherence, visualization, reduces discomfort when discontinuing IV
39
Q

Cleansing agent to air dry

A
  • 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
Q

Lidocane

A

-10 sec for effects

41
Q

IV bag

A

-position/hang 36 inches above IV site

42
Q

Backpriming Secondary Tubing

A

-ensures none of the med is wasted or lost

43
Q

Discontinuing IV

A
  • do NOT use alcohol swab
  • causes stinging
  • vasodialation leads to increase post-removal bleeding
44
Q

IV Catheter

A
  • 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
Q

Inserting IV

A
  • 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
Q

Proper Technique inserting IV cath

A

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
Q

Hypotonic

A
  • 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
Q

Hypotonic Solutions

A
  • 0.45% sodium chloride (half NS)
  • .33% sodium chloride
  • 2.5% dextrose in water.
49
Q

Hypertonic

A

• 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
Q

Hypertonic Solutions

A
  • 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
Q

Isotonic

A 
" I so happy" 
Compatible body fluid 
For fluid floss, dehydration 
NS, D5W, LR
Water for fluid overload
52
Q

Chain of infection

A

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
Q

Osmolality

A

osmolar concentration in 1 kg of water. Refers to fluid inside the body

54
Q

Osmolarity

A

Osmolar concentration in 1 L of water

Refers to water out side of the body

55
Q

Piggyback Set

A
  • short tubing (30-36 inches)
  • standard drop factor of 10-20/mL
  • used to deliver 50-100 mLs
56
Q

Volume controlled set

A
  • 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
Q

Catheter Colors

A
  • Blue: 24-gauge
  • Yellow: 22-gauge
  • Pink: 20 gauge
  • Green: 18-gauge
  • Gray: 16-gauge

IV Exam (1 decks)

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