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P&A II midterm > IV therapy fluid > Flashcards

IV therapy fluid Flashcards

1
Q

Where is most fluid located?

A

Inside the cells

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2
Q

What is diffusion?

A

Movement of particles from high concentration to low concentration

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3
Q

What is osmosis?

A

The movement of water through a semipermeable membrane

Low particle concentration -> high particle concentration

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4
Q

What is osmotic pressure?

A

The pressure exerted on a semipermeable membrane by osmosis

Pressure necessary to create equilibrium

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5
Q

What is filtration?

A

Movement of fluid and small particles due to hydrostatic pressure

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6
Q

Where does filtration happen?

A

Kidney/capillary level

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7
Q

What is active transport?

A

Movement of particles from an area of LOW concentration to an area of HIGH concentration
Requires ATP

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8
Q

What are the 2 types of solutions?

A

Crystalloid

Colloid

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9
Q

What is a crystalloid solution?

A

Clear solution
Isotonic fluids
Hypotonic fluids
Hypertonic fluids

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10
Q

What is a colloid solution?

A

Proteins/starch
Blood products
Parenteral nutrition

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11
Q

When do you use an isotonic fluid?

A

Low BP

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12
Q

When do you use a hypotonic solution?

A

When cells needs fluid and are dehydrated

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13
Q

When do you use a hypertonic solution?

A

In people with edema

To pull fluid from cells into vasculature

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14
Q

What is insensible fluid loss?

A

Losing fluid that cannot be measured (sweating during a hot day - diaphoresis, respiration)

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15
Q

What is sensible fluid loss?

A

Fluid loss that can be measured

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16
Q

When is 3% fluid usually used?

A

For brain swelling because the swelling has no where to go

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17
Q

How do you treat a dehydrated pt?

A

Give 0.9% NS to increase fluids, THEN hypotonic

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18
Q

What is fluid osmolality?

A

The number of dissolved particles per unit of water

We refer to solutions in relation to plasma

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19
Q

What is a hypotonic solution?

A

Less concentrated (more dilute) than plasma

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20
Q

What is a hypertonic solution?

A

More concentrated than plasma

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21
Q

What is IV therapy?

A

Infusion of a fluid into a vein to prevent or to treat fluid or electrolyte imbalance or to deliver medications, nutrition, or blood products

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22
Q

What are types of venous access devices?

A 
Peripheral insertion devices
Midline infusion devices
Peripheral inserted central venous access devices
Tunneled central venous access devices 
Implanted vascular access devices
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23
Q

What is a peripheral insertion device?

A

Over-the-needle intravenous catheters

Winged infusion or small vein needles

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24
Q

What are advantages of a peripheral insertion device?

A

Choice of sites
Ease of insertion and removal
Decreased infection rates

25
Q

What are disadvantages of a peripheral insertion device?

A

Short term (72 hours)
Infiltration/phlebitis
Inability for hyperosmolar solutions
Inability to draw blood

26
Q

What is infiltration?

A

When the catheter is dislodged from the vessel and you have fluid leaking into the tissue

27
Q

What are symptoms of infiltration?

A

Cool to touch, swelling, discomfort and no blood return

28
Q

What is phlebitis?

A

Inflammation of the vessel

29
Q

What are symptoms of phlebitis?

A

Pain, warmth, redness at site, edema

30
Q

Can you draw blood off of peripheral IVs?

A

No

31
Q

What is a midline infusion device?

A

Similar to a PICC line

32
Q

What are advantages of a midline infusion device?

A

Ease of insertion and removal
Intermediate use
Decreased infection rates
TPN and blood draws

33
Q

What are disadvantages of a midline infusion device?

A

Infiltration/phlebitis/air embolism more common than peripheral line

34
Q

Why is an air embolism more common in midline infusion devices?

A

It’s a wider bore - concern for air getting inside the catheter

35
Q

Where are midline infusion devices usually placed?

A

Basilic, cephalic, or brachial veins 3-8 inches

36
Q

How long are midline infusion devices usually good for?

A

6-8 weeks

37
Q

What is a peripheral inserted central venous access device?

A

A PICC line

Considered a central line because it feeds into the heart even though it’s peripheral

38
Q

What are advantages of a peripheral inserted central venous access device?

A

Ease of insertion and removal
Long term & home use
Decreased infection rates
May infuse all solutions and blood draws

39
Q

What are disadvantages of a peripheral inserted central venous access device?

A

High thrombosis rate
Small Diameter
Higher malposition risk
CLAB/CRBSI

40
Q

How long is a a peripheral inserted central venous access device good for?

A

1 year

41
Q

What veins could a a peripheral inserted central venous access device be put into?

A

Basilic, cephalic, or brachial veins (end near right atrium)

42
Q

What is an implanted vascular access device?

A

Port

Central line

43
Q

When are implanted vascular access devices used?

A

Oncology or people with long term autoimmune disease that requires lots of medication over time

44
Q

What are advantages of implanted vascular access devices?

A

Long term & home use
No external catheter
Low maintenance, swim/shower/bath, cosmetic
Decreased infection rates than tunneled

45
Q

What are disadvantages of implanted vascular access devices?

A

Surgical insertion and removal

Need to access - port is under skin

46
Q

What is a central venous access device?

A

Central line

Can have a triple-lumen catheter

47
Q

What are advantages of central venous access devices?

A

Ease of insertion and removal
Intermediate term
May infuse all solutions and blood draws
*TPN line has to remain specifically for that

48
Q

What are disadvantages of central venous access devices?

A

CLAB/CRBSI

49
Q

What are guidelines for peripheral site selection?

A

Determine type and duration of therapy
Inspect the patient’s veins
Place a tourniquet 4 to 6 inches above venipuncture site
Lower extremity below the level of the heart.
Ask the patient to open and close fist several times
Warm soaks x 5 minutes before venipuncture: vasodilates selected vessel

50
Q

Where is the best place to put an IV?

A

Antecubital because the veins are big there

51
Q

What factors affect flow rate?

A 
Height of the solution container
Position of the extremity
Tubing obstruction
Position of the IV access
IV patency
52
Q

What are nursing functions in IV therapy?

A 
Initiating
Maintaining
Assessing
Discontinuing
Administering
53
Q

How does the nurse initiate IV therapy?

A 
Preparing the patient
Selecting the site
Preparing the site
Performing the venipuncture
Securing the venipuncture device
54
Q

How does the nurse maintain IV therapy?

A

Monitoring and documentation
Dressing changes (72 hours)
Changing IV solutions and tubing
Intermittent flushing of an infusion lock
Disconnect as little as possible to decrease risk for infection

55
Q

How does the nurse assess for complications in IV therapy?

A 
Check for:
Infiltration
Phlebitis
Infection
Fluid overload
Air embolism
Pneumothorax (think in relation to central lines)
Catheter breakage or damage
56
Q

What are S&S of infected IV site?

A

Local - redness, warmth, purple to drainage

Systemic - fever, wbc, chills, malaise

57
Q

How does the nurse discontinue IV therapy?

A

When all ordered fluids have infused or when complications develop
Inspect the integrity of the catheter after removal

58
Q

How does the nurse administer IV therapy?

A 
IVP
Intermittent infusion
Continuous infusion
PCA
Epidural analgesia
59
Q

How does IV therapy change through the lifespan?

A

Newborn and infant
- Veins are tiny and difficult to locate and cannulate
- IVs normally put in scalp because you can see the veins better
Toddler and preschooler
- Avoid areas over joints - children’s increased activity level
School-age child or adolescent
- Fear of invasive procedures
Adult or older adult
- Requires special care because of age-related changes in the skin and vessels
- Vessels become more fragile
- “Rolling”

P&A II midterm (8 decks)

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