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IV Therapy, IV Fluids and Medication Administration Flashcards

1
Q

Do determine what type of needle a patient needs what type of questions should you ask?

A
  • what kind of therapy will the patient need to recive?
  • what is the lenght of tx and duration of the device will remain in place?
  • what does the vasculature of the patient look like?
  • what is the patients age?
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2
Q

Why is Iv therapy so important?

A

patients can require various things:
- fluids
- medications
- electrolytes

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3
Q

Type of needle

Angi-Caths

A
  • most commonly used to access veins
  • short, goes into the peripheral system
  • for intermittent use (short duration)
  • blood, iv fluids, medications (IVP or piggyback antibiotics)
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4
Q

Iv catheter

24G - Yellow

A
  • yellow for the little fellows ages 2 - 4
  • younger / neonates, ederly with pooor vein access
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5
Q

Iv catheter

22G - Blue

A
  • Blue 22 bid it a do
  • try to avoid 22 with blood administration
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6
Q

IV Catheter

20G - Pink

A
  • pretty in pink in age 20
  • best
  • good for anything in the adult population
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7
Q

IV Catheter

18G - Green

A
  • there 18 holes on a green golf range
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8
Q

IV Cathere

16G - Gray

A

rarely used
- large amouts of fluid or blood
- trauma
- @ age 14-16 you think you are the biggest and the baddest, they have the largest diameters

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9
Q

IV Cathere

14G - Orange

A

rarely used
- large amouts of fluid or blood
- trauma
- @ age 14-16 you think you are the biggest and the baddest, they have the largest diameters

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10
Q

Type of needle

Butterflys

A
  • phebotomy (lab draws)
  • one time medication administration (higher risk for phlebitis and extravasation)
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11
Q

Central Vascular Access Devices

A
  • Implanted: Huber portcath
  • External Tunneled (Hickman, Broviac, Groshong)
  • Peripherally inserted Centeral Catheter
  • Central venous catheter
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12
Q

Implanted: Huber porthcath

A
  • implanted venous port
  • purple part is surgically inserted
  • cancer pts or patients with long term needs
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13
Q

External tunneled (hickman, Broviac, Groshong)

A
  • permanent
  • in through the subclavian or the jugular
  • fluids, medications, nutrition
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14
Q

central venous catheter

A
  • placed by HCP, can be inseted by the beside
  • the patient is placed in trendelenburg
  • short term venous access
  • sutured againt the chest at the insertion site
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15
Q

Peripherally Inserted Central Catheter (PICC)

A
  • long term antibiotic use
  • inserted into the antecubital fossa or the bacilic or cephalic vein and advanced up until the catheter reaches the superior vena cava
  • pts can go home with this

dacron cuff covered in antimicrobial solution
dressing changes need to be done

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16
Q

Intraosseous Access

A
  • into the bone
  • used as a last resort in emergencies, trauma
  • physician, EMS, or flight RN initiated
  • 24 hour use
17
Q

Angiocath as a saline lock

Equipment:
- correct size angiocath
- kit: tourniquet, tape, transparent dressing, antiseptic chlohexidine, 2x2 gauze, label
- clean gloves
- j-loop with deedless connector
- 5-10mL prefilled saline syringe
- stat lock (stabilization device) if avaliable and policy
- prepare equipment with saline infused J-loop ready for connection with access

A
  1. verify the oder
  2. gather equipment
  3. identify and educate patient
    • purpose of VAD (meds, IVF, procedures)
    • to notify nurse with s/s of complications (redness, pain, swelling, bleeding, drainage/leaking)
  4. apply tourniquet & locate vein
  5. release tourniquet
  6. hand hygine and DON gloves
  7. place towel/pad under ligament of insetion site
  8. scrubsite with antiseptic and let dry
    • scrub for 30 secs. in a circular motion from clea to dirty.
    • always begin inseting the catheter in the distal part of the vein and work proximal if needed.
    • avoid dominant hand, wrist and leg and neck if possible.
  9. reapply the tourniquet 10-15 cm above the cleaned area
  10. stabilize above the vein & voice that you will stick
  11. insert needle bevel up
  12. observe for flashback and advance 1/4 in
  13. thread cannula into vein
  14. Release the tourniquet and stabalize the hub and apple pressure
  15. connect j-loop to hub of cannula while stabalizing the device
  16. flush the j-loop while securing the needle
  17. secure the site with tape and dressing
    • transparent dressing hould be over the hub (not J-loop) with insertion site covered and visible
    • label: date, time, initials
    • statlock securement device or tape
  18. document
18
Q

how long can a transparent dressing be placed and left on a stat lock?

when does it need to be changed?

A

every 5-7 days
or when its wet, soiled or the integrity of the dressing is compermised

19
Q

dressing change

A
  1. hand hygiene and DON gloves
  2. ID patient
  3. remove old IV site while securing device with nondominant hand
  4. assess if securement device needs to be changed
  5. slean site and allow to dry
  6. apply new op-site dressing
  7. secure hub and tubing with tape
  8. label dressing change
20
Q

DO NOT DO OF IV THERAPY

WHAT ARE CONTRAINDICATIONS OF IV PLACEMENTS?

A
  • do not start an IV on the same side there is AV fistual, AV shunt, A mastectomy, impairment, infection, previous infiltration with edema or infection, or blood clots.

can cause clots to form, infections, rupture

21
Q

IV Complications

A
  • Infiltration or extravasation (Scales)
  • Phlebitis or thrombophlebitis (Scales)
  • Air Embolism
  • Fluid overload
  • Cellulitis
  • Dislodgement
22
Q

Local Infiltration

A

DESCR: IV fluid enters subcutaneous tissue around venipuncture site.

CAUSE: catheter dislodged or vein ruptures

AE: skin around catheter site taut, blanched, sool to touch, edematous; painful.

NI: stop Infusion. D/C IV infusion.

23
Q

Extravasation

A

DESRC: A Vesicant fluid enters subcutaneous tissue around the venipuncture site.

CAUSE: catheter dislodged or vein ruptures

AE: Skin around catheter site taut, blanched, cool to touch, edematous; painful.

NI: stop infusion. D/C IV infusion. Give antidote if indicated. disconnect IV tubing and aspirate drug from catheter.
elevate affected extremity. avoid applying pressure over site; can force solution into contact with more tissue. contact HCP is solution contained KCL, a vasoconstrictor, or other potential vesicant. apply warm, moist or cold compress according to procedure for type of solution infiltrated. start new IV line in other extremity.

*vesicant = tissue damaging drug that will enter the tissue

example: chemotherapy

24
Q

Phlebitis

A

DESCR: Inflammation of inner layer of vein

AF:

advanced foundations (13 decks)

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