IV Therapy/ Medical Math Exam Review Flashcards
What is the purpose of IV therapy?
to restore and replace intravascular volume
administer meds
maintain IV access in emergency situations
actual or POTENTIAL need
What are the INDICATIONS of the IV therapy ALS standard??
actual or potential need for IV meds OR fluid therapy!!
What are the CONDITIONS for IV CANNULATION as per the ALS IV and Fluid Therapy Medical Directive?
age over or equal to 2 years of age!!!!!!
What are the CONDITIONS for FLUID BOLUS as per the ALS IV and Fluid Therapy Medical Directive?
> = 2 years old
hypotensive!!! (<90mmHg SBP)
What are the CONTRAINDICATIONS for IV CANNULATION as per the ALS IV and Fluid Therapy Medical Directive?
suspected # proximal to the access site!!!
What are the CONTRAINDICATIONS for FLUID BOLUS as per the ALS IV and Fluid Therapy Medical Directive?
fluid overload of course
don’t give more fluid to overloaded fluid patients lol
What are the INFUSION RATES for maintenance infusion rate of someone aged >= 2 yrs old - <12 yrs old as per the ALS IV and Fluid Therapy Medical Directive?
15ml/hr
What are the INFUSION RATES for maintenance infusion rate of someone aged >=12 yrs old as per the ALS IV and Fluid Therapy Medical Directive?
30-60ml/hr
In what circumstance must we patch to BHP during the IV cannulation treatment of the ALS fluid and IV therapy medical directive?
for authorization to administer 0.9% saline fluid bolus to hypotensive pts 2-12 (paediatrics) with suspected DKA
What are the INFUSION RATES for a FLUID BOLUS rate of someone aged >= 2 yrs old - <12 yrs old as per the ALS IV and Fluid Therapy Medical Directive? (= the max volume and assess every ____mLs?)
20ml/KG
assess every 100ml
max volume of 2,000ml
What are the INFUSION RATES for a FLUID BOLUS rate of someone aged =>12 yrs old as per the ALS IV and Fluid Therapy Medical Directive? (= the max volume and assess every ____mLs?)
20ml/KG
assess every 250ml
max vol of 2,000ml
What are some clinical considerations in this directive??
micro drips should be considered for IV access in pts <12 y/o
PCP IV assist- an ACP can ask a PCP to cannulate an IV, but not administer any meds or fluid therapy
IV access should be considered for pt’s who do not meet the trauma TOR criteria
How do you calculate a child’s weight?
(age x2) +10= weight in kg
A PCP can monitor an intravenous IV line for a pt who…..
- an IV line TKVO
- an IV line for fluid replacement - with a max vol of 200ml/hr
- thiamine, multivitamin preparations
- drugs within his or her certification
- potassium chloride for pts >= 18 years old to a max pf 10mEq in a 250mL bag
What is extracellular fluid??
15% of total body weight
water found outside of the cell!!
What are the 2 diff types of extracellular fluid?
- intravascular- in the blood vessel
- intersistial - outside the vasculature but not in the tissue
What is intracellular fluid?
45% of total body weight
includes all fluids IN THE CELLS
How many body fluid compartments are there in the body?? And what percent of the body is water?
two areas!!!
70% of total body weight is water
Which part of the circulatory system has valves?
VEINS have valves to prevent backflow
What are the 3 layers of the veins and arteries?
tunica adventitia (outer)
tunica media (middle)
tunica initima (inner)
What are macro drip sets? What sizes are there?
bigger drop sets
10,15,20
commonly used for TKVO and large fluid admin (bolus)
What are micro drip sets? What are the purpose of it? What sizes is it??
60
to deliver meds over a long period of time
assist in the precise measurement of meds (dopamine)
control the amount of fluid for easily overloaded patients
(peds. and elderly/CHF)
margin of error is LESS with micro sets in vulnerable pts
What are the parts of the administration sets?
insertion spike
drip chamber
macrodrip stem
roller clamp
injection ports
needle adaptor
tubing
Why would we used micro drips?
to deliver meds over a long period of time
regulate the flow of meds precisely
to control the amount of fluid- such as in children and the elderly
for TKVO in pt’s when fluid overload is a concern (CHF)
What is the purpose of saline locks?
no tubing to worry about
easy to move pt
still allows quick access to vein
more cost effective
greater freedom to pt/more mobile
reduces fluid overload
What are the three main types of IV catheters?
- Hollow needles
- Indwelling plastic catheters over a hallow needle
- Indwelling plastic catheters inserted through a hallow needle
What are the catheter sizes and colours?
14 orange
16 grey
18 green
20 pink
22 blue
24 yellow
What is a crystalloid solution?
dissolving crystals such as SALTS and SUGARS in water creates this solution, contains NO proteins
What are examples of crystalloid solutions?
normal saline and lactated ringers
What is the ACTION of the crystalloid solutions??
remain in the intravascular space for only a short amount of time before diffusing across the capillary walls into the tissue
What is a colloid solution??
contains LARGE molecules such as PROTEIN
What are examples if colloid solutions?
expanders, plasma subititutes, packed red blood cells and whole blood
plasmanate
dextran
hetastarch
Do colloid solutions pass through the capillary membrane as readily as crystalloid solutions?
NO they are not as easily passed through
Which solution causes the cells to SHRINK??
Hypertonic solutions
Which solution causes the cells to SWELL??
Hypotonic
Which solution keeps the cells the same inside and outside?
ISOTONIC
What are the 4 things we should check while inspecting the IV solution bags?
- leaks/precipitation
- correct solution name
- expiration date
- cloudiness/ precipitation
How long is each bag good for once primed??
24 hrs
Once you have primed an IV bag, what do you have to write on the bag ?
date time name initals
What is a common arm vein used for IV cannulation??
antecubital fossae (AC)
How can we manually vasodilate veins to IV cannulate?
tourniquet
muscle stimulation (squeezing hand)
gravity
application of heat
What size gauge should we use for FLUID BOLUS??
14-16 gauge!!! for fluid replacement, bigger is better
What size gauge should we use for TKVO?
18-20 gauge (smaller is better!!)
For CVA pts where should the IV insertion go?
opposite of effected side with a 20g or bigger in the AC
Where should we avoid puncturing in trauma pts?
burns
# of the RT hip should have an IV on the LT arm!!
pt that needs surgery on that extremity
What are common causes of unsuccessful IV cannulation??
angle of entry too steep (cut through the vein)
not enough tension on skin (vein rolls)
attempting while in a HURRY (vehicle moving, PLAN ahead!!)
stylet not retracted enough during disconnection phase (cuts through vein while advancing the catheter)
lack of confidence and experience, poor vein location!!
you are doing great!!
keep going :)
