IV Therapy/ Medical Math Exam Review

Question 1

What is the purpose of IV therapy?

Answer 1

to restore and replace intravascular volume

administer meds

maintain IV access in emergency situations

actual or POTENTIAL need

Question 2

What are the INDICATIONS of the IV therapy ALS standard??

Answer 2

actual or potential need for IV meds OR fluid therapy!!

Question 3

What are the CONDITIONS for IV CANNULATION as per the ALS IV and Fluid Therapy Medical Directive?

Answer 3

age over or equal to 2 years of age!!!!!!

Question 4

What are the CONDITIONS for FLUID BOLUS as per the ALS IV and Fluid Therapy Medical Directive?

Answer 4

> = 2 years old
hypotensive!!! (<90mmHg SBP)

Question 5

What are the CONTRAINDICATIONS for IV CANNULATION as per the ALS IV and Fluid Therapy Medical Directive?

Answer 5

suspected # proximal to the access site!!!

Question 6

What are the CONTRAINDICATIONS for FLUID BOLUS as per the ALS IV and Fluid Therapy Medical Directive?

Answer 6

fluid overload of course

don’t give more fluid to overloaded fluid patients lol

Question 7

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?

Answer 7

15ml/hr

Question 8

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?

Answer 8

30-60ml/hr

Question 9

In what circumstance must we patch to BHP during the IV cannulation treatment of the ALS fluid and IV therapy medical directive?

Answer 9

for authorization to administer 0.9% saline fluid bolus to hypotensive pts 2-12 (paediatrics) with suspected DKA

Question 10

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?)

Answer 10

20ml/KG
assess every 100ml
max volume of 2,000ml

Question 11

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?)

Answer 11

20ml/KG
assess every 250ml
max vol of 2,000ml

Question 12

What are some clinical considerations in this directive??

Answer 12

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

Question 13

How do you calculate a child’s weight?

Answer 13

(age x2) +10= weight in kg

Question 14

A PCP can monitor an intravenous IV line for a pt who…..

Answer 14

1. an IV line TKVO
2. 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

Question 15

What is extracellular fluid??

Answer 15

15% of total body weight
water found outside of the cell!!

Question 16

What are the 2 diff types of extracellular fluid?

Answer 16

1. intravascular- in the blood vessel
2. intersistial - outside the vasculature but not in the tissue

Question 17

What is intracellular fluid?

Answer 17

45% of total body weight

includes all fluids IN THE CELLS

Question 18

How many body fluid compartments are there in the body?? And what percent of the body is water?

Answer 18

two areas!!!
70% of total body weight is water

Question 19

Which part of the circulatory system has valves?

Answer 19

VEINS have valves to prevent backflow

Question 20

What are the 3 layers of the veins and arteries?

Answer 20

tunica adventitia (outer)
tunica media (middle)
tunica initima (inner)

Question 21

What are macro drip sets? What sizes are there?

Answer 21

bigger drop sets

10,15,20

commonly used for TKVO and large fluid admin (bolus)

Question 22

What are micro drip sets? What are the purpose of it? What sizes is it??

Answer 22

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

Question 23

What are the parts of the administration sets?

Answer 23

insertion spike
drip chamber
macrodrip stem
roller clamp
injection ports
needle adaptor
tubing

Question 24

Why would we used micro drips?

Answer 24

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)

Question 25

What is the purpose of saline locks?

Answer 25

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

Question 26

What are the three main types of IV catheters?

Answer 26

1. Hollow needles
2. Indwelling plastic catheters over a hallow needle
3. Indwelling plastic catheters inserted through a hallow needle

Question 27

What are the catheter sizes and colours?

Answer 27

14 orange
16 grey
18 green
20 pink
22 blue
24 yellow

Question 28

What is a crystalloid solution?

Answer 28

dissolving crystals such as SALTS and SUGARS in water creates this solution, contains NO proteins

Question 29

What are examples of crystalloid solutions?

Answer 29

normal saline and lactated ringers

Question 30

What is the ACTION of the crystalloid solutions??

Answer 30

remain in the intravascular space for only a short amount of time before diffusing across the capillary walls into the tissue

Question 31

What is a colloid solution??

Answer 31

contains LARGE molecules such as PROTEIN

Question 32

What are examples if colloid solutions?

Answer 32

expanders, plasma subititutes, packed red blood cells and whole blood

plasmanate

dextran

hetastarch

Question 33

Do colloid solutions pass through the capillary membrane as readily as crystalloid solutions?

Answer 33

NO they are not as easily passed through

Question 34

Which solution causes the cells to SHRINK??

Answer 34

Hypertonic solutions

Question 35

Which solution causes the cells to SWELL??

Answer 35

Hypotonic

Question 36

Which solution keeps the cells the same inside and outside?

Answer 36

ISOTONIC

Question 37

What are the 4 things we should check while inspecting the IV solution bags?

Answer 37

1. leaks/precipitation
2. correct solution name
3. expiration date
4. cloudiness/ precipitation

Question 38

How long is each bag good for once primed??

Answer 38

24 hrs

Question 39

Once you have primed an IV bag, what do you have to write on the bag ?

Answer 39

date time name initals

Question 40

What is a common arm vein used for IV cannulation??

Answer 40

antecubital fossae (AC)

Question 41

How can we manually vasodilate veins to IV cannulate?

Answer 41

tourniquet
muscle stimulation (squeezing hand)
gravity
application of heat

Question 42

What size gauge should we use for FLUID BOLUS??

Answer 42

14-16 gauge!!! for fluid replacement, bigger is better

Question 43

What size gauge should we use for TKVO?

Answer 43

18-20 gauge (smaller is better!!)

Question 44

For CVA pts where should the IV insertion go?

Answer 44

opposite of effected side with a 20g or bigger in the AC

Question 45

Where should we avoid puncturing in trauma pts?

Answer 45

burns
# of the RT hip should have an IV on the LT arm!!
pt that needs surgery on that extremity

Question 46

What are common causes of unsuccessful IV cannulation??

Answer 46

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!!

Question 47

you are doing great!!

Answer 47

keep going :)