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IV therapy > IV therapy test 3 > Flashcards

IV therapy test 3 Flashcards

1
Q 
Shorter Cath 
Sterile 
subclavian to Superior Vena Cava /internal/external Jugular
or femoral vein to Inferior Vena cava 
Shorter term use
Right Side
A

Centrally inserted catheters

Regular central line

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2
Q 
longer catheter
Sterile 
AC(median), basilica or cephalic of upper arm into Superior Vena Cava 
Longer Term
Home care
A

Peripherally inserted central catheter PICC

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3
Q 
Subcutaneous implanted device 
advantages of central lines with out Cath exposed outside the skin 
Medi-port, Infus-a-port, Port-a-cath 
Superior vena Cava via subclavian 
Sterile
Special hook or L shaped needle (Huber)
A

Centrally implanted ports

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4
Q

the path to the SVC is less torturous and associated with lesser chance of tension pneumothorax that from left side

A

the right side placement is best in central catheters

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5
Q

in the position of a central or peripheral line they should

A

terminate in the superior vena cava within 3-4 cm of the junction of the superior vena cava with the Right Atrium

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6
Q

where should the terminal line terminate

A

in the inferior vena cava

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7
Q

what must be done to confirm placement before using a peripheral or central line

A

Xray

cant use until Doctor read and confirmed in the right place and is ready to use

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8
Q

can happen during insertion, tubing change or removal

A

air embolism

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9
Q

puncture of an artery by the needle or guide wire during insertion

A

Arterial Laceration

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10
Q

d/t perforation of the pericardium by Catheter

A

cardiac tamponade

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11
Q

breakage of a portion of the Central venous Cath

A

Catheter embolism

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12
Q

dislodgment outside the superior vena cava

A

catheter malposition

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13
Q

blood or air accumulation in the pleural cavity d/t perforation of the pleura or vessel laceration during insertion

A

hemothorax or pneumothorax

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14
Q

to the cervical and upper dorsal spinal nerves that supply the arms and hands

A

Nerve injury

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15
Q

An air embolism is a __ major complication

A

Preventable

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16
Q

a central or peripheral catheter shouldn’t rest In the Right Atrium as it could traverse the SA node and cause ___ or become entrapped in the ___ valve and cause valvular damage that may require replacement surgery

A

dysrhythmias

tricuspid

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17
Q

in Air bolus effect a ___ ml/sec influx, breach in a ___ g Central venous Catheter in a client sitting in a ___ position. The bolus of air proceeds to the __ where it lodges against the ___ valve and blocks ___ blood flow

A 
100
14
upright 
heart 
pulmonic 
pulmonary
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18
Q

The treatment for air bolus effect is

A 
immediately Left trendelenburg position 
clamp central venous catheter 
02@ 100% 
monitor VS 
Call physician
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19
Q

prior to the insertion of the central venous catheter the client should be instructed to perform the ___ to reduce the risk of an air embolism

A

valsalva maneuver (gotta shit)

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20
Q

Lumens are usually __ coded, with __ and __ stated on the line

A

color
name
size

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21
Q

this port is used in high volume or viscous fluids, medications. Its the largest lumen and close to the heart

A

Distal port

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22
Q

this port is used for blood sampling

A

proximal port

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23
Q

Reserved exclusively for TPN

If TPN Isn’t used may deliver meds through this port

A

Medial Port

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24
Q

this port should be used for fluids or medications

A

fourth lumen

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25
Q

Each lumen should be ___ according to its ___ use.

A

labeled

intended

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26
Q

CDC recommends at least __ changes to the dressing and replacement of the dressing if it becomes __, __, __, __or if inspection of the site requires removal of the dressing

A 
weekly 
soiled
damp
wet
loosened
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27
Q

Long term complications are often the result of __ catheter care or the clients ___ situation

A

inadequate

clinical

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28
Q

With catheter site management clean skin is to be disinfected using ___, preferably, or tincture of ___ or ___ and allowed to air dry

A

chlorhexidine
iodine
70% alcohol

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29
Q

One of the most important mechanisms used to maintain the latency of the central line and prevent occlusion

A

flushing/irrigating a Central Venous Catheter

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30
Q

during flushing or irrigating if resistance is felt __ irritant into the vessel, results in thrombus embolism

A

never force

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31
Q

With flushing and irrigation of a central venous catheter never use less than a ___ ml syringe to irrigate, smaller barrel syringe generate more ___ that larger ones

A

10

pressure

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32
Q

What type of method do we use other than continuous pressure

A

push pause method

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33
Q

when locking the line it must be ___ to maintain patency if not in use which prevent __ formation; its done every __ hours for canals not in use.

A

heparinized
thrombus
8-12

34
Q

When drawing blood from the Central Venous catheter infusates need to be turned __ for ___ before drawing blood for ___ or ___

A

off
1 full minute
glucose
electrolytes

35
Q

blood draws should be done from the ___

A

proximal port

36
Q

If an infusion has been running, after the infusion is stopped for ___ full minute, the line is flushed with __ ml NS using Push pause method ___ ml of blood is drawn from the line and ___

A

1
10
5-10
discarded

37
Q

A soft medical grade silicon catheter with a __ near the exit site that __ it in place and acts as a securing device and __

A

Cuff
Anchors
Microbial barrier

38
Q

The proximal end of the catheter is __ in the ___ tissue to an exit site on the anterior or posterior trunk of the body

A

Tunneled

Subcutaneous

39
Q

The central venous tunneled catheters care is a __, except that there are ___ to care for. methods of __, ___. Are the same as for non-tunneled Central venous catheters

A

Central line
Skin incisions
Flushing
Heparinizing

40
Q

The brands of central venous tunneled catheters

A

Broviac
Hickman
Leonard
Groshong

41
Q

Piccs are used for administration of

A

Fluids
Blood
Meds

42
Q

A picc line can stay in place for __ weeks or a __, to be __ effective; therapy should be required for ATLEAST __ days

A

1-12
Year
Cost
7

43
Q

Picc lines are used for ___ sampling, ____ and ___ administration

A

Blood
Chemotherapy
TPN

44
Q

Risks with the picc lines are arm __ d/T limited __, bleeding normal within the first ___ hrs of placement, ___, infusion pain, ____, fluid leakage, catheter malposition, catheter occlusion, stuck catheter

A 
Edema 
ROM
24
Phlebitis 
Thrombophlebitis
45
Q

Picc dressings changes are done usually every __ days or __ when the dressing is __, ___ or ___.

A 
7 
PRN
Loose 
Wet
No occlusive
46
Q

Flushing of the picc line is done with ___, followed by ___ based on policy

A

0.9% NS

Heparin

47
Q

Subcutaneously implanted advantages are that the port is palpated under the skin. Under sterile technique, the port is accessed. ___ is applied, a ___ needle is used to access the port, inserted at a __ angle (L shaped) the port is flushed and blood withdrawn to confirm __ dressing is ___

A 
Betadine
Huber
90
Patency 
Tegaderm
48
Q

Formally known as hyperalimentation, also known as center As parenteral nutrition

A

Total parenteral nutrition TPN

49
Q

Typical indications for TPN

A 
Bowel surgery 
Bowel rest 
Pancreatitis 
IBD
OBSTRUCTION 
chronic weight loss
Coma
Hepatic or renal failure 
Malnutrition 
Multiple trauma
50
Q

The TPN solution is patient ___, taking into consideration ___ and ___ status, stress factors and renal competency

A

Specific

Nutritional metabolic

51
Q

TPN can be administered ___ or ___; bulk of TPN given durning __ and __ hours, remainder of nutrients given Orally in the ___

A 
continually 
cyclically 
evening 
night 
day
52
Q

TPN solution usually contains ___ (amino acids), sugar (___10%-70%), ___ = ___ solution that usual IVF’s

A

protein
dextrose
lipids
thicker

53
Q

TPN solutions can include other substances like ___, ___, ___ and trace ___.

A

electrolytes, minerals, vitamins, elements

54
Q

TPN can only be given in the ___

A

medial port

55
Q

Nurse administering TPN is responsible for reviewing the clients

A 
weight
height
nutritional status
diagnosis 
current lab values prior
56
Q

Rapid infusion of hypertonic dextrose may result in ___, ___, ___or a ___ coma

A

diuresis
hyperglycemia
glycosuria
hypersomolar

57
Q

TPN lipid containing solutions (3-1) must complete the infusion within ___ of hanging; The lipid ONLY infusion must be complete within ___ of hanging (___ hours if volumes require longer time)

A

24
12
24

58
Q

If Breaking out or oiling out - separation and yellowish streaking or accumulation of yellow droplets in the emulsion occur what must the nurse do

A

Do not administer and discard

send back to pharmacy and request another

59
Q

With lipids you DO NOT use ___, because fat molecules are too large to pass through

A

Filters

60
Q

The initial rate of administration of TPN should be ___ for he first __ minutes. Then increase to ___. No more than ___ should be administered to an adult in the first ___ of therapy. Thereafter rate should not exceed ___

A 
1ml/min
15-30
2ml/min
500ml 
24
2.5G/kg/day
61
Q

Should the infusion of TPN get behind schedule DO NOT __ causes ___ and ___

A

speed up to catch up
hyperglycemia
metabolic complications

62
Q

when administering TPN use an ___ using a special ___, monitor fusion every ___, vital signs q __ and ___, obtain daily __ with strict ___

A 
infusion pump 
filter 
30-60 minutes
4 
PRN
weight 
I&O's
63
Q

When discontinuing TPN adequate oral intake must be assessed __ TPN can be stopped, ___ must occur to prevent ___; done over ___ period by gradually ___ the volume of TPN while monitoring Patient response

A 
before 
weaning 
rebound hypoglycemia 
24-48 hour
decreasing
64
Q

Method of giving diluted solutions of protein and calories in a peripheral IV site is ___, consists of nutritional support of __ and ___ and ___ lipid content, either given with the __ and ___ or ___

A 
PPN Peripheral Parenteral Nutriton 
amino acids 
dextrose 
10-20%
protein 
sugar 
separately
65
Q

PPN are used for stable clients who’s GI feedings will be ___, its used for persons who have __ intake but refuse an ___ feeding tube

A

reestablished quickly
poor
Enteral

66
Q

PPN is mildly ___ 10% dextrose and can be administered via a large ___ vein rather than a central ___. Short term therapy lasting less than __ weeks usually __ days

A 
hypertonic 
peripheral 
vessel 
3-4
5-14
67
Q

Documentation includes ___ of Parenteral nutrition solution, ___ and ___ for infusion, Site ___ before and ___ infusion
___ of the catheter __ before, ___, and after infusion, all __ used, ___ and ___ of tubing ___ , any ___ or ___ or ___ experienced before, during or after the infusion and any action used to ___ problem, daily ___ and accurate ___, all client and caregiver ___ and ___ teachings

A

components, infusion rate, equipment used, assessment
during, observations, patency, during, supplies, date, time
changes, complaints, discomforts symptoms
correct/address
weight/ IO’s
education, discharge

68
Q

The electrolyte imbalances that are common with Parenteral infusions are

A

K
P
MG

69
Q

indications for long term IV therapy central lines

A
70
Q

Picc line most preferred line

A

basilic

71
Q

central line, flushing what size syringe

A

10cc

72
Q

how do you flush

A

push pause

73
Q

why is it important for tip not to go into right atrium or tricuspid valve

A

dysrhythmias

74
Q

to prevent a air embolism when we manipulate central line

A

bear down

75
Q

access in femoral vein tip lies

A

inferior venacava

76
Q

central line dressing change

A

7 days

77
Q

reduce risk of air embolism what position

A

supine

78
Q

subcutaneous implant ports

A

under the skin, nothing exposed when not in use, access with huber needle

79
Q

3 lumens

A

distal - meds, fluids
medial -TPN
proximal - blood

80
Q

why need blood

A

hemorrhage
anemia
replacement

IV therapy (2 decks)

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