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Comps > IV Tx > Flashcards

IV Tx Flashcards

1
Q

4 personnel authorized to administer IV Fluids?

A

RN, SN, Certified LVN, Affiliating Nurse Faculty

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2
Q

3 purposes for IV therapy?

A

Replace past + present fluid loss; provide maintenance fluids; provide parenteral route for meds, blood, and nutrients

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3
Q

Plastic overwrap for IV solution bag removed 10/30. Can this solution be saved until 11/15 ?

A

No. Open overwrap IV solution bag expire at end of shift.

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4
Q

Who must be notified when IV solutions are noted to be cloudy, crystallized, colored, or coagulated?

A

Pharmacy

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5
Q

Policy states that IV solutions should be changed q

A

q 72 hours

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6
Q

Per policy, licensed personnel who are IV certified may only administer IV solutions mixed by whom?

A

themselves and Pharmacy

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7
Q

Where does one find information regarding drug incompatibility?

A

Pharmacy, drug information, pharmacology references, micromedex

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8
Q

What assessments should be made when a patient is receiving potassium in the IV solution?

A

Serum potassium level, urine ouput

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9
Q

IV solution mixed by the nurse must be administered within what time frame?

A

by end of shift

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10
Q

How often must continuous primary IV tubings be changed?

A

q 96 hours

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11
Q

What does drop factor mean?

A

Number of drops per mL

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12
Q

How can one find out the drop factor of an administration set?

A

on the IV tubing packaging

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13
Q

What is the drop factor of a microdrip set?

A

60 gtt/mL

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14
Q

What is the drop factor of a macrodrip set?

A

15 gtt/mL

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15
Q

What is the drop factor of Alaris pump tubing?

A

20 gtt/mL

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16
Q

Infant/Children < 10 kg Formula for calculating Fluid requirements

A

100 mL/kg/day

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17
Q

Infant/Children 11-20 kg Formula for calculating Fluid requirements

A

1000 mL/ 1st 10 kg / day + 50 mL/ addt’l kg /day

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18
Q

Infant/Children > 20 kg Formula for calculating Fluid Requirements

A

1500 mL / 1st 20 kg / day + 20 mL / addt’l kg / day

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19
Q

Child wt 15 kg. How many mL for IV fluid per day?

A

1000 + (50 x 5) = 1000 + 250 = 1250 mL/day

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20
Q

4 saftey factors that must be adhered to prior to IVPB medication administration.

A

check site + patency, pt allergy + med incompatibility, expiration date, warm at room temp 1 hr prior

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21
Q

How often must IVPB tubings be changed?

A

q 24 hr for intermittent

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22
Q

2 exceptions for changing continuous IV tubing q 24hrs

A

TPN, experimental drugs, contaminated, precipitates, drug required it, change in concentration

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23
Q

T/F All RNs are approved to administer medication via IVP

A

False. Need orientation + approved per Unit Structure Standard

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24
Q

T/F State Certified LVNs can administer drugs via continuous infusion.

A

False. Not even if certified.

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25
Q

What must be included in a physician’s order for drugs to be administered by continuous infusion?

A

Name drug, Rate infusion, Duration infusion, con’t or titrating dose, titrating or discontinue parameters

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26
Q

The amount of flush solution instilled in a heparin/saline LOCK

A

1-3 mL; 3 mL NS adults; 1-3 mL NS + 1-3 mL heparin (10 units/mL) Peds

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27
Q

Infusion pumps must be utilized for pts who are receiving

A

all/any infusion

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28
Q

Gauge size for infants, slow flow rate.

A

24 G Yellow

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29
Q

Gauge size for most infusion, most ages.

A

20 G Pink or 22 G Blue

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30
Q

Gauge size for blood administration.

A

18 G Green

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31
Q

Gauge size for large vol, trauma or surgery pts

A

16 G Gray

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32
Q

Venipucture sites

A

Cephalic + Basilic, median cephalic, median cubital, median ante-, Dorsal Venous Arch, Metacarpal, Digital Vein

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33
Q

Do NOT use peripheral veins because

A

Interfere with ambulation, vascular insufficiency, Infection; exception in Peds/Neonate ok BLE + scalp

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34
Q

How often must the MD reorder IV solutions with additives?

A

q 24 hrs

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35
Q

Are TKO rate orders acceptable?

A

No. MD need to specify rate for “To Keep Open”

36
Q

3 factors to consider when selecting IV needle/cannula?

A

purpose, pt. population, condition of available vein, type of solution

37
Q

6 factors to consider when selecting IV sites

A

pt age, pt activity, type of solution, previous illness, surgery, or anticipated procedure; available vein; pt preference; anticipated duration of tx

38
Q

T/F Licensed nursing personnel authorized to administer IV tx start an IV in the jugular vein in an emergency?

A

False. Only MD can.

39
Q

5 techniques that may augment vein distention?

A

fist formation; dependent position; milking; gentle tapping; relaxation

40
Q

BEST solution to clean an IV insertion site

A

Antiseptic Chlorohexidine or povodine iodine to decrease skin flora

41
Q

How many times may the licensed personnel attempt to start an IV on any one pt?

A

3 times max

42
Q

2 methods that may be utilized when inserting an IV needle/cannula?

A

Direct one step + Indirect 2 step

43
Q

Gauze dressings are changed every

A

48 hours

44
Q

Transparent dressings are changed every

A

96 hours

45
Q

T/F State certified LVNs can change central line dressings

A

True. LVN that is state certified can do it.

46
Q

3 nursing responsibilities related to ensuring safety during venipuncture.

A

standard precaution, do NOT recap needle, discard contaminated supplies appropriately

47
Q

Systematic method of examining the IV system is to start from (x) and following the tubing to the (x).

A

Container to insertion site

48
Q

6 things the nurse should assess if IV infusion stops

A

bottle to low, fluid level, drip chamber, kinked tubing, infiltration, IV needle placement

49
Q

You may irrigate an IV?

A

No. Never irrigate an IV.

50
Q

IV system should be checked every (x) for adults

A

2 hours

51
Q

IV system should be checked every (x) for Peds

A

1 hr

52
Q

T/F When removing IV needle/cannula, an alcohol swab should be placed over the insertion site?

A

False. Use a dry 2x2 dry steril gauze

53
Q

Where must administration of IVPBs be documented?

A

MAR; diluent used for mixing IVPB is documented on I&O’s

54
Q

Primary purpose of administering TPN is to provide (x) intraveneously

A

Nutrients

55
Q

Peripheral TPN contains (x) Dextrose concentration.

A

< 12.% Dextrose

56
Q

Central TPN contains (x) Dextrose concentration.

A

> 25% Dextrose

57
Q

Central TPN may be infused into a perpheral vein?

A

No. Central TPN for central vein only

58
Q

T/F Fluid, electrolytes, and glucose should be evaluated during TPN administration.

A

TRUE

59
Q

TPN Recording is q

A

q 24 hrs

60
Q

TPN administration set change is q

A

q bottle/bag and q 24 hrs

61
Q

TPN solution/bag change is q

A

q 24 hrs

62
Q

TPN content inspection is q

A

q prior to inspection and during administration

63
Q

If TPN infusion rate is behind schedule, rate should be (x) to catch up?

A

Do NOT catch up.

64
Q

Which IV solution should be hung when TPN is NOT available?

A

D5W or D10W whichever is the closest match to the prescribed TPN dextrose concentration.

65
Q

T/F Electrolyte disturbances can cause cardiac and neuromuscular abnormalities.

A

True. Monitor EKG, dysrhythmias. Hypokalemia s/s flat/inverted T waves, U wave, ST depression; Hyperkalemia s/s Peaked T wave, loss of P wave, prolonged PRI, widened QRS; neuromuscular s/s muscle weakness, paresthesia, spasms, tetany

66
Q

Potassium normal serum level.

A

3.5 - 5.1 mEq/L

67
Q

Magnesium normal serum level.

A

1.7 - 2.3 mg / dL

68
Q

Phosphorus normal serum level.

A

2.5 - 4.5 mg / dL

69
Q

K+ can be given IVP

A

Nope. Never IVP

70
Q

K+ is usually administered at 10 mEq/ hour peripherally?

A

Yes.

71
Q

K+ is best infused in a peripheral vein?

A

No. K+ is an irritant. Best to use central vein

72
Q

As an IV additive, the max dose of magnesium is

A

6 gm/24hrs

73
Q

As an IV additive, the max dose of potassium is

A

40 mEq/24hrs

74
Q

How fast can you administer potassium?

A

no faster than 20 mEq/hour via central line; no faster than 10 mEq/hr via peripheral line.

75
Q

What is the usual dose for potassium phosphate infusion in acute care units?

A

15 mmol over 8 hrs; 30 mmol over 12 hrs; max 30 mmol/24 hrs in acute care

76
Q

MD order for iV electrolyte replacement must include

A

dose, duration, parameters, weight, complete drug name

77
Q

When do you evaluate electrolyte values with IV electrolyte replacement therapy?

A

evaluate during and after therapy.

78
Q

T/F Continuous cardiac and electrolyte monitoring is required for IV electrolyte replacement?

A

True. Monitor continuously.

79
Q

Electrolytes infusion given for replacement therapy may be mixed in (x)

A

500 mL or less of compatible IV solution

80
Q

T/F Can administer potassium phosphate via same IV line, port furthest to the pt?

A

False. No. Use separate IV line with port closest to pt. when administering potassium phosphate

81
Q

T/F potassium phosphate precipitates in dextrose and saline?

A

False. Potassium phosphate precipitates in most solutions EXCEPT Dextrose and Saline.

82
Q

T/F Ok to administer potassium phosphate IVP?

A

False. Never. May cause lethal dysrhythmia and death.

83
Q

Magnesium sulfate usual dose is

A

1-4 g (1 g over 4 hours in acute care)

84
Q

Max magnesium sulfate dose is

A

6 gm/24hrs

85
Q

T/F When administering electrolytes, it is important to use infusion pumps.

A

True. Use infusion pumps for electrolyte administration.

86
Q

T/F When administering electrolytes, it is important to monitor lab values.

A

True. Monitor lab values with electrolyte administration.

87
Q

T/F Administering electrolytes, it is important to assess cardiac and neuromuscular effects.

A

True. Monitor cardiac and neuromuscular effects with electrolyte administration.

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