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Np3 > L7+8 IV Therapy > Flashcards

L7+8 IV Therapy Flashcards

1
Q

Fluid intake

A

1200mL from water
1000 from food
200 from food metabolism
=2.5L

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2
Q

Fluid intake

A

Thirst response from hypothalamus
1.Osmotic pressure decrease
2.vascular volume decrease
Causing sensation of thirst

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3
Q

Importance of electrolyte

A
  1. Maintain fluid balance
  2. Transmit neuron’s reaction
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4
Q

Type of electrolytes

A

Sodium
1. Regulate extracellular fluid
2. Maintain blood volume

Potassium
1.Regulate intracellular fluid
2. Transmitt nerve impulse
3.insulin helps move potassium into cell

Bicarbonate
1. Major buffer for acid-base regulation

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5
Q

Factors affecting body fluid& electrolyte balance

A
  1. Age
    2.gender
  2. Body size
    4.environmental temperature
    5.lifestyle
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6
Q

Age factor related to fluid & electrolyte balance

A

Infant
—) high metabolism
—) high rr
More fluid loss
Less able to conserve water

Older:
1.Thirst response weakened
—) less hydrated
2.Nephron less able to conserve water

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7
Q

Gender and body size factor related to fluid & electrolyte balance

A

Lean muscle has great amount of water content

Woman usually have more fat—) less water

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8
Q

Environmental temperature factor related to fluid & electrolyte balance

A

Fluid loss faster at hot places

Both water and electrolyte loss when sweating

Water refilled but electrolyte not: headache, anorexia, nausea

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9
Q

Liefstyle( diet, exercise, alcohol consumption)

A
  1. Malnourish ppl cause edema
    2.weight bearing exercise helps calcium balance
  2. Stress will decrease urine production
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10
Q

Fluid volume excess

A

When body retain too much water and sodium
- )hypervolemia( too much blood)
Pushing excessive fluid to interstitial muscle—) edema

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11
Q

Risk factors of fluid volume excess

A

Excess intake sodium-containing IV fluid

Excess ingest sodium in diet
—)heart failure
Renal failure
Liver cirrhosis

Manifestation
2%=mild
5%=moderate
8%=severe

Intervention
Monitor vital sign
Asses of edema
Asses of breath sound.

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12
Q

Fluid imbalance: dehydration vs overhydration

A

Dehydration
Reason: prolonged high fever
Ketoacidosis

Overhydration
Cause: drink alot of water after sweat

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13
Q

Assessment of fluid/ electrolyte imbalance-history taking

A

1.Your intake?
2.Any imbalance?—gain or lost weight
3.Any problem like swelling?
4.current medical and treatment

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14
Q

Physical assesment

A

Skin
-colour, temp, moist
(Flushed, warm, dry)

Mucous membrane
-colour, moisture
(Dry and crack)

Eye
-stiffness
(Soft to palpate)

Cardiovascular system
-hr
(Bradycardia, tachycardia)

Respiratory
-frequent
(Quick)

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15
Q

Diagnosis

A

Risk:
1. Reduced icf
2. Impaired oral mucous membrane
3. Decreased cardiac output related to hyvolemia
4. Acute confusion related to electrolyte imbalance

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16
Q

Planning for imbalance

A

1.Restore normal fluid balance
2. Restore normal electrolyte balance in ecf+icf.
3. Prevent risk associated: tissue breakdown, decreased cardiac output, confusion

17
Q

Implementation- enteral fluid 腸內液

A

can orally if
no vomit
No excessive fluid loss
No NPO
Have intact GI tract

Drink 6-8 glasses water
Avoid food in high salt, sugar and caffeine
Avoid alcohol as it is diuretic
More milk product to maintain calcium level

18
Q

Fluid intake modification-restriction

A

Place water in small containner
Provide frequent mouth care to prevent thirst
Restrict food contain sugar like candy or gum as it produce thirst

19
Q

Fluid intake modification-dietary change

A

Oral supplements
Sodium supplement
Potassium supplements
Calcium supplements

20
Q

Parental-IVF

A
  1. Intravenous fluid is need ed when client not able to take sufficient food & fluid orally
  2. Provide salt + other nutrients to maintain electrolyte balance
  3. Rapid rescue for medication or blood transfusion
21
Q

Iv fluid saturation

A

Hypotonic 0.45% normal saline
Isotonic 0.9% normal saline
Hypertonic 5% normal saline

22
Q

IVF equipment

A

IVF catheter
1. With different gauze size
2. Less than 72hr

Butterfly
1.needle with plastic flaps
2. Less than 24hr

23
Q

Venipuncture site
Dos and dont

A

Usually on arm
Most distal site to make sure IVF move up

Yes:
Easily palpate and soft
Naturally hold by bones

NO:
Highly visible( will slip from needle)
Damaged by previous use
Flexible site

24
Q

Ivf-central venous access device

A

For long term iv therapy
Promote freedom of ambulation
BUT greater risk at hemothorax, pneumothorax, cardiac perforation, thrombosis

AT SUBCLAVIAN VEIN

25
Q

Ivf- peripherally inserted central venous catheter

Insertion

A

At basilic vein above or under antecubic space

26
Q

Caring from cvad

A

1.Make sure it is aseptic & catheter patency
2.Change dress ing per 48hr
3.Any redness swelling tenderness of the site
4. Educate not to let anyone take bp from picc hand
5. PICC arm should not immerse in water

27
Q

Ivf-drip set precautions

A

1.Type and amount of solution
2.Exact amount of medication to be added
3.rate of flow

28
Q

Infusion pump

A

A machine deliver iv fluid to very young or old client with positive pressure accurately

29
Q

Accident of infusion therapy

A

Infiltration
Extravasation
Phlebitis

30
Q

Infiltration

A

Accidental administration of medicine or fluid into subcutaneous tissue, caused by
1. Puncture of vein when venipuncture
2.dislodgement of catheter
3. Poorly secured infusion device

31
Q

Extravasation

A

Accidental drug administered in subcutaneous tissue

32
Q

Extravasation

A

Accidental drug administered in subcutaneous tissue

33
Q

Phlebitis

A

Inflammation of vein
1. Mechanical phlebitis
Too large catheter to a small vein

  1. Chemical phlebitis
    When a vein is inflamed by medicine or drug that is irritating
  2. Bacterial phlebitis
    Inflammation of vein and bacteria infection
    Cause by poor aseptic technique during insertion
34
Q

Prevention of infiltration/ extravasation/ phlebitis

A

1.Avoid venipuncture at joint flexion places
2. Use manufacture stabilization to avoid unnecessary movement causing injury
3. Take hand hygiene and perform aseptic technique

35
Q

Blood product for transfusion

A

Whole blood: rare and only for acute hemorrhage

Packed rbc: to increase oxygen up-taking ability

Autologus : slef donate for surgery later

Platelet: for bleeding disorder or platelet deficiency.

36
Q

Transfusion reaction

A

If have allergic response: immediate stop and continue the line of new normal saline

Np3 (4 decks)

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