LEC 3: IV Starts Flashcards
Is starting an IV a medical asepsis or surgical asepsis procedure?
Starting an IV is a clean procedure
- Clean gloves and sterile procedure
What are common IV sites?
- Hands
- Antecubital Fossa
- Feet
Starting an IV Site
- Start distally
- Use non-dominant arm
- Want a vein that is easily palpable and feels soft and full
Want vein to be large enough to allow good circulation around catheter - Patient preference
Why do you want to start an IV distally and work your way up?
You can move up if vein does not work
- If you start higher, you can’t go down down due to leaky veins
What are common sites to avoid when starting an IV?
- Avoid sites easily moved/ bumped
- Knees
- Avoid wrist or any area that bends, may occlude veins
- Avoid dominant hand
- Avoid bifurcation veins
- Avoid starting an IV in the side where patient has had a mastectomy
- Avoid starting an IV on patients who are in dialysis
What are tips for starting an IV?
- Proper lighting
- Get patient to pump hands
- Apply heat to ares you want to start IV
- Lower arm down below heart level
- Use a tourniquet at 10 to 15 cm away from IV site
How far away do you need to place the tourniquet from incursion site for IV?
10 to 15 cm away
How many tried do you get to start an IV?
The Health Car Region says you get two tries before needing to get someone else to start the IV
Normal Saline Lock
- Is out connection/ access; how we can administer drugs
- Need to clean saline lock with alcohol swap for 15 seconds before administrating anything
- Need to flush the saline lock with saline every 24 hours or before giving medications
- Should feel no resistance
- Patient should feel no pain and no swelling
Why do you flush saline within the saline lock every 24 hours?
- Too make sure that the IV is still in the vein
- ## Too ensure there are no kinks
How much saline should you flush through a saline lock?
3 mL of saline
Documenting your IV Start
- The size of needle gauge you used
- Location
- Patient tolerance
- How you secured it
- How many attempts it took if first time was unsuccessful
- What you administered and the amount
- Component is CVS
Needle Gages
- The smaller the gage, the larger the diameter
- The larger the gage, the smaller the diameter
- Most common gage is 20 gage
Body Fluid Compartments
- Intracellular (67%)
- Extracellular (32%)
- Intravascular (8%)
- Interstitial (24%) - Transcellular (1%)
Intracellular Fluid
Fluid inside the cells
- counts for 67% of fluid
Extracellular Fluid
Fluid outside of cells
- Counts for 32% of fluid
a. Intravascular fluid: Fluid in the blood vessels (8%)
b. Interstitial fluid: Fluid between the blood vessels (24%)
Transcellular Fluid
Aqueous humor, CSF, and CVS
- Counts for 1% of fluid
Cellular Plasma Membranes: Barrier
Conditions inside are different than outside
Cellular Plasma Membranes: Permeability
Cells are selectively permeable Selective
Cellular Plasma Membranes: Selective Permeable
Permits free passage of some material and restricts others
Cellular Plasma Membranes: Passive Process
No energy expenditure by cell
Cellular Plasma Membranes: Active Process
Energy expenditure by the cell
Osmolality
Total solute concentration in an aqueous solution
- The concentration of molecules/ ions in a liquid solution inside the body
Tonicity
Cells affected by the osmolality of fluid around them
What are the three types of tonicity?
- Isotonic solution
- Hypertonic solution
- Hypotonic solution
Isotonic Solution
Two solutions having the same osmotic pressure across a semipermeable membrane. This state allows for the free movement of water across the membrane without changing the concentration of solutes on either side
- Cell stays the same
Hypotonic Solution
The concentration of solutes is greater inside the cell than outside of it
- The cell will expand
Hypertonic Solution
The concentration of solutes is greater outside the cell than inside it. Fluid will leave the cell and go into interstitial space
- The Cell will shrink
What will happen to the cells if the solution is isotonic?
The cell will stay the same size
What will happen to the cells if the solution is hypotonic
The cell will expand/ swell
What will happen to the cells if the solution is hypertonic?
The cell will shrink
Fluid IV and Electrolyte Replacement: Isotonic
- 0.9 NS
- D5W
- LR
Fluid IV and Electrolyte Replacement: Hypertonic
- D5NS
- D5 1/2 NS
Fluid IV and Electrolyte Replacement: Hypotonic
- 0.45% NS
How do you know if you inserted the needle catheter in a vein?
Will have flash back
- Blood will fill up
