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Dosage - Exam 2 > Lecture 11 > Flashcards

Lecture 11 Flashcards

sterile liquid formulations (2/13)

1
Q

vascular access devices

A

peripheral (needle, over-the-needle catheter) and central (peripherally-inserted central catheter - PICC, surgically implanted)

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2
Q

peripheral access - administration sets

A

basic set
add-a-line set
volume control set

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3
Q

basic set

A

piercing spike –> drop orifice –> drip chamber –> roller camp –> y site –> luer-lock adapter

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4
Q

add-a-line set

A

piercing spike –> drop orifice –> drip chamber –> backcheck valve –> luer-lock adapter –> y site –> roller clamp –> y site

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5
Q

volume control set

A

piercing spike –> roller clamp –> volume control chamber –> drop orifice –> drip chamber –> y-site –> needleless adapter

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6
Q

IV administration sets

A

macrodrip
microdrip

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7
Q

macrodrip

A

delivers large quantities
faster rates
10,15, or 20 drops per mL

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8
Q

microdrip

A

delivers smaller amounts
60 drop per mL
used in pediatrics
patients who need small or closely regulated amounts of IV solution

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9
Q

drop conversion factor

A

drop number
initial educated guess
seldom the exact converrsion factor for actual parenteral preparations

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10
Q

Poiseuille’s Law

A

rate = driving force/resistance
Q = delta(P)pi(r^4) / 8nl

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11
Q

components of resistance to flow

A

tubing (macrobore vs microbore)
in-line filter (may or may not be used)
viscosity of IV fluid
length of tubing
venous backpressure

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12
Q

acutal number of drops/mL depends on

A

viscosity of the CSP
surface tension
density

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13
Q

peripheral access

A

butterfly needle
over the needle catheter

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14
Q

central venous therapy

A

infusion of large volume of fluid
multiple infusions
long term infusion therapy
infusion or irritating medications like potassium
infusion of fluids of high osmolarity
parenteral nutrition (PN)

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15
Q

central lines

A

peripherally inserted central catheter - PICC
two common names - Hickman and Broviac

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16
Q

PICC line steps

A
  1. prep acess and introduce the thinwall percutaneous entry needle into the vessel
  2. using guidance, introduce the wire guide through the needle 15 to 20cm into the vessel
  3. leave the wire guide in place, but withdraw needle
  4. introduce the sheath-introducer assembly over the wire guide and twist to advance the assembly into the vessel
  5. determine the correct length by advancing the wire to desired location and mark the length with clamping forceps. withdraw wire guide and measure to determine correct catheter length
  6. leave sheath in place, remove the dilator
  7. introduce the catheter/obturator into the sheath and advance to position
  8. by grasping the two knows of the sheath, pulling outward and upward remove the sheath and remove obturator after catheter is in final position
  9. catheter can now be sutured to the skin and dressed
17
Q

central venous access sites

A

through subclavian vein (chest) or through internal jugular vein (neck)

18
Q

central vein catheter (CVC)

A

surgically implanted

19
Q

hickman catheter

A

requires surgical insertion
dacron cuff prevents excess motion
inserts in subclavian vein

20
Q

vascular access port (VAP)

A

requires non-coring needle (conventional, straight, right-angle)
the tube and the port are under the skin

21
Q

advantages of central venous therapy

A

access to central veins
rapid infusion of large amounts of fluid
a way to draw blood and measure CV pressure
reduced need to repeated venipunctures
reduced risk of vein irritation from infusing irritating substances

22
Q

risk of central venous therapy

A

sepsis
thrombus formation
perforation of vessel and adjacent organs
air embolism

23
Q

disadvantages of central venous therapy

A

cost
requires more skill to insert then peripheral therapy

24
Q

risks associated with infusion

A

complications from damage to the inner lining of the vein (intima)

25
Q

intima types

A

stenosis (narrowing)
thrombus (clot)
venous occlusion
chemical inflammation (phlebitis) and pain

26
Q

instrumented flow control

A

controllers (use gravity as driving force)
pumps (powered devices)

27
Q

controllers

A

use gravity as driving force
drop counting sensor flows into the controller (automatic clamping device)

28
Q

infusion pump caution

A

the use of excessive infusion pressure can be a hazard with respect to infiltration at the site of injection

29
Q

infusion pumps

A

powered devices
provide pressure in the range of 2-12 psi (100 to 600 mmHg) – high end of this pressure range is used for intra-arterial infusions

30
Q

features of infusion pumps

A

volumetric delivery, independent of vascular back pressure, position of patient, composition of infusion solution, or tubing resistance
pump does not turn the drip chamber into an ornamental item

31
Q

safety features of infusion pumps

A

occlusion of line
infusion complete
air in line
empty container
flow rate error

32
Q

IV infusion pumps

A

symbiq infusion system
omni-flow 4000 plus (complex therapy - program multiple drugs)

33
Q

syringe pumps

A

use commercial syringes
smart machines
especially useful for giving intermittent IV medications
provide the best control for small volume infusions
useful for pediatric patients

34
Q

other parenteral pumps

A

patient-controlled analgesia (PCA)
ambulatory pumps
implantable pumps

35
Q

PCA

A

pain relief is generally obtained at a lower total dose of drug
patient-controlled analgesia pump

36
Q

ambulatory pumps

A

refers to size and weight of the pump, as well as ability to operate without an external power source
attaches to hip
example - insulin pump

37
Q

implantable pumps

A

usually with reservoirs of around 50mL
used for IV, intraspinal, and intra-arterial routes
can deliver as low as 1 mcg/hr

Dosage - Exam 2 (6 decks)

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