Lesson 2 (MIIDTERMS) Flashcards
Commonly used for short-term IV therapy in the hospital setting
Peripheral Devices
- Intravenous catheter inserted by percutaneous venipuncture into a peripheral vein and held in place with a sterile transparent dressing.
- The transparent dressing helps to keep the site sterile and allows the nurse to visualize the insertion site through the dressing
- Used for short-term infusions of fluids, medications, or blood
- Easy to monitor and can be inserted at the bedside by nurses and other trained professionals
Peripheral IV
- Refers to the use of a short extension set that allows IV access without requiring ongoing IV infusions
- When not in use, the lock is flushed with saline according to agency policy and clamped to ensure the site remains sterile and blood does not flow out of the extension tubing
Saline Lock
Enumerate contraindications for IV
- History of lumpectomy or mastectomy
- Arteriovenous fistula
- Current lymphedema
- Deep vein thrombosis (DVT)
- Fractures
Hospitalized patients may have signage or a bracelet stating “_____” to alert heath care professionals to these conditions
Limb Alert
- Larger catheters that allow for rapid infusions
- Much longer and inserted deeper than a peripheral IV
- Typically inserted into the basilic, cephalic, or brachial veins of the upper arm with the tip placed near the level of the axilla.
- Can also be used for longer duration than traditional peripheral venous access, which is ideal for patients needing extended hospital stays or IV access
Midline Peripheral Catheters
- Can be left in for longer periods of time and is useful for administering concentrated medications and fluids.
- Type of vascular access that involves the insertion of a tube into a vein in the neck, chest, or groin and threaded into a central vein and advanced until the tip of the catheter resides within the inferior vena cava, superior vena cava, or right atrium.
- Have an increased risk for the development of bloodstream infections, so strict aseptic technique is required during insertion and maintenance
Central Venous Access Devices
- Thin, flexible tube inserted into a vein in the upper arm and guided into the superior vena cava.
- It is used to give intravenous fluids, blood transfusions, chemotherapy, and other medications requiring a central line.
- May stay in place for weeks or months and helps avoid the need for repeated needlesticks
Peripheral Inserted Central Catheters
The process of IV start and vessel cannulation includes a comprehensive vein search, identification, and assessment process.
Site Selection
Site selection. Veins in the ______ (hands and arms) are typically the preferred sites for insertion.
Upper Extremities
Site selection. Should be _____ when assessing potential vessels for insertion, examining potential sites both visually and through palpation while progressing up the patient’s extremity.
Systematic
Site selection. The arms should be _____ so that vessels on the dorsal surface can be considered as well.
Rotated
Site selection. Taking time to identify the best access site will _____ the chances for successful cannulation and _____ discomfort for the patient
Increase & Decrease
Site selection. The veins of the _____ are common places to begin one’s assessment.
Hands
Site selection. Veins on the _____ of the wrist should be avoided due to potential nerve damage.
Palmar Side
Site selection. These veins on the _____ of the hand are typically easily visualized and palpated due to the proximity to the surface of the skin.
Dorsal Surface
Site selection. A limitation of using hand veins for venous access is they are _____ than the cephalic, basilic, or brachial veins in the arm
Smaller
Site selection. If no suitable veins are found on the hand, should progress ___ the arm and continue to assess for good access sites.
Up
Site selection. The brachial vein can be considered, but caution must be used due to its location near the _____ in the antecubital fossa.
Brachial Artery
Site selection. Palpating for a pulse and then avoiding the area where the _____ is located can help ensure cannulation occurs into a vein rather than the artery.
Pulse
Site selection.
- For blood sampling, should direct attention to the large veins located in the _____ because the veins are larger in size and can be accessed frequently
- However, these veins are _____ for routine IV fluid administration because every time the patient bends their elbow, a mechanical obstruction in the IV catheter may occur.
Antecubital Fossa & Not Optimal
Site selection. If a patient has several suitable venous access sites, preference should be given to establishing an access site on their _____ or arm.
Nondominant Hand
Site selection.
- Patients typically use their _____ when moving to reposition themselves, take meals or fluids, or operate the television remote.
- These movements can increase the chance of the _____ from the vein
Dominant Hand & Cannula Dislodging
Site selection. Additional considerations are avoiding extremities with _____ such as those with a previous history of mastectomy, lymph node dissection, or arteriovenous (A/V) fistula.
Restrictions
Site selection. The presence of an IV cannula in extremities with these conditions _____ the risk for localized infection and other complications
Increases
Veins that have _____ sections of straight surface are usually easily accessed.
¼- to ½-inch
Veins that _____ (divide into branches), narrow significantly, or are curved can be difficult to access and thread the cannula.
Bifurcate
Peripheral IV catheters are available in a variety of sizes, most commonly ranging from _____.
14 gauge to 24 gauge
The lower the gauge size, the _____ the diameter of the catheter.
Wider
Color coding of IV cannulas. Yellow gauge size and maximal flow rate (mL/min)
24G; 13
Color coding of IV cannulas. Blue gauge size and maximal flow rate (mL/min)
22G; 31
Color coding of IV cannulas. Pink gauge size and maximal flow rate (mL/min)
20G; 67
Color coding of IV cannulas. Green gauge size and maximal flow rate (mL/min)
18G; 103
Color coding of IV cannulas. Gray gauge size and maximal flow rate (mL/min)
16G; 236
Color coding of IV cannulas. Orange gauge size and maximal flow rate (mL/min)
14G; 270
Catheters with a _____ permit infusion of viscous fluids, such as blood products, at a faster rate with decreased opportunity for catheter occlusion.
Smaller Gauge
The most common IV catheter size for adult patients is _____ catheters.
18- or 20-gauge
Frail elderly patients and children have smaller vasculature, so a _____ catheter is often preferred.
22- or 24-gauge
Shielded IV catheters or winged devices also known as
Butterfly
The _____ and _____ are typically added to the catheter itself and not included with the cannulation needle
Stabilizing Device and Extension Tubing
- Diseases acquired while the patient is in a hospital environment
- Proper infection control practices are important in a health care environment to prevent this.
Nosocomial Disease
Can cause epidemics and pandemics which have the potential to overwhelm the capacity of communities with serious health and socioeconomic consequences.
Communicable Disease
Enumerate communicable diseases
- Water-borne diseases
- Vector-borne diseases
- Diseases associated with overcrowding
- Vaccine-preventable diseases
Lack of access to safe water and inadequate sanitation facilities transmission of water-borne and food-borne pathogens.
Water-borne Diseases
- Cholera
- Typhoid fever
- Shigellosis
- Hepatitis E
- Leptospirosis
Water-borne Diseases
Disease that results from an infection transmitted to humans and and fleas
Vector-borne Diseases
- Chikungunya
- Dengue and severe dengue
- Yellow fever
- Zika virus
- Malaria
Vector-borne Diseases
Unvaccinated populations and outbreaks are common when emergencies lead to crowding in these populations.
Diseases Associated with Overcrowding
- Tuberculosis
- Meningococcal disease
- Acute respiratory infections
Diseases Associated with Overcrowding
Infectious diseases caused by viruses or bacteria that can be prevented with vaccines
Vaccine-preventable Diseases
- Polio
- Tetanus
- Pertussis
- Diphtheria
- Chicken Pox
Vaccine-preventable Diseases
Cycle of infection.
- The organism that causes the infection
- Different categories of pathogens can infect humans
Pathogen
Cycle of infection.
- Resistance the person or animal develops against the pathogen after overcoming infection or through immunization.
- Depending on the pathogen, the effectiveness of active immunity often decreases over time.
- Usually, immunity only develops against the specific pathogen that caused the infection
Active Immunity
Cycle of infection.
- The person or animal infected by the pathogen.
- The importance of the host in the transmission cycle is its roles as both reservoir and source of pathogens.
Host
Host. Person or animal infected with the adult, or sexual, form of the pathogen
Definitive Host
Host. An animal or person infected by a larval, or asexual, form of the pathogen
Intermediate Host
Cycle of infection.
- The person or animal infected can potentially spread the pathogen but does not show clear symptoms.
- The symptoms may be mild, or may be completely absent
Carriers: Asymptomatic Carriers
Cycle of infection.
- To survive as a species, pathogens must infect new people or animals.
- They must leave the body of the host, find their way to a new susceptible person or animal, and enter the body of that person or animal.
Transmission of Diseases
Cycle of infection.
- Everything that surrounds the pathogen in its transmission from host to susceptible person or animal.
- Obviously, the _____ is a vast subject, and we can only look at some of the more important environmental factors here
Environment
Cycle of infection.
- The ____ and its seasonal changes play an important role in disease transmission.
- The presence of vectors and intermediate hosts often depends on rain and temperature.
Climate
Enumerate types of disease transmission
- Direct contact
- By air
- Indirect contact
- By food
- Insect
- Rabid animal
The easiest and most convenient method of preventing the spread of microorganism.
Hand Washing
Should wash their hands _____ each patient.
Before and After
Enumerate when will you must perform hand washing.
- After examining patients with known communicable diseases
- After encountering blood or body fluids
- Before beginning invasive procedures
- Before touching the patient, who are at risk of infection
Hands should be kept _____ and _____ from roughness or chapping by the frequent use of soothing lotions.
Smooth and Free
All abrasions should be protected by _____ to prevent the entrance of bacteria.
Bandages
Standardized categories and colors of precautions. Precaution type: Standard
Yellow
Standardized categories and colors of precautions. Precaution type: Contact
Orange
Standardized categories and colors of precautions. Precaution type: Contact Enteric
Orange/Brown Stripe
Standardized categories and colors of precautions. Precaution type: Droplet
Green
Standardized categories and colors of precautions. Precaution type: Airborne Contact
Blue/Orange Stripe
Standardized categories and colors of precautions. Precaution type: Airborne Respirator
Blue/Pink Stripe
Standardized categories and colors of precautions. Precaution type: Special Precautions
White
Refers to a variety of barriers and respirators used alone or in combination to protect mucous membranes, airways, skin, and clothing from contact with infectious agents.
Personal Protective Equipment (PPE)
Protect both patients and healthcare personnel from exposure to infectious material that may be carried on hands.
Gloves
Nonsterile disposable medical gloves made of a variety of materials are available for routine patient care…
- Latex
- Vinyl
- Nitrile
_____ are free of all viable microorganisms.
Sterile Disposable Medical Gloves
They are used for invasive procedures and contact with sterile sites
Sterile Gloves
Worn to protect patients from contamination during an invasive procedure and to provide protection for the wearer.
Sterile Gloves
- Recommended during surgery at high risk of glove perforations as it minimizes the risk of exposure to blood during surgery.
- If the outer glove becomes contaminated or tears, the inner glove offers protection until the gloves can be removed and replaced.
Double Gloves
- Used as specified by Standard and Transmission Based Precautions, to protect the HCW’s arms and exposed body areas and prevent contamination of clothing with blood, body fluids, and other potentially infectious material.
- Based on the nature of the patient interaction, anticipated degree of contact with infectious material and potential for blood and body fluid penetration of the barrier.
Isolation Gowns
- Placed on healthcare personnel to protect them from contact with infectious material from patients.
- Respiratory secretions
- Sprays of blood or body fluids, consistent with standard precautions and droplet precautions.
Mask
Placed on healthcare personnel when engaged in procedures requiring sterile technique to protect patients from exposure to infectious agents carried in a healthcare worker’s mouth or nose
Mask
Placed on coughing patients to limit potential dissemination of infectious respiratory secretions from the patient to others
Mask
Preventing exposure to infectious agents transmitted via respiratory droplets
Goggles and Face Shields
_____ may be used as an alternative to goggles.
Disposable or non-disposable face shields
_____ can provide protection to other facial areas in addition to the eyes
Face shield
Respiratory Etiquette also known as
Cough Etiquette
Designed to limit the transmission of respiratory pathogens spread by droplet or airborne routes
Respiratory Etiquette
Enumerate proper donning of PPE
- Gown
- Mask or respirator
- Goggles or Face shield
- Gloves
Enumerate safe work practices
- Keep hands away from face
- Limit surfaces touched
- Change gloves when torn or heavily contaminated
- Perform hand hygiene
Proper doffing of PPE
- Gloves
- Goggles or face shield
- Gown
- Mask or respirator
