nursing final

Question 1

intravenous?

Answer 1

(via the veins) route is the main method of supplying the patient with fluids and medications when the patient is unable to take them orally or rectally. instantly available to circulation to all tissues.

Question 2

IV infusion?

Answer 2

slow introduction of fluids to veins

Question 3

what are some examples delivered by the IV route?

Answer 3

fluids and electrolytes.
medications that are more effective when given by this route or cannot be given any other way.

blood, plasma, or other blood components.
nutritional formulas containing glucose, amino acids, and lipids.

Question 4

the average adult needs how many fluids in a 24 hour period to replace fluid eliminated by the body?

Answer 4

1500-2000 mL.

Question 5

how are fluids lost by elimination?

Answer 5

hemorrhage, severe prolonged vomiting, moderate or excessive drainage from wound.

Question 6

what 3 types of intravenous solutions?

Answer 6

Isotonic, hypotonic, hypertonic

Question 7

isotonic?

Answer 7

solutions have the same concentration or osmolality as blood and are used to expand the fluid volume of the body.

Question 8

hypotonic?

Answer 8

solutions contain less solute than extravascular fluid and may cause fluid to shift out of the vascular compartment.

Question 9

hypertonic?

Answer 9

solutions have a greater tonicity than blood. they are used to replace electrolytes and when given as concentrated dextrose.

Question 10

what are concentrated solutions of glucose, mannitol, or sucrose given for?

Answer 10

they are given to reduce cerebral edema in patients with head injuries because osmotic pressures draws out water of the cells.

Question 11

what administration sets can be classified as?

Answer 11

1. primary intravenous sets
2. secondary piggy back intravenous sets
3. parallel or “y” intravenous sets
4. controlled- volume intravenous sets

Question 12

when is tubing generally changed for infection control?

Answer 12

every 24-72 hours

Question 13

what is primary IV infusion set consists of?

Answer 13

consists of a bag of a solution, a regular tubing set, a needless connector, and an IV stand.

Question 14

what are the 3 major drops selected for primary IV tubing?

Answer 14

1. regular
2. macrodrops
3. microdrops

Question 15

regular drop?

Answer 15

10 -20 gtt/mL of fluid specified by the manufacture- used for administrating IV therapy to most adult patients.

Question 16

macrodrops?

Answer 16

10 gtt/mL used for vicious sticky or gummy fluids such as blood, maybe used for regular fluids.

Question 17

microdrops?

Answer 17

60 gtt/mL used when small amounts of fluids are required or when extreme care must be used to measure the exact amount ‘ most often used for IV fluids to infants and children’ recommended for the elderly with fragile veins.

Question 18

secondary or piggy back intravenous?

Answer 18

are often given to an existing to an existing line. the advantage is when the solution is in smaller bag has been infused, the primary IV begins to flow again with out further adjustments.

Question 19

parallel or Y intravenous sets?

Answer 19

is used to infuse certain blood products.

Question 20

transfusion?

Answer 20

introduction of blood components into the blood stream.

Question 21

infusion pump?

Answer 21

machine that delivers IV fluids at a rate that is set by the nurse. it is used to administer small volumes of fluid or medication.

Question 22

burette?

Answer 22

tube like chamber that will hold 150 mL of fluid.

Question 23

intermediate intravenous?

Answer 23

patients that do not require large amounts of fluid by the IV route but may need to receive IV medications at intervals or have IV access incase of an emergency.

Question 24

what is the only solution used with infusion of blood products?

Answer 24

saline

Question 25

filters?

Answer 25

they trap small particles such as undissolved medication or salts that have precipitated from solution.

Question 26

(TPN) total parenteral nutrition?

Answer 26

technique of providing needed nutrition intravenously. or for medications that require critically accuracy.

Question 27

infiltrated?

Answer 27

solution is deposited in tissue outside the vein.

Question 28

what are some disadvantages of pumps?

Answer 28

1. they exert pressure on the vein 2. they are expensive, 3. certain types of pumps require special administration sets.

Question 29

insulin pump?

Answer 29

small portable device that can be programmed to deliver a continuous infusion of regular insulin that mimics normal physiology.

Question 30

what are the 3 basic types of IV needles and catheters used for peripheral IV fluid administration?

Answer 30

winged or butterflied over the needle catheters through the needle catheter

Question 31

vascular access devices?

Answer 31

devices such as a needle or catheter that allow direct access to the circulatory system.

Question 32

catheter embolus?

Answer 32

piece of the catheter obstructing blood flow.

Question 33

infiltration?

Answer 33

most common problem. occurs when fluid or medication leaks out of the vein in the tissue.

Question 34

phlebitis?

Answer 34

caused by irritation of the vein by the needle, catheter, medications, or additives. ( signs) erythema, warmth, swelling, tenderness.

Question 35

bloodstream infection?

Answer 35

occurs from breaks in sterile technique. when infectious pathogens are introduced into the blood stream.

Question 36

when should IV sites be checked?

Answer 36

once an hour

Question 37

what do adults adapt best to what fluids?

Answer 37

20-60 gtt/minute. { larger amounts increase the work of the heart}

Question 38

bore?

Answer 38

internal diameter

Question 39

sites used most frequently for peripheral IVs are the veins of the?

Answer 39

forearm and hand.for veins are used when no other sites are available

Question 40

what are the sites of choice for adults?

Answer 40

cephalic, basilic, and antebrachial veins of lower arm and the veins in the back of the hand.

Question 41

what can alter the rate of IV?

Answer 41

patient movement

Question 42

how is potassium used?

Answer 42

always diluted in fluid and is never given as a bolus because it can cause cardiac arrhythmia and arrest.

Question 43

what happens if medication is administer too rapidly?

Answer 43

speed shock

Question 44

speed shock?

Answer 44

is a systemic reaction that occurs when a substance unfamiliar to the body is infused rapidly.(signs: light headed, tightness in chest, flushed face, and irregular pulse)

Question 45

bolus or IV push injections?

Answer 45

medication that is directly given over a few minutes.

Question 46

antineoplastic medication?

Answer 46

used to destroy or alter the growth of malignant cells and are very toxic to normal as well as abnormal cells.[ they can be absorbed by the skin, by inhalation or droplet, or by oral contamination from residue on the hands of the nurse.

Question 47

autologous?

Answer 47

from the patients own body

Question 48

when should the consent be signed before receiving blood ?

Answer 48

signed no more 48 to 72 hours prior

Question 49

what would happen if a minor was a jehovas witness and refuse blood transfusion?

Answer 49

if pt. is a minor and if the treatment would be lifesaving, a court order can be obtained that allows the administration of blood or blood products.parenteral?

Question 50

parenteral?

Answer 50

refers to medication route other than the digestive tract.

Question 51

what is used when a patient needs intermittent rather than continuous IV therapy ?

Answer 51

saline lock.

Question 52

central catheter devices include what kind of catheters?

Answer 52

tunneled, non- tunneled, peripherally inserted central catheters, and implanted ports,

Question 53

when should dialisis catheters be used?

Answer 53

only for dyalisis and not for IV therapy, and should be accessed only by physicians or specially trained dialysis nurses.

Question 54

non- tunneled central catheter?

Answer 54

inserted by a physician into the jugular or subclavin vein. they are determined by xray before use, short term and normally in for 7 days up to several weeks.

Question 55

tunneled catheters?

Answer 55

are intended for use of month to years to provide long- term venous access. catheter tip is placed in superior vena cava. advantages: break or tear are easy to repair. Disadvantages: include weekly sit care, cost and pt. body image.

Question 56

peripherally inserted central catheters?

Answer 56

long catheter that is inserted int he arm and terminates in central circulation. used when therapy will last more than 2 weeks.

Question 57

ports?

Answer 57

reservoir that is surgically implanted into pocket created under the skin, usually in upper chest. tunneled under skin into the central vein.

Question 58

how and why do fluids move?

Answer 58

fluids can move between compartments by a variety of methods in order to maintain homestasis.

Question 59

where are fluids distributed?

Answer 59

between intracellular and extracellular compartments.

Question 60

electrolytes?

Answer 60

are minerals that are present in all body fluids. they regulate body balance and hormone production. when dissolved in water or other solvents then they seperate into ions. and then wither conduct positive or negative electical current.

Question 61

what are some imbalances that a nurse should be familiar with?

Answer 61

fluid volume deficit | fluid volume excess

Question 62

fluid volume deficit?

Answer 62

(hypovolemia isotonic)loss of water and electrolytes from the ECF. and loss of water and no loss of electrolytes(dehydration osmolar)

Question 63

what can hypovolemia lead to?

Answer 63

hypovolemic shock

Question 64

why are older adults more at risk of dehydration?

Answer 64

due to decrease in decrease of total body mass , which includes total body water content.

Question 65

what are some causes of hypovolemia?

Answer 65

abnormal gastrointestinal loss- vomiting, diahrea abnormal skkin loss- diaphoresis abnormal renal loss- diuretic therapy, renal disease hemmorrhage altered intake- such as NPO

Question 66

causes of dehydration?

Answer 66

hyperventilation diabetic ketoacidosis enteral feeding without sufficient water intake.

Question 67

what are some objective and subjesctive data for this?

Answer 67

vital signs- hyperthermia, tachycardia, thready pulse, hypotension, orthostatic, tachypnea neuromuscuoskeletal- dizziness, syncope, confusion GI- thirst, dry furrowed tongue, nausea, vomiting Renal- oliguria( decreased urine)

Question 68

lab findings?

Answer 68

hypovolemia- increase HCT | dehydration- increase in hemoconcentration but not present when dehydration in caused from hemorrhage.

Question 69

fluid volume excess?

Answer 69

(hypervolemia isotonic) water and sodium retained in abnormally high proprtions and (overhydration osmolar) more water gained then electrolyte zcan lead to pulmonary edema and heart failure. decrease in HCT, serum electrolytes, and protein

Question 70

risk of fluid volume excess?

Answer 70

chronic stimulus to the kidneys to conserve sodium and water abnormal renal functions with reduced excertion of soium and water interstitual to plasma fluid shifts. excessive sodium intake

Question 71

what are some causes of overhydration?

Answer 71

water replacement without electrolyte replacement

Question 72

subjective and objective data on fluid volume excess?

Answer 72

vital signs: bounding pulse, tachycardia, hypertension, tahcypnea, increased central venous pressure. neuromusculoskeletal- confusion, wakness GI- weight gain, ascites respiratory- dyspnea, orthopnea, crackles other signs- edema, distended neck veins

Question 73

lab findings in exccessive fluid volume?

Answer 73

hypervolemia- decreased HCT overhydrations- decreased HCT= hemodiluton decreased electrolytes, BUN, and creatine decreased paCO2 increased pH geater than 7.45

Question 74

collaborative care for fluid excess?

Answer 74

asses resp rate, symmetry, and effort. asses breath sounds in all lungs. monitor for shortness of breath and dyspnea monitor I&O

Question 75

what are ABGs used for?

Answer 75

most commonly used to evaluate acid- base balance

Question 76

what happends when great hydrogen concentration?q

Answer 76

more acidic and body fluids and lower the pH

Question 77

what happends if lower hydrogen concentration?

Answer 77

the more alkaline the body fluids and higher pH

Question 78

what are the acid- base balance maintained by?

Answer 78

chemical, respiratory, and renal processes

Question 79

chemical and protein buffers?

Answer 79

are the first line of defense eitehr bind or release ions as needed rspond quickly to changes in pH

Question 80

respiratory buffers?

Answer 80

are he 2nd line of defense | control the level of H+ ion in the blood through the control of CO2 levels

Question 81

renal buffers?

Answer 81

3rd line of defense much slower to respond, but most effective, with longest duration kidneys control movement of bicarbonate in urine. bicarbonate can be reabsorbed in bloodstream

Question 82

compensation?

Answer 82

refer to the proccess in which body attempts to correct changes and imblanances in pH levels. full compensation occors when pH of blood reteurn to normal.

Question 83

to determine the type of imbalance follow these steps..

Answer 83

step1. look at pH step2. look at PaCO2 and HCO3 simultaneously step 3. combine diagnosis of step 1 and 2 to name the type of imbalance. step 4. evaluate the PaO2 and the Sa)2 step5. determine compensation as follows.. pg 454 ati medsurg