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nursing final Flashcards

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1
Q

intravenous?

A

(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.

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2
Q

IV infusion?

A

slow introduction of fluids to veins

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3
Q

what are some examples delivered by the IV route?

A

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.

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4
Q

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

A

1500-2000 mL.

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5
Q

how are fluids lost by elimination?

A

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

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6
Q

what 3 types of intravenous solutions?

A

Isotonic, hypotonic, hypertonic

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7
Q

isotonic?

A

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

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8
Q

hypotonic?

A

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

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9
Q

hypertonic?

A

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

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10
Q

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

A

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

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11
Q

what administration sets can be classified as?

A
  1. primary intravenous sets
  2. secondary piggy back intravenous sets
  3. parallel or “y” intravenous sets
  4. controlled- volume intravenous sets
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12
Q

when is tubing generally changed for infection control?

A

every 24-72 hours

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13
Q

what is primary IV infusion set consists of?

A

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

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14
Q

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

A
  1. regular
  2. macrodrops
  3. microdrops
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15
Q

regular drop?

A

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

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16
Q

macrodrops?

A

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

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17
Q

microdrops?

A

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.

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18
Q

secondary or piggy back intravenous?

A

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.

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19
Q

parallel or Y intravenous sets?

A

is used to infuse certain blood products.

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20
Q

transfusion?

A

introduction of blood components into the blood stream.

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21
Q

infusion pump?

A

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.

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22
Q

burette?

A

tube like chamber that will hold 150 mL of fluid.

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23
Q

intermediate intravenous?

A

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.

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24
Q

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

A

saline

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25
Q

filters?

A

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

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26
Q

(TPN) total parenteral nutrition?

A

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

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27
Q

infiltrated?

A

solution is deposited in tissue outside the vein.

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28
Q

what are some disadvantages of pumps?

A
  1. they exert pressure on the vein
  2. they are expensive,
  3. certain types of pumps require special administration sets.
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29
Q

insulin pump?

A

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

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30
Q

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

A

winged or butterflied
over the needle catheters
through the needle catheter

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31
Q

vascular access devices?

A

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

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32
Q

catheter embolus?

A

piece of the catheter obstructing blood flow.

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33
Q

infiltration?

A

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

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34
Q

phlebitis?

A

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

35
Q

bloodstream infection?

A

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

36
Q

when should IV sites be checked?

A

once an hour

37
Q

what do adults adapt best to what fluids?

A

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

38
Q

bore?

A

internal diameter

39
Q

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

A

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

40
Q

what are the sites of choice for adults?

A

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

41
Q

what can alter the rate of IV?

A

patient movement

42
Q

how is potassium used?

A

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

43
Q

what happens if medication is administer too rapidly?

A

speed shock

44
Q

speed shock?

A

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)

45
Q

bolus or IV push injections?

A

medication that is directly given over a few minutes.

46
Q

antineoplastic medication?

A

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.

47
Q

autologous?

A

from the patients own body

48
Q

when should the consent be signed before receiving blood ?

A

signed no more 48 to 72 hours prior

49
Q

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

A

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?

50
Q

parenteral?

A

refers to medication route other than the digestive tract.

51
Q

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

A

saline lock.

52
Q

central catheter devices include what kind of catheters?

A

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

53
Q

when should dialisis catheters be used?

A

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

54
Q

non- tunneled central catheter?

A

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.

55
Q

tunneled catheters?

A

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.

56
Q

peripherally inserted central catheters?

A

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

57
Q

ports?

A

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

58
Q

how and why do fluids move?

A

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

59
Q

where are fluids distributed?

A

between intracellular and extracellular compartments.

60
Q

electrolytes?

A

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.

61
Q

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

A

fluid volume deficit

fluid volume excess

62
Q

fluid volume deficit?

A

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

63
Q

what can hypovolemia lead to?

A

hypovolemic shock

64
Q

why are older adults more at risk of dehydration?

A

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

65
Q

what are some causes of hypovolemia?

A

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

66
Q

causes of dehydration?

A

hyperventilation
diabetic ketoacidosis
enteral feeding without sufficient water intake.

67
Q

what are some objective and subjesctive data for this?

A

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

68
Q

lab findings?

A

hypovolemia- increase HCT

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

69
Q

fluid volume excess?

A

(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

70
Q

risk of fluid volume excess?

A

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

71
Q

what are some causes of overhydration?

A

water replacement without electrolyte replacement

72
Q

subjective and objective data on fluid volume excess?

A

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

73
Q

lab findings in exccessive fluid volume?

A

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

74
Q

collaborative care for fluid excess?

A

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

75
Q

what are ABGs used for?

A

most commonly used to evaluate acid- base balance

76
Q

what happends when great hydrogen concentration?q

A

more acidic and body fluids and lower the pH

77
Q

what happends if lower hydrogen concentration?

A

the more alkaline the body fluids and higher pH

78
Q

what are the acid- base balance maintained by?

A

chemical, respiratory, and renal processes

79
Q

chemical and protein buffers?

A

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

80
Q

respiratory buffers?

A

are he 2nd line of defense

control the level of H+ ion in the blood through the control of CO2 levels

81
Q

renal buffers?

A

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

82
Q

compensation?

A

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.

83
Q

to determine the type of imbalance follow these steps..

A

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

Nursing 1 (3 decks)

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