Pharm Exam 4 Flashcards
Speed Shock
When a client receives an IV medication too rapidly, causing dizziness, chest tightness, and flushed face.
Extravasation
Causes pallor, swelling, and pain at IV site, which can extend tissue damage over time.
Anaphylactic shock
Causes bronchospasm, wheezing, SOB, severe hypotension, tachycardia, and respiratory or cardiac arrest.
The nurse should call the rapid response team and start oxygen if suspected.
Fluid overload
SOB, increased blood pressure, increases heart rate, increases respiratory rate, crackles in the lungs, neck vein distention, and edema
The nurse should prepare to administer a diuretic if suspected.
Phlebitis
the nurse should use a catheter with the smallest gauge possible to prevent irritation of the vein and phlebitis
the nurse should use a warm compress to treat phlebitis
0.9 % NaCl
Normal saline uses:
Increases intracellular fluid volume
Administration of blood transfusions
Replace fluid losses
Contraindications:
heart failure
pulmonary edema
renal failure
hypernatremia
Lactated Ringers (LR)
Contains electrolytes, sodium, chloride, potassium, calcium and lactate.
Uses:
provide fluid resuscitation
correct metabolic acidosis
Contraindications:
Heart failure
Renal failure,
head injury
liver disease
respiratory alkalosis
Infiltration
manifestations: pallor, swelling, and pain at the IV site
Extravasation
manifestations: blistering, tissue necrosis, ulceration
0.45% NaCl
Half normal saline
Isotonic
0.9 % Normal saline
Lactated ringers
Remains in the intravascular space
Hypertonic
3% saline
Pulls fluid out of the cells and into the veins
Hypotonic
0.45% half saline
0.18% saline
D5W - after metabolized
Moves fluid from the veins to the cells and interstitial spaces
Hemolysis can occur due to fluid moving from veins into cells.
Electron infusion devices (IV pumps)
deliver an accurate rate of fluid infusion
Pumps have a variety of safety features that protect the patient from an unwanted bolus, running dry, or running at an infusion rate inconsistent with the usual administration of the medication or fluid.
IV Pump Alarm detections
air in the tubing
volume is low
infusion is complete
low battery
occlusion
Using the piggyback method, where should the nurse place the secondary bag?
Higher than the primary bag
Bolus
Fluids or concentrated medication solution given by IV route over a relatively brief period of time. Equipment used to deliver varies, depending on existing IV lines, volume, and time to be infused.
Continuous IV Infusion
IV solution that flows continuously (until further notice) - typically seen in NPO and surgical patients
Drop Factor
Number of drops per milliliter (mL) delivered through various sizes of IV tubing. The tubing diameter affects the size of the drop. The DF is used to calculate flow rates on gravity administration sets.
Flow Rate
Rate at which fluid is delivered by IV infusion devices, in milliliters per hour (mL/hr).
Administration Set
another term for IV tubing;
may be used by gravity or IV pump
Infusion Line, Primary
Main IV line or lines connected to the patient.
The first one is usually “dedicated” to fluid delivery and maintenance. Additional primary and secondary lines are usually reserved for medications or medicated solutions that are incompatible with other fluids.
Infusion Line, Secondary
Tubing that connects to ports on the primary line and permits an additional medication or fluid to be added without disruption of the primary line.
IV Injection Ports
accessible port located on the IV line or IV solution container that permits access for injection of additional fluids or medications.
Intermittent Infusions
Usually small-volume infusions (up to 250 mL) of IV solutions with medication added delivered at intervals.
piggyback equipment, syringe pumps, and calibrated volume-control burette chambers.
IV Piggyback (IVPB)
Small-volume infusions, usually 50 to 250 mL, infused through a short secondary tubing line that is “piggybacked” to a port on a primary line.
IV Push
IV medication intermittent bolus dose of 1 to 50 mL, usually administered by manual direct injection with a syringe, sometimes via an infusion pump.
“Keep vein open” or “To keep open”;
flow rate order that may be given for a minimum rate that will keep the IV line patent and prevent coagulation.
Macrodrip
Gravity IV infusion tubing set that has a wide diameter to deliver large drops
common 10 drops per mL
Microdrip (pediatric tubing)
Gravity IV infusion tubing set that has a narrow diameter to deliver small drops and slower flow rates.
common 60 drops per mL
Osmolartiy, Tonicity
Solute concentration in solution.
The milliosmol (mOs) is the unit of measurement in plasma and is used as a basis for comparison with the contents of IV solutions.
Parenteral Fluids
Fluids administered outside of the digestive tract (e.g., IM, IV, subcutaneous).
Patency
State of being open and unblocked, such as a “patent IV site” or “patent airway.”
PCA Pump
Patient-controlled analgesia pump
An electronic IV pump with a syringe or IV bag programmed to dispense prescribed amounts of analgesic narcotics at prescribed intermittent intervals with lockout intervals.
Saline Lock
Resealable access device that permits additional IV lines or medications to be added into or on primary (main) IV tubing without initiating another injection site or disrupting the main IV line.
Volume-Control Burette Device
Transparent, calibrated small-volume container, with a capacity of 100 to 150 mL, that is manually connected to an IV line just below the main IV solution container.
protects at risk patients of overload by limiting the total amount of solution available in case of equipment or a rate failure incident.
