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Nursing 171 > Pharmacology Week 10: IV Therapy > Flashcards

Pharmacology Week 10: IV Therapy Flashcards

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1
Q

Intravenous Therapy Uses

A
  • correct fluid and electrolyte disturbances
  • administer medications
  • TPN (total parenteral nutrition), PPN
  • administer blood and blood products
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2
Q

Components of IV Solutions

A
  • fluid (water, saline)
  • electrolytes (KCL)
  • nutrients (dextrose, glucose, lipids)
  • medication
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3
Q

Intravenous Solutions

A
  • Dextrose and Water (D5W)
  • Normal Saline (0.9% NaCl)
  • Lactated Ringers (LR)
  • 0.45% NaCl (half normal saline)
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4
Q

IV Orders

A

-type of solution
-amount of solution
-rate of fluid delivery
ex:
>1000ml q 8 hrs/ 3000ml / 24 hrs
>125 ml/hr

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5
Q

Solution D5W solute/solvent

A

D5W = 5% Dextrose and Water

  • Dextrose = solute
  • Water = solvent
  • 5% = 5 grams dextrose/ 100 ml water
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6
Q

D5W

A

5% dextrose and water

  • Dextrose = solute
  • Water = solvent
  • 5% = 5 grams dextrose/ 100 ml water
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7
Q

Types of Solutions

A
  • colloidal solutions

- crystalloid solutions

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8
Q

Colloidal Solutions

A

water and protein (plasma expanders)

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9
Q

Crystalloid Solutions

A

may diffuse out of the vascular compartment

  • Isotonic
  • Hypotonic
  • Hypertonic
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10
Q

Osmolarity

A

fluid type describes the effect the fluid has on the way fluid shifts between the intracellular and extracellular compartments

  • fluid concentration (tonicity)
  • relationship of solutes + solvents
  • measured in mOsm per liter
  • blood 290 mOsm
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11
Q

Isotonic Solutions

A

similar concentration (osmotic pressure) as blood

  • 250-350 moSm
  • stay in the vascular space
  • prevent fluid shifts
  • extend vascular volume
  • 0.9% NS (308 mOsm)
  • Lactated Ringers (273 mOsm)
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12
Q

Examples of Isotonic Fluids

A
  • 0.9% NaCl NS (308 mOsm)

- Lactated Ringers (273 mOsm)

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13
Q

Hypotonic Solutions

A

less osmotic pressure than blood

  • less than 250 mOsm
  • fluid shifts out of the vascular space to hydrate cells
  • 0.45% NS (154 mOsm)
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14
Q

Example of Hypotonic Solution

A

-0.45% NaCl NS (154 mOsm)

half normal saline

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15
Q

Hypertonic Fluid

A

greater osmotic pressure than blood

  • greater than 375 mOsm
  • cause fluid shifts from the tissues (intracellular and interstitial compartments) into the vascular space
  • D5NS (560 mOsm)
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16
Q

Example of Hypertonic Solution

A

D5NS (560 mOsm)

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17
Q

Vascular Access Devices

A

Peripheral Line Catheters

  • butterfly
  • angio cath
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18
Q

Saline Lock

A
  • intermittent use
  • SAS = saline/administration/saline
  • once a shift/ day when not in use (check policy)
  • 1-5 mL saline (most common 1-3 mL)
19
Q

Angio Catheter Care

A
  • change site and tubing every 72-96 hours
  • change bag every 24 hours
  • IVPB tubing change every 24 hours
  • use occlusive transparent dressing
20
Q

Central Line Catheters

A
  • Percutaneous central venous catheter
  • PICC
  • Implanted Ports–> Port a cath/ Medi Port
21
Q

Heparin Flush

A
  • 10 units/ mL
  • 100 units/ mL
  • 3-5 mL flush (minimum check hospital)
  • SASH = saline/administration/saline/heparin
22
Q

Complications of IV Therapy (Local)

A
  • Infiltration
  • Phlebitis
  • Site Infection
23
Q

Local Complication IV Therapy: Infiltration

A

escape of fluid into the subcutaneous space

-extravasation

24
Q

Signs + Symptoms of Infiltration of IV

A

cool, pale, edema, decreased heart rate, resistance to flush, pain or burning at site

25
Q

Prevention for Infiltration of IV

A
  • secure site
  • limit mobility (arm board)
  • occlusive dressing
  • assess hourly
26
Q

Interventions for Infiltration of IV

A

D/C and apply compresses according to agency policy

27
Q

Local Complication of IV Therapy: Phlebitis

A

inflammation of the vein

28
Q

Signs + Symptoms of Phlebitis of IV

A

warm, red, thick, cord-like vein, red streaking up the vein, pain and tender at site

29
Q

Prevention of Phlebitis of IV

A
  • change site per policy
  • assess hourly (occlusive dressing)
  • dilution of meds (KCL needs to be well diluted)
30
Q

Interventions of Phlebitis of IV

A

D/C and apply compresses according to agency policy

31
Q

Local Complications of IV Therapy: Infection

A

Bacterial contamination of the site

32
Q

Signs + Symptoms of Infection of IV

A
  • red
  • swollen
  • warm
  • pain at site
  • purulent drainage
33
Q

Prevention of Infection of IV

A
  • change site per policy
  • hourly assessment
  • occlusive dressing
  • good aseptic technique
34
Q

Interventions for Infection of IV

A
  • D/C
  • bleed site
  • culture tip
35
Q

Systemic Complications of IV Therapy

A
  • Septicemia
  • Air Embolism
  • Catheter Embolism
  • Speed Shock
  • Circulatory Overload
36
Q

Systemic Complications of IV Therapy: Septicemia

A

bloodstream infection

37
Q

Systemic Complications of IV Therapy: Air Embolism

A

air injected into IV line

38
Q

Systemic Complications of IV Therapy: Catheter Embolism

A

tip of catheter in patients vein

39
Q

Systemic Complications of IV Therapy: Speed Shock

A

IVPB med infuses too quickly

40
Q

Systemic Complications of IV Therapy: Circulatory Overload

A

IV fluid infuses too quickly

41
Q

TPN (total parenteral nutrition)

A

-dextrose (carbohydrate)
-amino acids (protein)
-lipids (fats)
-electrolytes (KCL)
-trace elements (vitamins/minerals)
-medication (insulin, heparin)
TPN for clients in need of calories in excess of 2500 calories

42
Q

Dextrose Calories

A

1000 mL/ D5W = 5 gm Dextrose/ 100 mL water
=50 gms. Dextrose (10x5= 50)
50gms. Dextrose= 170 calories
3 liters/day = 510 calories

43
Q

Caloric Needs

A

1000 ml/ D10W= 10gms dextrose/ 100 mL water
=100 gms. dextrose (10x10= 100)
100gms. Dextrose= 340 calories
3 liters/ day = 1020 calories
(TPN for clients in need of calories in excess of 2500 calories)

44
Q

Electronic Infusion Devices

A

-pumps: exert pressure

>volumetric (ml/hr)

Nursing 171 (38 decks)

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