PIVs, Subcuts and IN Meds Flashcards
What is a PIV?
Peripheral Intravenous (IV)
Vascular access device
Where are PIVs commonly placed?
hand
forearm
In emergencies where are PIVs placed?
foot
head
Which way do hypertonic solutions pull fluid and what is one caution?
pulls fluid from the cells - causes them to shrink - vascular volume increases
Pulmonary edema (especially heart or renal failure patients)
What does isotonic solution do for the body and when is it typically used?
increaes fluid volume only
no fluid shifts
vomiting/fluid loss
Which way does hypotonic solutions (0.45%) pull and what are they used for?
They pull fluid into the cells
used to help reduce Edema and Third spacing
If someone was hypertonic what solution would we give and why?
Give hypotonic to dilute ECF
This causes fluid to go back into the cells
What is a subcut line?
a line for subcut medications that are required often so that the patient doesn’t have to keep getting poked
What is hypodermoclysis?
administration of fluids through a subcut line
Used when IV access is limited
Used when patient is end of life
Used when patient is at risk for or with mild dehydration
slow rate of infusion b/c subcut is slow absorption
What is the max volume of meds administred via subcut at one time?
2 mL + NS flush post med of 0.5mL
total = 2.5 mL
When do we flush subcut?
after each use! (each med)
how often do we change subcut lines and sites?
Q 5-7 days (check agency policy)
or as indicated by irritation, infection, etc
What do we need to label / document with sub cut line?
- label the line (clear it’s not IV)
- client chart
- kardex
include
date
time
SC line insertion location
How often do we monitor sub cut lines?
at least every 8 hours
more often when in use
what do we assess with subcut lines?
- insertion site
- surrounding skin
- blood in the tube
- erythema
- swelling
- leaking
- hardness at site
- bruising
- burning
- pain
- heat
- necrosis…. etc.
what are 2 options if there are multiple subcut meds but only 1 line?
- maybe add a second line
- wait 15-30 min between each med for adequate absorption
what is MAD?
Mucosal Atomization Device
What must the nasal cavity be like for IN admin?
easily accessible
rich vascular supply for rapid absporption into bloodstream
What is the rate of IN med absorption similar to?
IV admin
what are the 5 classes of meds commonly given IN?
- vaccines (live attenuated)
- antiepileptics
- opiate analgesics
- hypoglycemics
- corticosteroids
What is the ideal volume PER NOSTRIL for IN administration?
0.2 to 0.3 mL
what is the max dose PER NOSTRIL for IN administration?
0.5 mL
what do we do if the dose is more than 0.5 mL?
two separate doses, 5-10 min between
What is Phlebitis?
Inflammation of the vein
What is thrombophlebitis?
complication of phlebitis
clot formation
What is infiltration?
leakage of infusing fluid from a vein into surrounding tissue
wht is extravasation?
leakage of vesicant agent into surrounding tissue
What is IV ecchyomosis?
bruising @ site
what is hematoma?
extravasated blood trapped in the tissues causing a swelling containing blood
