Routes of Administration (ASAN002/10)

Question 1

Fluid Therapy – Routes of Administration:

Answer 1

Oral\nSubcutaneous\nIntravenous\nIntraosseous\nIntraperitoneal

Question 2

Oral

Answer 2

Most physiological route of fluid admin.\nFluid absorption not rapid enough via this route for cases were fluid loss has been extensive or blood flow is inadequate.

Question 3

Oral route – Contraindications:

Answer 3

in vomiting patient.\ncontraindicated due to illness.\nsurgical procedure.\ninadequate for animals that have had acute or extensive fluid lossess.

Question 4

Subcutaneous

Answer 4

Rate of absorption approx 6 – 8hrs (in the absence of vasoconstriction &/or hypovolemia).\nIsotonic fluids only to be administered SQ.\nPotassium supplementation can be added to fluids up to 40 mmol/L.

Question 5

Subcutaneous – Fluid Administration:

Answer 5

Fluid injected in the subcutaneous tissues over dorsal neck and cranial trunk.\nFluids should be body temp to ↓ patient discomfort & improve absorption.\nRate & volume of fluids will vary from patient to patient.

Question 6

Subcutaneous – Administration tips:

Answer 6

Massage area being injected – this will help prevent formation of a lump.\nIf large amts need to be administered, divide into small amts and inject into different sites.\nie if 100mls needed = 4 separate injections of 25mls.

Question 7

Subcutaneous – Complications:

Answer 7

Skin necrosis\nInfection

Question 8

Intravenous

Answer 8

Best choice for restoring vascular volume.\nRapid fluid absorption.\nRate & volume of fluid will vary from patient to patient, based on patient condition and desired outcome.

Question 9

Intravenous – Solutions that can be administered:

Answer 9

Isotonic\nHypertonic\nHypotonic

Question 10

Intraosseous

Answer 10

Fluids administered via the bone marrow.\nFluid absorption is rapid.\nVeins in bone marrow drain into the systemic venous system, enabling quick & effective absorption of fluids.

Question 11

Intraosseous – when to choose this route:

Answer 11

This route is indicated when it is difficult to gain venous access using standard techniques.\nNeonate patients.\nPatients with collapsed circulation.

Question 12

Intraosseous – sites for catheter placement:

Answer 12

Tibial crest\nInter–trochanteric fossa of the femur\nWing of ilium\nTibial tuberosity\nGreater tubercule of the humerus

Question 13

IMAGE – Intraosseous Injection Sites

Answer 13

https://images.cram.com/images/upload-flashcard/65/28/30/34652830_m.png

Question 14

IMAGE – Disposable Intraosseous Needles

Answer 14

https://images.cram.com/images/upload-flashcard/65/28/33/34652833_m.png

Question 15

Intraperitoneal

Answer 15

Administration of fluids into the peritoneal cavity.\nRate of absorption roughly equivalent to SQ route.\nDoes not have advantages over other routes, therefore is used as a last resort.

Question 16

Intraperitoneal – Potential Complications:

Answer 16

Peritonitis\nIntra–abdominal abscess

Question 17

Intravenous Catheters

Answer 17

Intergral part of everyday vet med.\nVN must understand reasons for use, type, placement & monitoring of IV catheters.

Question 18

IV Catheters – Reasons for use:

Answer 18

Administration of IV medications\nAdministration of IV fluids\nAdministration of blood & blood products\nEnsure IV access available if required\nMultiple blood sampling\nCentral venous pressure

Question 19

IV Catheters – Admin of IV Medications:

Answer 19

Meds may not be able to be given orally due to patient condition.\nPO may be contraindicated for the medicine.\nRapid onset of meds may be required & IV is the fastest route for drugs to be absorbed into the blood stream, ie ↑ onset of action.

Question 20

IV Catheters– Admin of IV Fluids:

Answer 20

Rehydration & maintaining hydration of patients.\nAll types of fluids can be administered IV & are rapidly absorbed.

Question 21

IV Catherters – Admin of Blood & Blood Products:

Answer 21

IV is recommended route for blood & blood products.

Question 22

IV Catheters – Ensure IV access available:

Answer 22

ie. During Surgical Procedures\nfor induction agent admin\nin case of emergency under GA, iv access is already in place.

Question 23

IV Catheters – Multiple Blood Sampling:

Answer 23

Type & site of IV catheter placement will be dependent on patient, illness and tests required.\nPrevents multiple venipuncture to obtain blood samples.

Question 24

IV Catheters – Central Venous Pressure (CVP):

Answer 24

CVP is measured by placing a central line via jugular vein.\nTo monitor fluid therapy & hydration in critical care patients.\nCPV is the pressure of blood in the thoracic vena cava, near right atrium of heart. \nReflects the amt of blood returning to the heart and the ability of heart to pump blood into the atrial system.

Question 25

Choosing type & site of venous access:

Answer 25

Factors to consider:\nPatient’s condition\nPatient’s treatment plan\nReason for venous access\nAccessible vein(s)\nAvailability & type of catheter\nSkill of person placing catheter

Question 26

Types of Catheters

Answer 26

Winged or Butterfly \nOver–the–Needle\nThrough–the–Needle

Question 27

Type, length & gauge of catheter to use:

Answer 27

Dependent upon:\nSpecies & size of patient\nAvailable veins to be used\nReason for catheter placement

Question 28

Winged or Butterfly catheters

Answer 28

Generally short–term use\nPatient not overly mobile (ie during anaesthetic, medication admin)\nCatheters easy to place\nDifficult to maintain\nCan easily puncture the vessel wall

Question 29

IMAGE – Butterfly Catheter

Answer 29

https://images.cram.com/images/upload-flashcard/66/35/21/34663521_m.png

Question 30

Over–the–Needle catheters

Answer 30

Most commonly used\nCatheter is placed over metal stillette\nEasy to place\nPrimarily used in peripheral veins (e.g. cephalic)

Question 31

IMAGE – Over–the–Needle catheters

Answer 31

https://images.cram.com/images/upload-flashcard/66/35/43/34663543_m.png

Question 32

Through–the–Needle catheters

Answer 32

Catheters are passed through the stillette\nPrimarily used in jugular veins

Question 33

Multi–lumen catheters

Answer 33

Have 2 or 3 catheters in one lumen (tube)\nUsually placed in jugular veins\nExpensive\nRequire a skilled operator

Question 34

IMAGE – Through–the–Needle catheter

Answer 34

https://images.cram.com/images/upload-flashcard/66/35/53/34663553_m.png

Question 35

IMAGE – Peel–away Central Line Catheter

Answer 35

https://images.cram.com/images/upload-flashcard/66/35/47/34663547_m.png

Question 36

Suggested Lumen Uses for \nTriple Lumen catheters\n(e.g. Cook products)

Answer 36

Lumen 1 – Red (proximal port):\nMedication\nFluid \nMedication\nAcute hyperalimentation\nBlood or blood products\nBlood sampling\nCentral Venous Pressure (CVP)

Question 37

Central Lines or Jugular Lines

Answer 37

recommended for long–term use\nNo. of lumens needed dependent on patient condition, fluid therapy, blood sampling & IV meds required.\nCentral lines – used to measure CVP\nMulit–lumen catheters – generally made from silicone (least reactive for IV use).