Unit 5 Flashcards
drop factor (drops/milliliter) X volume (milliliter/hour)
drops
What factor could directly escalate the degree of anxiety a patient experiences when receiving IV therapy?
Misguided concept that IV therapy is only administered to critically ill patien
What is a goal of psychologically preparing a patient for intravenous therapy?
Provide the patient with an understanding of what the ordered therapy entails
Which of the following is an essential component of the patient’s IV therapy teaching plan?
Limitations or restrictions imposed as a consequence of the therapy
Which of the following factors are identified as affecting a patient’s personal psychological resources?
Previous experience with illness and pain, family relationships, relationship with health care team
Which of the following signs and symptoms are typical of a vasovagal reaction consequential to patient stress?
Vasoconstriction, syncope, and diaphoresis
Dependent, regressive behavior exhibited by an IV therapy patient is often a consequence of what condition?
Psychological stress
Which of the following factors is identified as generating noncooperation in an IV therapy patient?
Alteration in patient’s mental status secondary to chronic brain syndrome
Which of the following are considered appropriate nursing considerations when caring for an uncooperative IV therapy patient?
Closely monitor patient status and use safety mittens when indicated.
Length of vascular access device is called?
length
Female connection point of vascular access device
Hub
diameter size of vascular access device opening?
guage
space within the vascular access device?
Lumen
delivers 60 gtt/ml
Microdrip primary standard set
Used for drug delivery with pressure sensitive check-valve sets
Secondary administration set
Used for administration of blood/ blood components
Y set
Used to prevent absorption of certain infusates into tubing
Nonpolyvinyl chloride sets
Allows primary infusion to cease during IVPB delivery
Pressure sensitive check-valve sets
Drops per ml vary among set manufacturers
Macrodrip primary standard set
Contains a calibrated chamber
Precision volume-controlled sets
Catheter mounted on a needle; needle removed once catheter is inserted,
Over the needle (ONC)
Short, small gauge needle with one or two plastic side arms or wings
winged infusion needle
Has a permanently attached injection port
intermittent infusion device
Used with standard disposable syringes
syringe pump
Generates flow under positive pressure
standard electronic
Lightweight, compact, and battery driven
ambulatory pump
Has a remote control for patient activated bolus dosing
PCA pump
Design incorporates a drop sensor
Nonvolumetric controller
commonly referred to as a Hickman catheter
Tunneled central venous catheter
Site of insertion is in vein adjacent to the antecubital fossa
PICC
consists of three internal lumens
Multilumen central venous catheter
Has a rounded, blunt, venous catheter closed tip,
Groshong catheter
Consist of an implanted long- term venous access port device composed of a catheter and reservoir with a self-sealing septum
Implanted central venous catheter
What factors should be considered when selecting a peripheral vascular access device?
Ordered therapy, patient’s clinical status, and patient’s age
What are characteristics of parenteral fluid glass containers?
The containers may be of vented or nonvented designs, and they contain a vacuum.
What is a disadvantage of using plastic parenteral fluid containers?
It may be difficult to ascertain the volume of fluid remaining in the container.
What is an important nursing consideration when using resealable injection ports?
Integrity may be compromised if subjected to numerous penetrations.
What is a disadvantage of using transparent semipermeable membrane dressings?
cost of dressing
Needle protective systems are designed to:
reduce the risk of needle-stick injuries.
What is the most vital nursing consideration when using a non-electronic rate minder?
Its use does not negate the need for a nurse to monitor the infusion rate.
What is a true statement that correctly reflects the use of a microbore extension tubing set
Often used as an adjuvant to a PICC
What is the setting in which elastomeric infusion devices are predominantly used?
Home care setting
The purpose of an IV site protector is to prevent:
dislodgement of cannula
Evaluating the appropriateness of a parenteral fluid for infusion includes checking the:
fluid’s expiration date, evaluating the integrity of the fluid container and cap, and type/volume of fluid.
What supplies should be collected in preparation for establishing a peripheral intravenous site?
Tourniquet, antiseptic, dressing, cannulas, tape, gloves, prescribed fluid, and administration set
When verifying the appropriateness of a parenteral fluid for patient infusion, an essential factor is to determine:
that it corresponds with the physician’s order.
What protective barrier item should be included in the equipment collected for insertion of an intravenous line?
Gloves
The drip chamber of the administration set should be filled with fluid to at least which of the listed capacities?
1/3
How many feet is the appropriate height for suspending the fluid container from the IV pole in relationship to the intended IV site?
3
The six interactin items that are essential after patient identification are:
Provide privacy.
b. Question patient about allergy history.
c. Explain procedure.
d. Address patient’s concerns.
e. Explain restrictions necessitated by ordered therapy.
f. Demonstrate appropriate care, if applicable.
Prime factors to be considered when selecting a vein for venipuncture include:
characteristics of available veins, objective of ordered therapy, and anticipated duration of therapy.
What actions are considered appropriate when stabilizing an IV cannula?
It should not interfere with future site assessment.
True or False: For IV site dressings
Dressings may be gauze or transparent semipermeable membrane dressings?
True
What information should be inscribed on the IV site dressing label?
Date/time; gauge, type, and length of cannula; and nurse’s initials
Which of the following sites is considered appropriate when selecting a peripheral vein for intravenous cannula insertion
Soft, spongy veins located away from areas of flexion
When should a pt be avised to seek nursing assistance for IV site?
Dressing feels wet, Pain develops, Redness develops, Swelling develops, Blood backs up in administration set tubing
What is a characteristic of a vein that is appropriate for venipuncture?
Feels soft when palpated
Vein dilation may be achieved by
applying a tourniquet.
How and where should supplies be placed when setting up for an IV insertion?
In sequential order near the insertion site
What blood barrier precautions should be followed when inserting an IV?
Protective pad under site and gloves
What is the appropriate technique for inserting an ONC or a winged-infusion set?
Bevel up at 10º-30º angle
Which of the following actions is appropriate for site preparation?
Allow antiseptic agent to dry naturally
What precaution should be observed when inserting an ONC?
Avoid readvancing the needle into the catheter once threading has begun
What precaution should be observed when inserting a winged-infusion set?
Prime air from set before insertion.
A peripheral intravenous catheter may be converted to an intermittent infusion device by connecting what type of equipment to the catheter hub?
Injection port
The goal of injecting a flush solution into the intermittent infusion device is to:
maintain patency
What factors does the physician consider when ordering an infusion flow rate?
Patient’s clinical status, patient’s body surface area, and fluid composition
What drop factors are available in macrodrip administration sets?
10, 15, and 20 gtt/ml
When regulating the flow rate of a gravity infusion, for how many seconds should a nurse use a watch to time fluid drops?
60
What are the potential complications of an inaccurate infusion flow rate?
Inappropriate drug serum levels, pulmonary edema, and cannula occlusion
What factors affect the infusion flow rate?
Phlebitis, height of container, and viscosity of the fluid
The physician orders a 30 ml/hour of 0.45% sodium chloride on a 6-month-old infant. The administration set drop factor is 60.
30 gtts/min
Answer is 30 gtts per minute.
30/60 X 60 = 30 gtts per minute.
Calculate the following ordered flow rates in drops per minute.
The physician orders 1,000 ml of dextrose 5%/0.45% sodium chloride to infuse at 150 ml/hour. The administration drop factor is 15.
38 gtts/min
Answer is 38 gtts per minute.
150/60 X 15 = 38 gtts per minute.
Calculate the following ordered flow rates in drops per minute.
The physician orders 500 ml of dextrose 5%/W to infuse over 4 hours. The administration drop factor is 20.
42 gtts/min
Answer is 42 gtts per minute.
150/4 = 125 ml per hour.
125/60 X 20 = 42 gtts per minute.
Calculate the following ordered flow rates in drops per minute.
The physician orders a fluid challenge of 250 ml of 0.45% sodium chloride over 60 minutes. The administration set drop factor is 10.
42 gtts/min
Answer is 42 gtts per minute.
250/60 X 10 = 42 gtts per minute.
Calculate the following ordered flow rates in drops per minute.
The physician orders lactated Ringer’s 500 ml to infuse over 24 hours. The administration set drop factor is 60.
21 gtts/min
Answer is 21 gtts per minute.
500/24 = 21 ml per hour.
21/60 X 60 = 21 gtts per minute.
Calculate the following ordered flow rates in drops per minute.
The physician orders 500 ml of dextrose 5%/0.25% sodium chloride to infuse at 75 ml/hour. The administration set drop factor is 15.
19 gtts/min
Answer is 19 gtts per minute.
75/60 X 15 = 19 gtts per minute.
Calculate the following ordered flow rate in drops per minute.
The physician orders an infusion of normal saline 500 ml to infuse at 100 ml per hour. The administration drop factor is 10.
17 gtts/min
Answer is 17 gtts per minute.
100/60 X 10 = 17 gtts per minute.
Calculate the following ordered flow rates in drops per minute.
The physician orders 500 ml of dextrose 5%/NS to infuse over 10 hours. The administration drop factor is 60.
50 gtts/min
Answer is 50 gtts. per minute.
500/10 = 50 ml per hour.
50/60 X 60 = 50 gtts per minute.
What is the objective in establishing flow rate?
To ensure that fluid is delivered over the time span specified by the physician’s order.
What is the mathematical formula used to calculate IV infusion flow rate?
Ml per hour/60 X flow rate = drops per minute.
Calculate the following ordered flow rate in drops per minute.
The physician orders 3,000 ml of lactated Ringer’s over 24 hours. The administration set drop factor is 10.
21 gtts/min
Answer is 21 gtts per minute.
3000ml/24hrs. = 125 ml per hour.
125/60 X 10 = 21 gtts per minute.
Calculate the following ordered flow rates in drops per minute.
The physician orders 1,000 ml of dextrose 5%/NS at 100 ml/hour. The administration set drop factor is 20.
33 gtts/min
Answer is 33 gtts per minute.
100/60 X 20 = 33 gtts per minute.
Calculate the correct flow rate in milliliters/hour for a patient who is to receive 1,800 ml of solution in 24 hours.
75 ml/hr
Determine drops/minute for a patient who is to receive 1,000 ml of solution in 12 hours.
The IV infusion set delivers 15gtt/ml.
21 gtts/min
Determine drops/minute for a patient who is to receive 1,000 ml of solution in 12 hours.
The IV infusion set With a set delivers 10gtt/ml.
14 gtts/min
Determine drops/minute for a patient who is to receive 1,000 ml of solution in 12 hours.
The IV infusion set With a set delivers 20gtt/ml.
28 gtts/min
Determine drops/minute for a patient who is to receive 500 ml of 0.45% sodium chloride at a rate of 150 ml/hour. The administration drop factor is 15.
38 gtts/min
Determine drops/minute for a patient who is to receive 1,000 ml of LR over 10 hours.
The IV infusion set delivers 10 gtt/ml.
17 gtts/min
Determine drops/minute for a patient who is to receive 1,000 ml of LR over 10 hours.
The IV infusion set delivers 15 gtt/ml.
25 gtts/min
Determine drops/minute for a patient who is to receive 1,000 ml of LR over 10 hours.
The IV infusion set delivers 20 gtt/ml.
33 gtts/min
Determine drops/minute for a patient who is to receive 1,000 ml of dextrose 5%/W over 4 hours.
a. With a set that delivers 10 gtt/ml
42 gtts/min
Determine drops/minute for a patient who is to receive 1,000 ml of dextrose 5%/W over 4 hours.
b. With a set that delivers 15 gtt/ml
63 gtts/min
Determine drops/minute using a 10-gtt/ml set for a patient who is to receive 3,000 ml of dextrose 5%/LR at a rate of 125 ml per hour.
21 gtts/min
Determine drops/minute using a 60-mcgtt/ml set for a patient who is to receive 1,000 ml NS at a rate of 50 ml/hour.
40 gtts/min
Which of the following is a primary consideration in fluid and electrolyte imbalance in pediatric patients?
The younger the child, the greater the risk of fluid and electrolyte imbalance, fluid overload, and congestive heart failure.
When venipuncture is to be performed on a child, the parent or guardian should be:
provided with an explanation of what the procedure entails.
