week 2 med admin/IVs Flashcards
Saline lock=
peripheral IV cannula w/ distal med port used for fluid/med infusion. Saline is injected into device to maintain its patency
Huber needle=
needle w/ opening on side of shaft instead of tip
Heparin Lock=
peripheral IV cannula w/ distal med port for fluid/med infusions. Flushes of heparin solution, which inhibit blood coagulation are used to maintain patency of the device (for long term use)
Hemolysis=
destruction of RBCs
8 med rights =
patient, dose, route, drug, documentation, time, reason, response
Medical asepsis=
providing a medical environment that is free of pathogens
autoclave=
clean/sanitize w/ heat
Medical clean techniques=
handling medical equipment in a way to prevent contamination
Antiseptics on?
Disinfectants on?
Humans
Tools
4 dif/ ways to administer meds to PT:
Enteral (GI), parenteral (outside GI→ needles), percutaneous (per skin, any mucous membranes), pulmonary
med admin per Enteral=
(GI) PR, PO, gastric–>Ease of access & comfort but, can easily be affected by foods, stress, & illness
First pass effect=
any med down to stomach is absorbed through hepatic system (liver filters) hepatic vein)
EXCESSIVE SUCTIONING LEADS TO
HYPERALKINATION THROWING OFF OF PH (HALDANE BOHR EFFECT)
periculum=
important tissues
Parenteral med admin/ (outside GI):
Med packing: ampules (filter needle & change needle), single & multi dose vials, prefilled syringes, non-constituted meds (med w/ water), IV fluids
Luer lock=
screw on locking tips for IVs, tubing, ect
Intradermal injection (ID) steps:
Deposits into dermal, 10-15 degree w/ bevel up, creates response, less 1 mL
Subcutaneous (SQ) steps:
Deposits meds into SQ tissues, 45 degree bevel up, made for slower absorption, less 1mL
Intramuscular (IM) steps:
90 degree w/ bevel up, Z trach method when inserting needle to shift layers, pull back plunger,
IM sites and dose for sites:
deltoid(up to 2mLs)
Dorsal gluteal(butt (5 mLs or more) upper lateral side, vastus lateralus (5mLs or more),
Rectus femoris (up to 5mL) PEDIS and stabilize
Mucus membranes:
Sublingual, buccal, ocular, nasal, aural (ear), pulmonary
Fluid compartment sites in body:
45% intracellular
15% extracellular (outside cell)
Interstitial 10.5%
Intravascular 4.5%
types of fluid solutions:
Isotonic= solution does not cause shift/affect cells
(Isotonic crystalloid most common)
Hypertonic= concentration is greater than membrane (intracellular→ intramuscular) pulls water from cells outside>inside (causes cells to shrivel
hypotonic= (“hypo makes em blow)solution concentration is less than membrane causing cells to swell Outside<inside
Hydrostatic pressure=
pressure inside of a blood vessel that is created by the heart pumping (heart heart pushing out)
Oncontic pressure=
pulling force back into the blood vessels by the presence of large proteins in the blood (pulling back in)
Central Venous access sites:
(IJ) intra jugular,
subclavian,
femoral,
peripherally inserted central catheter (PICC) line,
Port-a-cath (requires Huber needle long bevel so doesn’t break off rubber)
accessing EJ
Turn head, finger flow towards heart (tamponade vein to get JVD)
Use 16-18 gauge, supine, cannulate vein, connect tubing & secure site (wrap around the ear),
Flow rates and mLs:
TKO
KVO
Wide open
(to keep open) = 20-25mLs/Hr
( keep vein open)= 20-25mLs/Hr
(letting flow w/o regulating)
Catheter shear=
pushing need in out back in→ can become a embolism (if happens put on left lateral side)
Thrombophlebitis=
Thrombus/air embolism in vein from improper IV causing inflammation
Infiltration aka extravication=
fluid coming out of blood vessels (will feel cool to touch)
The 3 knows of a med packaging =
name, EX date, total dose & concentration
non-constituted medication vial
prolongs viability & storage of meds w/ short shelf lives or that are unstable in liquid form. It includes 2 vials: one w/ powdered med & one liquid mixing solution.
Mix-o-Vial system=
2 vials are joined & you must squeeze them together to break the seal and mix.
Common IV Fluids:
Lactated Ringer’s (Hartman’s Solution)
Normal Saline (0.9% Sodium Chloride)
5% Dextrose in Water
Plasmalyte
Lactated Ringer’s (Hartman’s Solution) IV solution=
Isotonic.
Contains sodium chloride, potassium chloride, calcium chloride, and sodium lactate.
Plasmalyte IV solution=
Balanced crystalloid solution.
Mimics human plasma in electrolytes, osmolality, and pH.
Trendelenburg position =
Supine with head higher than head @ 15-30 degrees
(for EJ IV acess)
IV complication Infiltration=
when fluid leaks out of vein into surround soft tissue causing pain and swelling
IV complication Extravasation=
accidental infiltration of a med into surround IV site
IV complication Pyrogenic reaction=
(pyrogens= foreign proteins capable of producing fever) in the IV solution or admin/ set → fever onset (100.5-106F) occurs within ½ hour - 1 hour after IV
IV complication Circulatory overload=
too much fluid for PTs condition
Aural meds=
med/s given to ear/canal membrane
Emulsions=
These are medications combined with a fat or oil emulsifier
Lozenges=
These solid forms of medication dissolve slowly in the mouth, thus permitting gradual swallowing.
Cannulation=
accessing IV for blood withdraw
Colloidal/crystalloid solutions=
Solution w/ large proteins that cannot pass through the capillary membrane. Consequently, they remain in the circulatory system for a long time. Colloids have osmotic properties that attract water into the circulatory system.small amount of colloid can significantly increase intravascular volume (volume of blood and fluid contained within the blood vessels)
Common Colloidal/crystalloid solutions:
Plasma protein fraction (Plasmanate),
Albumin,
Dextran,
Hetastarch (Hespan)
Plasmanate solution=
protein-containing colloid. Its principal protein, albumin, is suspended with other proteins in a saline solvent.
Albumin solution=
contains only human albumin. Each gram retains ~18 mL of water in the bloodstream.
Dextran solution=
large sugar molecule with osmotic properties similar to those of albumin. It comes in two molecular weights: 40,000 and 70,000 daltons. Dextran 40 has from two to two and one-half times the colloidal osmotic pressure of albumin. Anaphylactic reaction is a possible side effect.
Hetastarch (Hespan) solution=
Like dextran, hetastarch is a sugar molecule with osmotic properties similar to those of protein. Hetastarch does not appear to share dextran’s risk of anaphylaxis.
