week 2 med admin/IVs

Question 1

Saline lock=

Answer 1

peripheral IV cannula w/ distal med port used for fluid/med infusion. Saline is injected into device to maintain its patency

Question 2

Huber needle=

Answer 2

needle w/ opening on side of shaft instead of tip

Question 3

Heparin Lock=

Answer 3

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)

Question 4

Hemolysis=

Answer 4

destruction of RBCs

Question 5

8 med rights =

Answer 5

patient, dose, route, drug, documentation, time, reason, response

Question 6

Medical asepsis=

Answer 6

providing a medical environment that is free of pathogens

Question 7

autoclave=

Answer 7

clean/sanitize w/ heat

Question 8

Medical clean techniques=

Answer 8

handling medical equipment in a way to prevent contamination

Question 9

Antiseptics on?
Disinfectants on?

Answer 9

Humans
Tools

Question 10

4 dif/ ways to administer meds to PT:

Answer 10

Enteral (GI), parenteral (outside GI→ needles), percutaneous (per skin, any mucous membranes), pulmonary

Question 11

med admin per Enteral=

Answer 11

(GI) PR, PO, gastric–>Ease of access & comfort but, can easily be affected by foods, stress, & illness

Question 12

First pass effect=

Answer 12

any med down to stomach is absorbed through hepatic system (liver filters) hepatic vein)

Question 13

EXCESSIVE SUCTIONING LEADS TO

Answer 13

HYPERALKINATION THROWING OFF OF PH (HALDANE BOHR EFFECT)

Question 14

periculum=

Answer 14

important tissues

Question 15

Parenteral med admin/ (outside GI):

Answer 15

Med packing: ampules (filter needle & change needle), single & multi dose vials, prefilled syringes, non-constituted meds (med w/ water), IV fluids

Question 16

Luer lock=

Answer 16

screw on locking tips for IVs, tubing, ect

Question 17

Intradermal injection (ID) steps:

Answer 17

Deposits into dermal, 10-15 degree w/ bevel up, creates response, less 1 mL

Question 18

Subcutaneous (SQ) steps:

Answer 18

Deposits meds into SQ tissues, 45 degree bevel up, made for slower absorption, less 1mL

Question 19

Intramuscular (IM) steps:

Answer 19

90 degree w/ bevel up, Z trach method when inserting needle to shift layers, pull back plunger,

Question 20

IM sites and dose for sites:

Answer 20

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

Question 21

Mucus membranes:

Answer 21

Sublingual, buccal, ocular, nasal, aural (ear), pulmonary

Question 22

Fluid compartment sites in body:

Answer 22

45% intracellular
15% extracellular (outside cell)
Interstitial 10.5%
Intravascular 4.5%

Question 23

types of fluid solutions:

Answer 23

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

Question 24

Hydrostatic pressure=

Answer 24

pressure inside of a blood vessel that is created by the heart pumping (heart heart pushing out)

Question 25

Oncontic pressure=

Answer 25

pulling force back into the blood vessels by the presence of large proteins in the blood (pulling back in)

Question 26

Central Venous access sites:

Answer 26

(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)

Question 27

accessing EJ

Answer 27

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),

Question 28

Flow rates and mLs:
TKO
KVO
Wide open

Answer 28

(to keep open) = 20-25mLs/Hr
( keep vein open)= 20-25mLs/Hr
(letting flow w/o regulating)

Question 29

Catheter shear=

Answer 29

pushing need in out back in→ can become a embolism (if happens put on left lateral side)

Question 30

Thrombophlebitis=

Answer 30

Thrombus/air embolism in vein from improper IV causing inflammation

Question 31

Infiltration aka extravication=

Answer 31

fluid coming out of blood vessels (will feel cool to touch)

Question 32

The 3 knows of a med packaging =

Answer 32

name, EX date, total dose & concentration

Question 33

non-constituted medication vial

Answer 33

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.

Question 34

Mix-o-Vial system=

Answer 34

2 vials are joined & you must squeeze them together to break the seal and mix.

Question 35

Common IV Fluids:

Answer 35

Lactated Ringer’s (Hartman’s Solution)
Normal Saline (0.9% Sodium Chloride)
5% Dextrose in Water
Plasmalyte

Question 36

Lactated Ringer’s (Hartman’s Solution) IV solution=

Answer 36

Isotonic.
Contains sodium chloride, potassium chloride, calcium chloride, and sodium lactate.

Question 37

Plasmalyte IV solution=

Answer 37

Balanced crystalloid solution.
Mimics human plasma in electrolytes, osmolality, and pH.

Question 38

Trendelenburg position =

Answer 38

Supine with head higher than head @ 15-30 degrees
(for EJ IV acess)

Question 39

IV complication Infiltration=

Answer 39

when fluid leaks out of vein into surround soft tissue causing pain and swelling

Question 40

IV complication Extravasation=

Answer 40

accidental infiltration of a med into surround IV site

Question 41

IV complication Pyrogenic reaction=

Answer 41

(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

Question 42

IV complication Circulatory overload=

Answer 42

too much fluid for PTs condition

Question 43

Aural meds=

Answer 43

med/s given to ear/canal membrane

Question 44

Emulsions=

Answer 44

These are medications combined with a fat or oil emulsifier

Question 45

Lozenges=

Answer 45

These solid forms of medication dissolve slowly in the mouth, thus permitting gradual swallowing.

Question 46

Cannulation=

Answer 46

accessing IV for blood withdraw

Question 47

Colloidal/crystalloid solutions=

Answer 47

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)

Question 48

Common Colloidal/crystalloid solutions:

Answer 48

Plasma protein fraction (Plasmanate),
Albumin,
Dextran,
Hetastarch (Hespan)

Question 49

Plasmanate solution=

Answer 49

protein-containing colloid. Its principal protein, albumin, is suspended with other proteins in a saline solvent.

Question 50

Albumin solution=

Answer 50

contains only human albumin. Each gram retains ~18 mL of water in the bloodstream.

Question 51

Dextran solution=

Answer 51

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.

Question 52

Hetastarch (Hespan) solution=

Answer 52

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.