WEEK 4 IV THERAPY Flashcards
What is the term for IV solutions that contain solutes that mix, dissolve, and cross semipermeable membranes?
Crystalloids
What is the term for IV solutions that contain protein or starch, and do not cross semi-permeable membranes?
Colloids
Name 4 examples of crystalloid solutions
Dextrose, NS, Lactated ringers, plasmalyte
Name 4 examples of colloid solutions
Dextran, pentaspan, hetastarch, blood products
What are 2 disadvantages of crystalloid solutions?
3x volume required for fluid replacement
Shorter half life
What is one advantage of crystalloid solutions?
Inexpensive
What are 2 advantages to colloid solutions?
Replaces fluid volume for volume
Longer half life
What is one disadvantage of colloid solutions?
More expensive
What fluid compartment is affected by isotonic solutions?
Extracellular fluid
Name 3 examples of isotonic solutions
Ringer’s, NS, D5
What fluid shift is caused by hypotonic solutions, and for what purpose is this used?
From extracellular fluid to intracellular fluid; maintenance fluid
What is the risk with hypotonic solutions?
Cell swelling
Name one example of a hypotonic solution
NS 0.45
What fluid shift is expected with hypertonic solutions, and for what purpose is it used?
From intracellular fluid to extracellular fluid; used to treat hypovolemia and hyponatremia
What are 2 risks associated with hypertonic solutions?
Intravascular fluid overload and intracellular dehydration
Name 2 examples of hypertonic solutions
Dextrose 10%, NS 3%
What is the purpose of plasma expanders?
Increase osmotic pressure
Why does hypokalemia develop in patients with normal renal function who are NPO?
The body cannot conserve potassium
Why is knowing renal function important when administering potassium?
Risk for hyperkalemia
How should potassium always be administered?
By IV pump and never IV push
How is placement of a central venous catheter confirmed?
X-ray
What are 2 things langara students can do with central lines?
Assess
Manage fluids/medications above the pump
What are 3 principles to remember when choosing an IV site?
- In children and older adults, avoid sites that are easily moved/bumped
- Avoid arm on same side as mastectomy or AVG for dialysis
- Place at most distal site possible to allow for use of proximal sites later
What are 2 risks with an infusion rate that is too slow?
- CVS compromise/collapse
- Clot formation/loss of IV site
What is the term for inadvertent administration of fluids into the tissues surrounding the blood vessel?
Infiltration
What is the term for inadvertent administration of medication/irritating substances into the tissues surrounding the blood vessel?
Extravasation
What are 6 symptoms of infiltration/extravasation?
- Pallor
- Swelling
- Pain
- Skin cool to touch (one sided only)
- Damp dressing
- Slowed infusion rate
What are 5 things done to treat infiltration/extravasation?
- Stop infusion, remove catheter
- Elevate extremity
- Active ROM
- Warm/cold compress
- Restart infusion proximal to site or in other extremity
What are 2 things done to prevent infiltration/extravasation?
- Choose site and catheter carefully
- Secure catheter well
What are 3 symptoms of phlebitis that differ from symptoms of infiltration?
- Increased skin temperature
- Erythema
- Red line along vessel with palpable band
What are 3 things done to prevent phlebitis?
- Rotate sites every 7-8 days
- Avoid lower extremities
- Hand hygiene and surgical asepsis
What should be done at an IV site with phlebitis that has drainage present?
Swab for culture
How is cellulitis different from phlebitis?
Cellulitis is bacterial infection to the skin while phlebitis is irritation to the blood vessel
How is catheter embolus prevented?
Never reinsert stylet into catheter
How often should site to source checks be performed?
q1h
What are advantages of administering medications via minibag?
- Medication diluted - decreased risk of adverse reaction
- Good for medications with short stability
- Good for clients with fluid restrictions
About what rate is considered TKVO?
25 ml/hr
