Week 4 - Study Cards Flashcards
What is Intravenous Infusion?
The administration of fluids or medications through a vein
Medications, electrolyte solutions, and blood and blood
What are advantages of intravenous infusion?
Immediate availability of the medication to the body
Rapidity of action
Why is intravenous infusion ordered?
Restore or maintain fluid and electrolyte balance
Replace lost fluids
Medium for administering medications directly to the blood stream
Replacement fluids
Client who has lost fluids due to diarrhea, vomiting, or hemorrhage
Maintenance fluids
Sustain normal levels of fluids and electrolytes for clients at risk for depletion (e.g., a client NPO).
Intermittent fluids
Are used to administer medications and supplemental fluids. E.g. IV piggyback (IVPB) and IV push
Intermittent peripheral infusion devices
saline or heparin locks are used to maintain venous access without the need of continuous infusion
Continuous medication infusion
Administration of medication by direct IV infusion
Peripheral lines
The infusion site is a vein in the arm, hand, or scalp in an infant; or if other sites are not accessible and on rare occasions, a vein in the leg
Central Lines
A special catheter is used to access a large vein such as the subclavian or jugular vein
The special catheter is threaded through a large vein into the right atrium. Examples of central catheters include triple-lumen, Hickman, Broviac, and Groshong catheters
PICC Line
Peripherally inserted central catheter line: a peripheral vein used to access a central vein.
Purpose of a Saline or Heparin lock
Administer IV medication intermittently
Access to a vein in an emergency situation
Intravenous Primary line
Carries main IV solution; is continuous
May have additives such as potassium or vitamins
Intravenous Secondary line
Usually connected to primary (variety of
systems)
Contains solutions of smaller volume with
medications
Usually intermittent (IVPB)
Macro drops
supplied as 10, 15 or 20 gtts/mL
Micro drops
All peds are micro drops
supplied as 60 gtts/mL
Infusion Pumps
The use of electronic infusion devices is based on the need to strictly regulate the IV
Electronic volumetric pumps infuse fluids into the vein under pressure and against resistance and do not depend on gravity.
The pumps are programmed to deliver a set amount of fluid per hour
What is Heparin?
Heparin is a potent anticoagulant that prevents clot formation and blood coagulation
Risk of Heparin
The U.S. Pharmacopoeia listed heparin as one of the top 10 medications most frequently involved in medication errors
Heparin is classified as a high-alert medication because it carries a significant risk of causing serious injuries or death to patients if misused
True or False: Heparin sodium injection and Heparin lock solution can be used interchangeably
FALSE
True or False: Heparin is a weight based infusion
True
Rounding rules based off weight
If patient is more than 10 kg round to the nearest 10th; If patient is less than 10 kg round to the nearest 100th
Insulin is…
A hormone secreted by the islets of Langerhans in the pancreas. It is a necessary hormone for glucose use by the body
True or False: Be sure to shake insulin before administering
False: Roll insulin between palms
Titrated Medications are…
added to a specific volume of fluid and then adjusted to infuse at the rate at which the desired effect is obtained
Drugs that are Titrated are…
potent antiarrhythmic, vasopressor, and vasodilator medications; require constant monitoring by the nurse.
True or false: Titrated medications are rounded to the nearest 10th mL/hr
True
SDR
Safe dose range
TDR
Total daily dose
Why must the IV drip rate be slow for small children?
to prevent complications such as cardiac failure because of fluid overload.
Calibrated burettes
The burette is calibrated in small increments that allow exact measurements of small volumes. Medication is added to the IV fluid in the chamber for a prescribed dilution of volume
Volumetric Pumps
Used to administer intermittent IV medications. When used, the electronic device sounds an alarm when the Buretrol chamber is empty
Rounding rules - Whole numbers
- Weight–based Heparin drip Weight
- All blood and blood products
- All maintenance IV Fluids (Box 21-1)
- Gravity drip or infusion pumps
gtts/min or mL/hour - All Piggybacks
gtts/min or mL/hr
Rounding rules - nearest tenth
- Continuous medication drips (Titrated medications) that affect coagulation, blood sugar, blood pressure, cardiac output, heart rhythm, etc.
Administered via pump
Heparin drip; insulin drip; cardiac medications via drips - Weight >10 kg
Exception of heparin nomogram – rounded to whole kilogram - Temperatures (centigrade or fahrenheit)
- Weight–based medications
- Liquid oral medications
- Parenteral medications >1mL
- IM, IVP, and SQ
Rounding rules - nearest hundreth
Parenteral Medications given <1mL
SQ, IM or IV Push
True or False: Pediatric medication doses to the hundredths place for mg doses (safe dose ranges)
True
True or False: The pediatric pump rates for IV fluids or medications should always be rounded to the hundreth of a milliliter (e.g., 4.83 mL/hour)
False: Correct statement: The pediatric pump rates for IV fluids or medications should always be rounded to the tenth of a milliliter (e.g., 4.8 mL/hour)
True or False: Pediatric weights in kilograms to the hundredth of a kilogram for infants weighing <10 kg (e.g., 4.25 kg).
True
