Week Six & Seven - IV Maintenance/IV Pumps Flashcards
What are the three classifications of IV solutions?
- Isotonic
- Hypotonic
- Hypertonic
What is an isotonic IV solution?
Used to restore and maintain vascular volume.
What is a hypotonic IV solution?
Hypotonic solutions have a lesser concentation of solutes.
What is a hypertonic IV solution?
A solution that has a greater concentration of solutes than plasma.
What are volume expanders?
IV solutions given to increase the blood volume or loss of plasma after severe loss.
Ex. Plasma & human serum albumin.
Define: Venipuncture
Venipuncture is the collection of blood though a vein, usually for laboratory testing. It could also be the site for administration IV’s.
What are some challenges related to the aging adult when choosing a venipuncture site?
- Loss of subcut tissues
- Thinning of the skin
- Fragile veins
What are three common veins used for IV?
Metacarpal, basilic, cephalic veins
What is a central venous catheter?
A catheter that is placed directly into the subclavian or jugular vein and feed directly into the superior vena cava.
What is a PICC?
Peripherally inserted central catheter
Where is the PICC inserted (Vein and Location)?
Basilic or Cephalic vein, just above or below the antecubital space on the right arm.
What equipment is needed in regards to an IV?
- IV catheter
- Catheter stabilization devices
- Solutions container
- Infusion and Administration sets
- IV filters
- IV poles
What catheter size should be used?
The size used should be the smallest and shortest length and will accommodate the therapy.
What should you check when dealing with solution containers?
- Check the expiration date.
- Is the solution clear? (Cloudiness and leaks indicate possible contaimination).
What is in an infusion administation set?
- Insertion spike
- Drip chamber
- Roller valve or screw clamp
- Tubing with secondary ports
- IV catheter adapter (with protective cap)
What is the purpose of the drip chamber?
Permits a predictable amount of fluid to be delivered.
What is the purpose of the roller valve or clamp?
It compresses the lumen of the tubing there-by controlling the rate of the flow.
What is an IV filter? What does it do?
IV filters remove air and particulate matter from IV infusions.
What are some problems associated with IV filters?
- They become clogged by debris, slowing or stopping the flow rate.
- Drugs can bind to the surface of the filter.
One important thing to remember about IV poles?
The higher the pole, the greater the force of the solution as it enters client vein, and a faster flow rate.
What 3 things should you assess when monitoring an IV infusion?
- Appearance of site and patency of system
- Type of fluid being infused and rate of flow
- Response of the client
Monitoring an IV infusion:
What should you do if the wrong solution is being infused?
1.Slow the rate of flow to a minimum, this ensures patency of the catheter.
2. If Pt. at risk for adverse effect, stop infusion and saline-lock the catheter.
Rationale: Stopping may cause thrombous to from in IV catheter, resulting in removal and new site established.
3. Change the solution to the correct one. Document error.
Monitoring an IV infusion:
What two things should you monitor every hour?
- The rate of flow (if > than 150ml/h check more frequently)
- Insertion site (Checking for infiltration)
What is the correct height of the solution container in relation to the IV site?
Less than 1 meter
Monitoring an IV infusion:
When inspecting the patency of the IV tubing and catheter, what are you looking for?
- Solution container >1m above IV site.
- Drip chamber - more than half full?
- Tubing - free of pinches or kinks
- Position of tubing - not below IV site
- Check for leakage, locate the source
What is extravasation?
Infiltration involving a vesicant drug which causes tissue necrosis. Stop the infusion immediately. Contact appropriate health care team member.
What is phlebitis?
Inflammation of a vein. Mechanical, Chemical, Infection. Discontinue infusion.
How often should the nurse inspect an IV site? What are some exceptions to this rule?
Q1H. However, if the drip rate is particularly fast, inspections should be Q15min.
What are you assessing on the patient in regards to iv care and maintenance?
Assessing site for redness, swelling, or discharge. The nurse should also be ensuring the dressing is dry and intact.
How often should IV sites be rotated?
Every 72 - 96 hours.
How often should sterile occlusive dressings be changed?
What are some other reasons why the dressing should be changed?
Every 72 - 96 hours.
Also, replace the dressings when the IV catheter is changed, the site is wet, or the dressing loses adherence to the skin.
What are some common problems why IVs are not infusing?
Tubing is kinked, IV is clotted, Positional IV (tip against vein wall),
What is the correct procedure for removing air in the IV line?
Close the clamp below the air. Roll the tubing above the clamp around a pen to compress tube and force air into the drip chamber. Alternatively, tap the tubing. Release clamp and reset drip rate.
Or:
Cleanse the lower med port with alcohol swab. Insert/Attach syringe and as air approaches withdraw air from tubing.
What is phlebitis?
Phlebitis is an inflammation of the vein. It can be caused by trauma, chemical irritation, or infection.
What is thrombophlebitis?
Thrombophlebitis is when phlebitis progresses to the point of vein occlusion and clot formation.
What is infiltration?
Infiltration is the accumulation of fluid in the tissues that occurs when the catheter has been dislodged out of the vein.
What is a hematoma?
A hematoma is an effusion of blood into the subcutaneous tissues.
What is an infection?
Microbial growth at the IV site, a possible complication of IV therapy.
What is arterial cannulation?
Arterial cannulation is the accidental insertion of an IV catheter into an artery.
What does TKVO mean?
To Keep Vein Open
What is the equation for determining Drops/Min?
Infusion Rate x Drip Rate = Drop/Hr / 60
What is the drop/mL of Micro drip tubing?
60 drop / mL
What is the drop/mL of Macro drip tubing?
10 drop / mL or 15 drop / mL
