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CPSS: IV Therapy & Venipuncture
Summer II 2011
41
Medical
Graduate
08/06/2011

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Cards

Term
What are the contraindications to IV therapy?
Definition
active skin infection
thrombophlebitis
Term
Where should an IV be placed if there is an area of pre-existing thrombophlebitis present?
Definition
IV lines should not be inserted distal to any area of preexisting thrombophlebitis
Term
What type of venipuncture should be avoided in elderly pts and in pts with PVD?
Definition
Lower extremity venipunctures
Term
What determines the gauge of the needle that should be used for an IV?
Definition
The rate of fluid administration is directly proportional to the bore of the catheter and inversely proportional to its length
Term
What type of IV fluids are isotonic?
Definition
LR, NS (0.9% saline)
Term
What is the risk of using isotnic fluids? What conditions should you use these with caution?
Definition
Risk of fluid overload
CHF, HTN
Term
When are hypotonic solutions helpful?
Definition
Helpful when cells dehydrated
- dialysis pt on diuretics
- hyperglycemic conditions
- diabetic ketoacidosis
Term
What IV solutions are considered hypotonic?
Definition
. 45% NaCl, 2.5% dextrose
Term
When is the use of hypertonic solution dangerous?
Definition
Dangerous in the setting of cell dehydration
Term
What IV solutions are considered hypertonic?
Definition
D5%
.45% NaCl,
D5% LR,
D5% NS,
blood products,
albumin
Term
With crystalloid solution, what is there a risk for?
Definition
Risk of edema
Term
What should IV crystalloid solutions generally be followed by?
Definition
Should generally follow with blood (after 2 L)
Term
What IV solutions are crytalloids?
Definition
LR, NS
Term
According to new data, which IV solution is best to use in trauma victims with massive hemorrhage?
Definition
LR
Term
What IV fluids are good at reducing edema?
Definition
colloids
Term
Which type of IV solution is described as hypertonic, containing molecules that are too large to cross vascular membranes?
Definition
Colloids
Term
Which type of IV solution is good for pulmonary edema and cerebral edema?
Definition
Colloids
Term
Which IV solution must be used cautiously as dramatic fluid shifts may occur?
Definition
Colloids
Term
What IV solution is considered colloid?
Definition
Albumin
Term
When selecting a vein for an IV, where should you begin?
Definition
distally in non-dominant upper extremity
Term
When placing an IV, what are the indicators that you are in an artery, not a vein?
Definition
Bright red blood
High pressure
Withdraw catheter
Apply gauze pad
Firm pressure at least 5 min
Term
What type of IV drip set is good for medication administration or pediatric fluid delivery? How many drops per mL?
Definition
Microdrip: 60drops/mL
Term
What IV drip set is described as great for rapid fluid delivery? How many drops per mL?
Definition
Macrodrip; 10 to 15 drops/ML
Term
What is the formula for finding drops per min?
Definition
volume in mL x drip set
________________________
time in minutes
Term
What are the complications of IV therapy?
Definition
bruising
cellulitis
infiltration
extravasation
phlebitis
systemic (sepsis, pulmonary thromboembolism, air embolism, catheter fragment embolism)
Term
Which veins provide a greater risk of Pulmonary thromboembolism with an IV?
Definition
lower extremities
Term
How can the complication of an air embolism when using an IV be avoided?
Definition
by flushing the IV line
Term
What type of IV equipment is especially useful in children?
Definition
butterfly needle?
Term
What special consideration should be taken with IV lines in the elderly population?
Definition
use smallest catheter possible
careful securing IV on fragile skin
AVOID LE IVs
Term
What areas should be avoided when performing a venipuncture?
Definition
Extensive scars from burns and surgery
UE on the ipsilateral side of a previous mastectomy
Hematoma
Ipsilateral side of IV therapy/blood transfusion
Cannula/fistula/heparin lock
Edematous extremities
Term
Which vessels are MC used for venipuncture?
Definition
median cubital and cephalic veins of the arm
Term
What must accompany each blood sample submitted to the lab?
Definition
A requisition form
Term
What is the order for blood draw tube types?
Definition
1st - blood culture tubes (yellow/black stopper)
2nd - non-additive tubes (red stopper or SST)
3rd - Coagulation tube (light blue)
4th - Additive tubes (Everything else)
Term
Which tube type should never be drawn first?
Definition
Coag tube (light blue)
Term
What is MANDATORY to check before blood draw?
Definition
Identification of Pt: Don't draw blood if armband is missing
Term
How can a hematoma be prevented?
Definition
Puncture only one wall of vein
Remove tourniquet before removing needle
Use major superficial vein
Make sure needle fully penetrates upper most wall of vein
Apply pressure to venipuncture
Term
How can you prevent test error with blood samples when an indwelling line or catheter is present?
Definition
Discard a sample at least three times the volume of the line before a specimen is obtained for analysis
Term
What may an increased concentration of larger molecules & formed elements in a blood sample be due to?
Definition
Prolonged tourniquet application (no more than 2 minutes)
Massaging, squeezing, or probing a site
Long-term IV therapy
Sclerosed or occluded veins
Term
How can increased exercise affect blood samples?
Definition
Can increase CK, AST, LDH, platelet count
Term
How can stress affect a blood sample?
Definition
Transient elevation in WBCs, cortisol and catecholamines
Term
What effects can an anxiety attack have on a blood sample?
Definition
may cause acid-base imbalances, & increased lactate
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