Term
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Definition
| Method used to administer fluids elecyrolytes and medications directly into the blood stream. |
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Term
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Definition
a. Treat fluid and electrolyte imbalance
b. Administer medications
c. Deliver blood products
d. Dilute Iritating drugs
e. Orders for IV therapy (how are the orders written?) |
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Term
| Advantages of the IV Route |
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Definition
a. Give medications rapidly
b. Administer fluids rapidly
c. Rapid onset and rapid action
d. Bypasses GI tract and therefore unaffected by GI
e. GREAT for medications which would otherwise irritate GI
f. When client is NPO, can still receive medications and fluids
g. THE GOAL IS TO REACH BALANCE IN THE BODY. The vascular system to be balanced with the extracellular fluid. Hypertonic, hypotonic, isotonic solutions. |
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Term
| Disadvantages of the IV Route |
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Definition
a. Once administered, there is no getting the medication back.
b. Requires considerable degree of skill to initiate and maintain
c. Iv related complications may occur
i. Phlebitis, sepsis, infection, allergies
d. There is [pain and/or discomfort associated with procedure |
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Term
| What are some incompatibilities of IV Therapy? |
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Definition
i. Solutions
ii. Drugs
iii. PCA meds
iv. ALLERGIES!!!!!
v. see a list of medications and common fluids used to administer/infuse that location |
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Term
| what are the Types of Primary Solutions? |
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Definition
a. Isotonic
b. Hypotonic – less sodium than blood and therefore water will cross from solution into blood
c. Hypertonic |
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Term
| What is Isotonic solution? |
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Definition
| having the same concentration of solutes as the blood (esp sodium) |
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Term
| what is the benefits of Isotonic Solutions? |
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Definition
i. Cells don’t shrink or swell
ii. Maintains balance because the amount of solute v solution ratios are equal. Therefore no fluid moves across membranes or the net change is zero. There is no pull of fluid in or out of the vascular space
iii. Given for bleeding, hypovolumia, etc after surgery |
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Term
| What are the most common types of Isotonic Solutions? |
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Definition
1. NS – Normal Saline (0.9% NaCl)
2. LR – Lactated Ringer
3. D5W – 5% dextrose in water |
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Term
| What is a hypotonic Solution? |
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Definition
| DRAWS WATER FROM CIRCULATION to CELLS |
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Term
| What are the benefit of Hypotonic solutions? |
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Definition
i. Cells Grow
ii. Free water moves from circulation (blood and IV) INTO cells to hydrate
iii. Used to treat cellular dhydration |
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Term
| What are the most common types of Hypotonic Solutions |
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Definition
iv. 0,45% NaCl (1/2 Normal Saline)
v. 0.33% NaCl (1.3 Normal Saline)
vi. 0.225% NaCl (1/4 Normal Saline) |
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Term
| What is an Hypertonic Solution? |
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Definition
| DRAWS WATER FROM CELLS to Circulation (blood+IV) |
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Term
| What are the benfits of Hypertonic Solution? |
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Definition
i. Cells Shrink
ii. Draws fluid out of the intracellular and interstitial compartments to the vascular compartments
iii. *NOT for clients with kidney or heart disease
iv. *NOT for clients who are dehydrated |
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Term
| What are the most common types of Hypertonic solutions |
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Definition
v. D5 normal saline
vi. D5 half saline
vii. Colloids |
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Term
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Definition
| 1. Plasma expanders – cause cell to expand. Small particles that cross the membrane and swell it in order to allow movement of cell out of |
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Term
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Definition
Total Parental Nutrition
1. Very high osmalarity so must go through a more significant portal of entry.
2. Can be infused indefinitely into centravenous access device: IJ, pic lines, Ports, etc
3. Lots of sugar – glucose |
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Term
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Definition
i. Water
ii. Electrolytes
iii. Most of the common IV solutions – particles are small enough to cross the semipermeable membrane
iv. Sometimes form crystals in the line. If this happens:
1. Stop IV, remove line, clean line. DO NOT want to infuse this into patient. |
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Term
| what are some plasma expanders? |
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Definition
1. Albumin
a. Hetastarch (Hespan)
2. Blood or blood products
a. Whole blood
b. Paced RBC
3. Too large to cross the permeate the membrane |
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Term
| what is colloidal solutions? |
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Definition
i. Plasma expanders
1. Albumin
a. Hetastarch (Hespan)
2. Blood or blood products
a. Whole blood
b. Paced RBC
3. Too large to cross the permeate the membrane |
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Term
| what is the FIRST thing to have before starting an IV? |
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Definition
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Term
| what should the Dr's order include? |
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Definition
i. Type of solution
ii. Medications / additives (potassium)
iii. Volume to be administered
iv. Time period for infusion or rate |
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Term
| what do we assess client for BEFORE starting IV? |
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Definition
i. Allergies: latex (gloves, tape etc), medications, cleaning solutions (betadyne (shellfish))
ii. Pertinent Labs (H&H, CBC, etc) |
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Term
| what equipment would you need to start IV? |
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Definition
| i. Gloves, angiocath, needle, alcohol prep, tape, dressing (e.g. tegaderm), gauze, drop set, saline flush, connector tubing, IV catheter, IV fluid, Tower, tourniquet |
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Term
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Definition
| site of IV, how pt tolerated |
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Term
| what do we assess the cleint for AS we are starting the IV? |
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Definition
i. veins for appropriate, size, shape, thickness, etc
ii. look for tattoos, scars, damaged veins, compromise (esp in legs
iii. consider lenths of IV infusion (hours, days etc) and additives of solution when selecting sites
iv. consider occulusions, circulation, location (don’t want it in an often-moved place (like antecubital)
v. do not use arm on side of a mastectomy
vi. adult arm-veins (avoid antecubital if possible (decreases mobility and may need to be used for pic line etc)
vii. children
1. older children, forearm, avoid restricting movement
2. small infants, hand, wrist, forearm, foot, ankle, avoid foot if learning to walk, I possible scalps, etc |
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Term
| what are some complications of starting an IV?? |
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Definition
- Infection
-Infiltration
-Phlebitis
-IV Fluid Excess
-Air Embolus |
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Term
| What are the s/s of IV infection? |
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Definition
| 1. Nausea, vomiting, increased respiration, pulse, back pain |
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Term
| What is the Nursing Care of IV infection? |
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Definition
1. Prevent spread of germs with aseptic technic
2. Monitor and observe |
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Term
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Definition
| fluid is entering the surrounding tissues |
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Term
| What are the s/s of IV infiltration? |
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Definition
| fluid is entering the surrounding tissues |
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Term
| What is the nursing care of IV iinfiltration? |
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Definition
– 1. Stop the IV 2. Elevate the area 3. Warm compresses for small volume 4. Cold if large volume 5. Document!
iii. Minimum checks every 2 hours but check as often as you are in the room (within reason). |
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Term
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Definition
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Term
| What are the s/s of phlebitis? |
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Definition
increase with time in vein, osmolarity of fluid, site of catheter in vein
1. Redness, swelling, at insertion site, Redness along the path of the vein |
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Term
| What is the nursing care of phlebitis? |
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Definition
discontinue IV (and put in other area)
1. Prevention – clean and assess, change site every 72 hours (or per agency), stabilize IV |
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Term
| What are the s/s of IV fluid excess? |
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Definition
| edema, fluid on lungs leads to crackled breath sounds bc of fluid in aveoli, neck vein distension, increased blood pressure, increased weight increased output, shortness of breath, wheezing, decreased hemocrit and hemoglobin (decreased oxygenation), |
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Term
| What is the nursing care of phlebitis? |
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Definition
| i&O, lung sounds, edema, weight, monitor therapeutic affect of diuretics, restrict PO fluids, teach client about salty foods and Na intake, orthopnea (can’t breathe unless sitting up) so semi to high fowlers position. |
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Term
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Definition
• A large air bubble in the arteries to the brain will cause immediate loss of consciousness and often causes convulsions (fits). It may also cause a stroke.
• An air embolism in the coronary arteries (which lead to the heart) will cause a heart attack. A heart attack can also be caused by a large air embolism in the arteries to the brain.
• An embolism in a blood vessel to the lungs (pulmonary embolism) causes chest pain and shortness of breath. |
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Term
| What are the s/s of air embolus? |
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Definition
• low blood pressure
• irregular heartbeat
• extreme fatigue (tiredness) or lack of strength
• blurred vision
• disorientation
• a faint blue tone to the skin caused by a lack of oxygen in the blood
• irregular breathing
• a lack of oxygen to the body tissues |
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Term
| How long can an IV solution hang? |
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Definition
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Term
| How often do you change the IV site? |
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Definition
| 72-96 hours or per agency policy |
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Term
| WHAT DO WE DO IF PRECIPITATE FORMS IN THE LINE? |
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Definition
i. Stop the machine
ii. Disconnect
iii. Remove tubing and replace with new.
iv. Flush the iv site completely and thoroughly.
v. re-connect tubing to iv site and continue to infuse correct fluids. |
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Term
| Special Info on Dilantin: |
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Definition
i. Dilantin is incompatible with everything – very alkaline
ii. Will precipitate other meds in the IV line
iii. Can only have NS in the IV line
iv. Flush carefully and thoroughly
v. Very irritating to vein – can cause tissue necrosis to vein and surrounding tissues |
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Term
| What are some IV equipment administration sets? |
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Definition
i. Primary
ii. Secondary
iii. Blood administration set
iv. Needleless systems
v. Buretrol (Volutrol)
vi. Macro vs Micro drip sets
1. Macro – larger drips
2. Micro - Smaller drops |
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Term
| what is the Rn's primary responsibility related to Iv Therapy? |
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Definition
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