IV Therapy

Card Set Information

Author:
SPCADN
ID:
140558
Filename:
IV Therapy
Updated:
2012-03-08 15:18:48
Tags:
IV Therapy
Folders:

Description:
IV therapy power points 3/8/2012
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user SPCADN on FreezingBlue Flashcards. What would you like to do?


  1. Why IV’s
    7 Uses of IV Therapy
    Fluid Volume Maintenance

    Fluid Volume Replacement

    Medication Administration

    • Blood and Blood Product
    • Administration

    Nutritional Supplementation

    To keep vein open for emergency

    Blood sampling for diagnostic tests
  2. What are some advantages?
    • Continuous
    • Fluid

    • Intermittent
    • Fluid

    • When Pt are
    • NPO

    Comatose
  3. What are some Disadvantages?
    Infection

    • Difficulty
    • finding a vein

    Painful

    Dangers:

    • embolism
    • thrombosis

    overdose

    sepsis
  4. Some Terminology
    Hematoma

    Thrombosis

    Phlebitis

    Thrombophlebitis

    • Infiltration
    • Local
    • Infection

    • Venous
    • Spasm
  5. More Terminology
    Septicemia

    • Circulatory
    • Overload

    • Pulmonary
    • Edema

    • Air
    • Embolism

    • Speed
    • Shock

    • Catheter
    • Embolism
  6. What are 6 nursing responsibilities?
    Assessment

    • Five
    • Rights of Medication Administration

    • Site
    • Care

    Documentation

    Teaching

    Discontinuance
  7. Considerations in Planning
    • Wear
    • gloves

    • Maintain
    • aseptic technique

    • Choose
    • tubing and needle appropriate for solution to provide optimal blood flow

    • Attempt
    • to enter vein at its lower end

    • NEVER
    • ATTEMPT TO RETHREAD A CATHETER
  8. VENIPUNCTURE
    • Use
    • distal branches of a large vein

    • Convenient
    • veins

    • Back
    • of hand

    Forearm

    • Inner
    • aspect of elbow

    Ankle

    foot
  9. Selecting a Vein
    • Perform
    • hand hygiene, apply gloves

    • Apply
    • tourniquet 3-5 inches below elbow

    • Look
    • for vein with largest diameter and fewest curves or junctions

    • Clean
    • site per policy
  10. Infusion Devices
    • Peripheral
    • devices

    • Scalp
    • vein needle (butterfly)-wings allow for ease of insertion, not for long term
    • use

    • Over-the-needle
    • catheter-easy to insert, patent longer, stable which allows greater patient
    • mobility

    • Inside-the-needle
    • catheter-less likely to damage vein, permits insertion into superior vena cava,
    • CVP monitoring, rarely used
  11. Central Infusion Devices
    • Percutaneous
    • catheters

    • Infraclavicular
    • approach-no tunneling

    • May
    • remain for a few days to several weeks

    • Access
    • to larger venous circulation

    Examples:

    Jugular

    Femoral

    Subclavian
  12. Central Infusion Devices
    • Tunneled
    • catheters

    • Broviac-90cm
    • long, 1mm diameter silicone Silastic,
    • used primarily in pediatric patients.

    • Hickman-modified
    • Broviac
    • with larger diameter, tunneled subcutaneously.

    • Groshong-thin-walled
    • translucent silicone rubber catheter, similar to Hickman, allows both fluid
    • administration and blood draw through same lumen.
  13. Inserting the catheter
    • Hold
    • skin taut, insert catheter with bevel up

    • Watch
    • for backflow of blood, advance quarter inch

    • Remove
    • needle, slide catheter into vein

    • Attach
    • solution or cap

    • Secure
    • according to policy
  14. Assessment of the IV Site
    • No
    • erythema (redness)

    • No
    • warmth

    • No
    • edema (swelling)

    • No
    • infiltration (cold, swelling)

    • No
    • leaking of blood or fluid

    • dressing
    • intact

    • dressing
    • should be dated
  15. How often should you check the IV
    • The
    • Nurse should assess the site and
    • the infusion rate at least every
    • hour
  16. Site Care
    • Changing
    • the dressing

    • When
    • it opens

    • When
    • it becomes soiled

    • or
    • every 48-72 hours

    • Changing
    • the site

    • Every
    • 72 hours
  17. Assessment of the Patient with IV
    • Daily
    • Weights

    • Compare
    • I & O

    • Vital
    • Signs

    • Breath
    • Sounds

    Pulse

    • Skin
    • Turgor

    • Urine
    • Specific Gravity

    • Lab
    • Values
  18. Documentation in nursing notes
    • No
    • s/s of infiltration or infection

    • Where
    • is it? What does it look like?

    • What
    • is the date marked on the dressing
  19. Documentation upon initiation of IV site
    • Where
    • it is and What size catheter it is

    • INT
    • or Continuous IV Fluids

    • How
    • patient tolerated it

    • Patient
    • teaching
  20. Commit to memory
    • Once
    • a medication is given intravenously, it’s
    • given! You can’t
    • take it back!
  21. Maintenance
    Therapy
    • daily
    • body fluid requirements
  22. Replacement
    Therapy
    • for
    • present deficits with acute distress
  23. Restoration
    Therapy
    • for
    • concurrent or continuing losses
  24. Parenteral Supplements
    • maintain
    • or replenish body levels of essential chemicals

    • water
    • provides hydration

    • Na+,
    • K+, and Ca++ for normal nerve and muscle function

    • Cl-
    • and Bicarbonate buffer to correct acid base imbalance

    • Sugars
    • in concentrations less 10% carbohydrate
    • calories
  25. Types of Parenteral Fluids
    Hypertonic

    Isotonic

    Hypotonic

    Blood
  26. Hypertonic Solutions
    • Cause
    • shift ECF from interstitial space to plasma

    • To
    • replace electrolytes

    • Give
    • slowly to prevent circulatory overload

    • Examples:
    • D5NS 0.45%, D5NS 0.9%, D5LR
  27. Isotonic Solutions
    • Expand
    • extracellular fluid (ECF)

    • No
    • affect on intracellular and interstitial compartments

    • Danger
    • is circulatory overload

    Examples:

    • Lactated
    • Ringers

    • 0.9%
    • sodium chloride Lactated Ringers
  28. Hypotonic Solutions
    • Hypotonic solutions cause fluid to
    • shift out of vessels and into the interstitial and intracellular compartments.

    • Hydrate cells while depleting
    • circulatory system.

    Don’t give with low blood pressure

    Examples: 0.45% sodium chloride
  29. Types of Parenteral Fluid
    • Crystalloid
    • Solutions-electrolyte solutions-hypotonic, isotonic, hypertonic. “True” solutions.

    • Colloid
    • Solutions-do not dissolve-blood and blood products
  30. Types of Parenteral Fluid
    • Dextrose
    • and Water Fluids-hydrate interstitium more
    • than intravascular space. Difficult to
    • get total calories needed. More than 20%
    • cause vein damage. Don’t mix
    • with blood.

    • Sodium
    • Chloride Fluids-provides ECF replacement, treats metabolic alkalosis, used with
    • blood transfusions
  31. Types of Parenteral Fluid
    • Dextrose
    • & Sodium Chloride-replaces nutrient and electrolytes, temporarily treats
    • circulatory insufficiency & shock.

    • Hydrating
    • Fluids-assess status of kidneys, use cautiously in edematous patients, hydrates
    • medical and surgical patients
  32. Types of Parenteral Fluid
    • Multiple
    • Electrolyte Fluids-may be balanced hypotonic or isotonic maintenance and
    • replacement solutions.

    • Normosol R,
    • Lactated Ringers, Isolyte E.

    • Ringer’s
    • Fluids-fluid & electrolyte content similar to plasma-short time replacement
    • for blood, substitute potassium and calcium for sodium.
  33. Types of Parenteral Fluid
    • Lactated
    • Ringer’s-less
    • sodium, calcium, & chloride, adds bicarbonate precursor-assist in acidotic
    • states.

    • Plasma
    • Expanders-increase blood volume.

    • Alkalizing
    • & Acidifying-bicarbonate levels increased or decreased-lactate or ammonium
    • chloride.
  34. Total Parenteral Nutrition (TPN
    • for
    • normal metabolism

    • tissue
    • growth

    • weight
    • gain

    • preparations
    • containing concentrated sugars, amino acids, and lipid.

    • Nutrients
    • administered IV replace those that normally would be absorbed from the GI tract
  35. Who gets TPN?
    • cachectic
    • or debilitated persons

    • who
    • cannot take adequate oral nutrition

    • clients
    • going to surgery

    • severe
    • intestinal malfunction

    • temporary
    • measure to improve the prognosis

    • long
    • term measure for maintaining clients with chronic malfunction
  36. How does one administer TPN?
    • parenteral
    • formulas containing sugars and amino acids are concentrated and cannot be
    • infused into peripheral veins

    • high
    • osmotic tonicity would damage erythrocytes, other cells, and vessels

    • rapid
    • dilution to normal tonicity is achieved by directly infusing into the largest
    • veins the vena cava, subclavian or
    • jugular
  37. Are there dangers associated with
    TPN?
    • Air
    • embolism

    • Lipid
    • embolism

    • protein
    • aggregation embolism

    hyperglycemia

    hyperammonemia
  38. More Dangers associated with TPN
    • Valsalva
    • Maneuver

    • Left
    • side, Trendelenberg

    • In-line
    • Filters

    • Strict
    • Aseptic Technique

    • Monitor
    • & Assess
  39. Hematocrit
    • The
    • volume of red blood cells found in a 100ml of blood, expressed as a percentage

    • Too
    • Low

    • Blood
    • loss or Anemia

    • Tired,
    • pale, tachycardia

    • Too
    • High

    • Dehydration
    • or hypovolemia
  40. Hemoglobin is a protein substance
    found in Red Blood Cells. It is composed
    of iron and carries oxygen
  41. Low hemoglobin
    • anemia-
    • iron deficiency, aplastic,

    • severe
    • hemorrhage

    • excess
    • IV fluids
  42. too high hemoglobin
    Dehydration

    Polycythemia

    COPD

    CHF
  43. Blood Transfusions
    • Whole
    • blood

    • Packed
    • Red Cells

    Plasma

    Platelets

    Albumin

    • Clotting
    • Factors

    • Gamma
    • Globulins
  44. Why the need for a Blood
    Transfusion
    Hemorrhage

    • Temporary
    • correction for deficiencies

    • RBC,
    • WBC, Platelets

    • Bone
    • Marrow Depression

    Hemolysis

    • At
    • this time, there is no synthetic blood substitutes
  45. What are the Problems with Blood
    Transfusions?
    • Antigen-Antibody
    • Reaction

    Hemolysis


    disrupts circulation

    • damages
    • organs- especially kidneys.

    • Circulatory
    • Overload

    Hyperkalemia and Hypocalemia

    • Allergic
    • Reactions

    • Infectious
    • Diseases
  46. Blood Compatibility
    As easy as A B O
    • A
    • Blood Type presence of A antigen

    • B
    • Blood Type presence of B antigen

    • O
    • Blood Type No antigens

    • AB
    • Blood Type both antigens

    • Antigens-substance
    • capable of producing a immunological response
  47. A
    serum mixed with B
    serum will clump as a result of the
    Antigen-Antibody reaction.

    Give
    A or O blood to A group

    Give
    B or O blood to the B group

    Give
    A, B, AB, or O blood to the AB group

    Give
    O blood to the O group
  48. Rh Factor
    Rh+ (D antigen)

    Rh- absence of the antigen

    Rh+ presence of the antigen

    • An Rh- person must only be transfused
    • with Rh-
    • blood to avoid the formation of antibodies to Rh+ blood

    • The
    • Rh+ patient may receive Rh+
    • or Rh-
  49. Transfusion Reactions
    • Signs
    • and Symptoms

    anxiety

    restlessness

    • chest
    • or back pain

    flushing

    • increased
    • pulse +/or respirations

    • shaking,
    • chills, fever, and cyanosis
  50. If you suspect a Blood Transfusion
    Reaction
    • STOP
    • THE INFUSION IMMEDIATELY
  51. Lab Values
    • Serum 3.5-5.0 meq/l
    • K+

    • Serum 135-145 meq/l
    • Na+

    • Serum 8.9-10.3 mg/dl
    • Ca++

    Hemoglobin w12-16 g/dl M 14-18

    Hematocrit w39-47% M44-52

    • Serum 60-110 mg/dl
    • Glucose

    BUN 8-25mg/dl

    Creatinine .6 - 1.5 mg/dl
  52. IV CALCULATIONS
    • How
    • many mls per
    • hour?

    Order-1000ml. D5W every 12 hr.

    • 1000ml. = Xml
    • 12 hr. 1hr

    • 12X
    • = 1000ml

    • X
    • = 83.3
  53. DRIP RATES
    How many gtts. per minute?

    83.3ml./ hr., 1.39ml./min.

    60 gtts. /ml drop factor

    • 60 gtt. = X gtt
    • 1ml. 1.39 ml/min

    X=83.4 gtts./min.

What would you like to do?

Home > Flashcards > Print Preview