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Food that contain purine - uric acid -
What should the nurse do when pt is suspected from air embolism?
How can it be prevented?
- 1. Clamp cathether
- 2. Place client on left side with head lower than feet
- 3. Notify MD
- 4. Give O
Instruct pt to do valsava maneuver ( take deep breath and hold while bearing down, as if having a bowel mvt) for IV tubing and cap changing
How often should IV tubing be changed? Dressing at the IV site?
In which complications of parenteral nutrition should the nurse contact the phyisician 1st?
- Infection - bc of the risk of sepsis
Difference between enteral and parenteral
- enteral: going through the gut
- parenteral: going through vein - least desirable form of nutrition, should be tried last.
When is a picc line used for PN?
for longer than 4 weeks, if shorter the subclavian vein is used
What pt can benefit from fat emulsion? - and what allergies should we watch for?
DM pts bc it helps control BG levels and lower insulin reqs caused by infused dextrose
Pts allergic to eggs and components cannot take lipids ( fat emulsion)
Nothing can be added to the lipids.
Storage of PN solution?
When not to administer?
stored in fridge, give w/in 24 hrs from the time prepared, remove from fridge 30 mins to 1 hr before admin.
Do not admin when cloudy or dark or when fal globules can be seen in bottle - return to pharmacy
Substances should be added in pharmacy not on the nursing unit.
SS of hyperglycemia
- Kussmaul's resp
Isotonic solutions? - functions and example
- same consistency as body fluid. - do not enter cell.
- Ex: Normal saline, LR, 5% dextrose in water
- more dilute w/ lower osmolality than body fluids
- causes mvt of water into cell by osmosis
- admin slowly to prevent edema
- Ex: 1/2, 1/4, 1/3 NS ( which is normally 0.9%)
- more concentrated with higher osmolality than body fluids
- cause water to move out of cell by osmosis.
- Ex: 3%, 5% NS, D10W, D5W/NS, D5W/0.45 NS, 5% dextrose in LR
- Plasma expanders, pull fluid from interstitial compartment to vascular compartment.
- Ex: Dextran, Albumin - given to inc vasc vol rapidly such as in hemorrhage and severe hypovolemia
Gauges size and when to use them.
- Rapid emergency admin, blood products, or anesthetic: 14,16,18,19
- Lipid infusion peripherally: 20-21
- Std IV or clear liquid IV: 22 -24
- Pts w/ very small veins: 24-25
Difference between infiltration and phlebitis
- Def: tissue damage also called extravasion, seepage of the IV fluid out of the vein and into the surrounding interstitial space
- SS: edema, pain, coolness at the site, may or may not have a blood return.
- Treat: remove IV device, elevate extremity and apply compress warm or cool depending on the solution that was being given
- Def: inflammation of the vein that can occure from mechanical or chemical trauma or from a local infection
- SS: heat, redness, tenderness at the site, not swollen or hard, IV infusion sluggish
When to change venipuncture, IV dressing and IV tubing?
- venipuncture: q 48-72 hrs
- IV dressing: q72 hrs or when wet and contaminated
- IV tubing: q24-72 hrs
IV bag or solution should not hang for > 24hrs
What are the c/i of an epidural catheter?
- skeletal and spinal abnormalities
- bleeding disorders
- use of antigoagulants
- hx of multiple abcesses