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___ administration refers to the introduction of fluids directly into the venous bloodstream.
Intravenous
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Iv administration is the most ___ of all parenteral routes because it bypasses all barriers to drug absorption.
RAPID
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Drugs can be administered by IV in three ways:
- 1. Direct injection with a needle in the vein.
- 2. Intermittently through a peripheral or central IV line.
- 3. Continuously through a peripheral or central IV line.
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_____ is defined by the Infusion Nurses Society as the use of the nursing process as it relates to technology and clinical application, fluids and electrolytes, pharmacology, infection control, pediatrics, transfusion therapy, oncology, parenteral nutrition, and quality assurance.
IV nursing
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ALL IV therapy requires a written order from a health care provider that is :
dated, type of solution, dosage, medication to be administered, rate and frequency of administration.
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In general, LPN responsibilities ____ ____ include administration of certain IV medications ( IV pushes) and antineoplastic agents.
DO NOT
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If you are unsure about the requirements for LPNs to perform infusion therapy, you may contact the __________.
Kentucky Board of Nursing
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The ____ (INS), a professional nursing organization, publishes the Infusion Nursing Standards of Practice and the _____(CDC) publish recommendations for infection control relating to infusion therapy.
Infusion Nursing Society and the Centers for Disease Control
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____ are the apparatus that connects a large volume of parenteral solution with the IV access device in the patients vein.
IV administration set
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____ chambers used for IV fluids administered more than 100 mL per hour.
Macrodrip
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____ chambers used when a small volume of fluid is being administered ( less than 100 mL per hour) or for accurate volume administration for neonatal and pediatric patients.
Microdrip
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____ constricting devices that regulate glow by being adjusted while the nurse counts the number of drops that pass through the drip chamber per minute, not very accurate.
Roller & Slide clamps
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____ apply external pressure to the administration set tubing to squeeze the solution through the tubing at a specific rate; can be programmed for a specific volume over time and are much more accurate than the clamps. These also have an alarm system that sounds if there is resistance in the IV line caused by a developing occlusion from thrombus formation or a kink in the line because of patient movement.
Pumps
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____ hold a prefilled syringe and apply positive pressure to the plunger, delivering a specific volume of medication over a set time.
Syringe pumps
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_____ are for short term use in the peripheral veins in the hand or forearm; should be changed every 72 hours to prevent infection and phlebitis; blood samples should never be drawn from peripheral catheters.
Peripheral access devices
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___ are often left in place for 2-4 weeks; catheters are flexible and are inserted at the antecubital site and advanced to the distal subclavian vein; have lower rates of infection and phlebitis than with peripheral catheters; cost less than ventral venous catheters; blood should not be drawn from this type of catheter.
Midline catheters
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___ are used when the purpose of therapy dictates; when peripheral sites have been exhausted because of repeated use or the condition of veins for access is poor; when long term or home therapy is required; and when emergency conditions mandate adequate vascular access.
Central Access devices
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Most commonly used sites for insertion:
subclavin, jugular, and femoral vein.
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_____ (PICCs) are inserted into the superior vena cava or just outside the right atrium by way of the antecubital space; blood should not be drawn through PICC lines; total parenteral nutrition should not be given through PICC lines; can remain in place for 1-3 months or longer if properly cared for.
Peripherally inserted central venous catheters.
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____ are surgically placed in an outpatient procedure under local anesthesia; inserted into the subclavian vein and advanced to the superior vena cava.
Tunneled central venous catheters.
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Three common types of catheters are
Hickman, Broviac, and Groshong.
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____ are placed into central veins for long-term therapy of IV fluids, medications, total parenteral nutrition, and blood products; also referred to as Port-A-Caths; this type of access is implanted and sutured into a subcutaneous pocket in the chest area; must be accessed with a 90* angel Huber needle; can withstand up to 2000 punctures; may remain in place for more than a year; should be flushed with a saline-heparin solution after each medication given or daily if not in use; these access devices require a post insertion x-ray to verify location of the device and to check for the presence of a pneumothorax.
Implantable Infusion ports
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____ includes blood vessels: arteries, veins, and capillaries.
Intravascular compartment
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_____ means inside the cell
Intracellular compartment
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_____ means between the cells
Interstitial compartments
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_____ refers to the intravascular and interstitial compartment and makes up __ of the total body water.
Extracellular.... 1/3
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The intercellular compartment makes up __ of the total body water.
2/3
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_____ solutions are ideal replacement fluids for the patient with an intravascular fluid deficit; used for hypovolemic, hypotensive patients to increase vascular volume to support blood pressure; pts must be monitored for fluid overload, especially if the patient has congestive heart failure. Examples of __ solutions are : _____,_____, and ______.
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