DewittChapter36

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lramirez79
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60115
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DewittChapter36
Updated:
2011-01-16 17:14:14
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Chapter36
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  1. IV (via the veins) route
    is the main method of supplying the pt with fluids and medications when the pt is unable to them orally or rectally.
  2. IV infusion (slow intro of fluid into a vein)
    amounts are recorded under parenteral fluid.
  3. Substances delivered by IV route:
    • 1. Fluids and electrolytes
    • 2. Effective meds given by this route
    • 3. Blood plasma or other blood components
    • 4. Nutritional formulas glucose, amino acids and lipids.
  4. The average adult needs
    1500 to 2000 mL of fluids in a 24 hr period to replace fluids eliminated by the body.
  5. Isotonic solutions
    have the same concentration, or osmolality, as blood and are used to expand the fluid volume of the body.
  6. Hypotonic solutions
    contain less solute than extravascular fluid and may cause fluid to shift out of the vascular compartment.
  7. Hypertonic solutions
    have a greater tonicity than blood. Are used to replace electrolytes and when given as concentrated dextrose solutions, produce a shift in fluid from the intracellular to the extracellular compartment.
  8. Primary IV set consists of
    a bag of solution, a regular tubing set, a needleless connector, and an IV stand.
  9. 3 major sizes of drops
    • 1. Reg drops ( 10 to 20 gtt/mL) IV therapy to most adults
    • 2. Macrodrops (10 gtt/mL) used for viscous fluids, blood
    • 3. Microdrops (60 gtt/mL) small amts of required infants and children. frag veins
  10. Secondary or PB IV set
    advantage is that when the solution in the smaller bag has been infused, the primary IV begins to flow again w/o further adjustments.
  11. Parallel or "Y" IV set is
    used to infuse certain blood products. Blood on one side and normal saline on other side.
  12. Transfusion is
    intro of blood components into the blood stream.
  13. Infusion pump is
    a machine that delivers IV fluids at a rate that is set by the nurse.
  14. Burette is
    a tubelike chamber that will hold 150 mL of fluid.
  15. Using a controlled-volume set ensures
    that a fluid overload cannot occur because only a specified amt of fluid is available to be infused at any one time.
  16. Total Parenteral Nutrition (TPN)
    technique of providing needed nutrition IV or for medications that require critical accuracy such as heparin, insulin, cv meds, chemotherapy drugs.
  17. Infiltrated
    solution is deposited in tissue outside the vein.
  18. Disadvantages of pumps include:
    • 1. they exert pressure on the vein
    • 2. expensive
    • 3. certain types require special admin.
  19. Insulin pump is
    a small portable device that can be programmed to deliver a continuous infusion of regular insulin that mimics normal physiology.
  20. Vascular access devices
    such as a needle, or catheter that allow direct access to the circulatory system.
  21. Correct placement of subclavian catheters
    must be verified by radiographic studies before any fluid is infused through them.
  22. No other type of needle should be used because
    other needles cause damage to the port.
  23. Epidural
    epidural space of the spinal column.
  24. Intrathecal
    intrathecal space of the spinal column.
  25. Read the labels and immediately
    alert the charge nurse if you find these medications are being stored together.
  26. Catheter embolus
    piece of the catheter obstructing blood flow.
  27. Infiltration is the most commom problem
    and occurs when fluid or medication leaks out of the vein into the tissue.
  28. Phlebitis is caused
    by irritation of the vein by the needle, catheter, medications, or additives in the IV solution.
  29. Blood stream infection occurs
    when infectious pathogens are introduced into the bloodstream from breaks in sterile technique during cannula insertion or any time the system is opened to change the bag or tubing.
  30. IV sites
    must be checked at least once and hour.
  31. Always assess the patient
    for adverse or side effects of previously administered doses of IV or PB medications before admin of next dose.
  32. Factors that influence the rate of flow of an IV solution are
    size of the catheter, the height of the solution container, and the viscosity of the fluid.
  33. Students must have
    supervision when performing a venipuncture.
  34. If you cannot initiate a pt IV in two attempts
    ask another nurse to peform the task.
  35. Movement of the patient
    can alter the rate of the infusion.
  36. Nursing students should not
    adjust the dosage or change the pump setting of heparin infusions.
  37. All medications are administered
    following the 5 rights and are documented on the MAR.
  38. Autologous ( from the pt's own body) infusions are
    common during and after surgery.
  39. A consent to receive blood
    must be signed by a patient.

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