Parental Fluids

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Author:
mandalana
ID:
91096
Filename:
Parental Fluids
Updated:
2011-06-17 23:15:38
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IV
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k notes IV
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  1. Tonicity?
    concentration of a substance dissolved in water
  2. Isotonic fluids
    same concentration as body fluids
  3. Hypertonic
    solute concentration greater than that of body fluids
  4. Hypotonic
    solute concentration less than that of boldy fluids
  5. ECF
    Extracellular fluid
  6. Types of isotonic fluids
    • 1. 0.9% NaCl
    • 2. Ringers Solution
    • 3. Lactated Ringers
    • 4. 5% dextrose in water ( is isotonic but become hypotonic when glucose is metabolized)
  7. Types of Hypotonic solution?
    1. 0.45% NaCL
  8. Hypertonic soluditon types?
    • 10-15% dextrose in water
    • 3% NaCl
    • Sodium bicarbonate 5%
  9. Formulat for ML/hour
    • Total soluiton
    • ___________= ml/hr
    • hours to run
  10. Formula for drops /min?
    • Total volume x 15
    • ______________= gtts/min
    • Time in minutes
  11. Assessment for Peripheral IV
    • Condition of vein
    • Type of fluid/med to be infused
    • Duration of therapy
    • Clients age, size, status
    • Skill of nurse
  12. How to insert a Catheter?
    • 1. Explain, check ID
    • 2. Distend vein 8-10' above site, tap on vessel or have pt open and close first, or hang arm over side of bed
    • 3. Clean with alcohol swab/ inside to out
    • 4. Repeat with povidine iodine
    • 5. Hold skin taut to stabilize
    • 6. Insert cath bevel up 15-20'
    • 7. lessen angle to advance cath, watch for flashback
    • 8. Once blood return/ push in extra 1/4" and then remove tourny
    • 9. Withdraw need from cath, advance cath up to hub
    • 10. secure cath
    • 11. attach IV tube
    • 12. begin IV infusion
    • 13 check for infiltration and hematoma
  13. Assement for infiltration
    • Edema
    • Pain
    • Coolness
    • Significant decrease in flow rate
    • Apply tourniquet above infusion site
    • ; if it continues to flow it's infiltrated
  14. Nursing care for Infiltraton
    • 1. D/C IV
    • 2. Apply warm compresses to site
    • 3. Apply sterile dressing
    • 4. Elevate limb
    • 5. Start new site proximal to infiltrate if same limb
  15. Phlebitis assessment
    • 1. red, warm at insertion site, or along the veing
    • 2. tenderness
    • 3. swelling
  16. Nursing care for phelbitis
    • 1. D/C IV
    • 2. Apply warm moist compress
    • 3. restart at new site
  17. Thrombophlebitis assessment
    • 1. Pain
    • 2. Swelling
    • 3. Redness & warmth around insertion or along path of vein
    • 4. Fever
    • 5. Leukocytosis
  18. Nursing Care Thrombophlebitis
    • D/C IV
    • Apply warm compress
    • Elevate extremity
    • Restart IV opposite extremity
  19. Hematoma Assessment
    • Ecchymosis
    • immediate swelling at site
    • leakage of blood at site
  20. Hematoma nursing care
    • D/C IV
    • Apply pressure with sterile dressing
    • Appy cool compress ( ice bag) for 24 hr to site/ followed by warm compress
    • Restart on opposite extremity
  21. Clotting assessment
    • decreaed IV flow rate
    • back flow of blood into IV tubing
  22. Nursing care for clotting
    • D/C IV
    • Do not irrigate or milke the tubing
    • Don not increase the IVe flow rate or hang the solution higher
    • do not aspirate clot
    • Urokinase may be injected into cath to clear occlusion
  23. A PICC stands for and is what type of Cath
    • Peripherally inserted central catheter
    • Central venous access device
  24. Where is the PICC inserted
    Venipuncture performed above or below anticubital fossa into basilic, cephalic, or axillary veins of dominant arm ( encourages blood flow and reduces risk of dependent edema)
  25. How long can you leave a PICC in?
    6 months
  26. Potenatil complications of a PICC
    • Malposition
    • Pneumothorax
    • Dysrhythmias
    • Nerve or tendon damage
    • Respiratory distress
    • Catheter embolism
    • Thrombophlebitis
  27. PICC dressing
    change 2-3 times a week and when wet or nonocclusive
  28. How to flush PICC
    saline, meds , saline , hep 100 units
  29. Do not with PICC
    • draw blood from that extremity
    • or take blood pressure

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