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Iv therapy adults 1
Iv piggy back lab.
Question | Answer |
---|---|
Intravenous therapy is used for? | 1.) Fluid administration. 2.) medication administration. 3.) blood administration. 4.) Iv access line. 5.) drawing blood. 6.) long-term nutritional support. (Need a doctors order) |
Peripheral lines catheter size: | 22, 20, 18 gauge. |
peripheral line IV bag last up to: | 24 hours. |
Peripheral line tubing is changed every: | 72-96 hours. |
Peripheral line is put in: | for a few days/short term use. |
Midline is: | 4-6 inches long and inserted in the anteculital area, ends in the vein before the axilla. |
Midline is used for: | home care, antibiotic therapy. It last longer than a peripheral line. |
Central venous lines are used for: | 1.) infusion of TPN or irritatig medications. 2.) long-term or home IV or medication therapy. 3.) short term use in hospitals for therapy. |
Types of central venous lines: | 1.) single or multiple lumen catheters. 2.) PICC 3.) tunneled catheters or implanted access port catheters. |
For central venous lines you should always | take an x-ray to confirm where the tip is. |
Central venous lines are put in by: | the MD into the subclavian or internal jugular vein. |
the tip of the catheter (in central venous lines) sits: | in the superior vena cava above the right atrium. |
central venous lines lumens are flused with | heparinized normal saline (50-100 units/ml in 9 ml NS) |
acute care central venous catheters are: | single or multilumen |
long term care central venous catheters are: | PICC, tunneled catheters, implanted access port. |
PICC: peripherally inserted central catheter is placed into: | brachial, cephalic or femoral vein and advanced into the superior or inferior vena cava. (confirm with x-ray) |
PICC line can remain in place for: | 6 months. |
For PICC lines always measure: | the exposed catheter part. If it is not the same length as before, stop iv and call doctor and get an x-ray. |
PICC is used for: | long term IV therapy, TPN, chemotherapy, narcotic infusions, blood access, popular for home care. |
Tunneled catheters are used for: | long-therm therapy, PED's. |
tunneled catheters contain: | a dacron cuff causing adhesion to form in the chest, this stabilizes the catheter in place and DECREASES the occurrence of infection. |
Tunneled catheter enters via the | subcutaneous tunnel on chest, enters subclavian vein and advanced into subclavian vein about right atrium, other end exits chest. |
VAD: vascular access device is used | For long term chemotherapy, medication administration, or blood sampling. Can last for several months to 10 years without being changed. |
Complications of IV's | 1.) infection. 2.) infiltration. 3.) tissue damage. 4.) fluid overload. 5.) phlebitis. 6.) anaphylaxis. 7.) speed shock. |
infection: | redness, Increased WBC, normally local, fever, chills. |
Infiltration: | catheter comes out of vein and leaks. Can cause tissue damage, burns, decreased movement, looks swollen, glassy, cool to touch. |
fluid overload: | put pt. on pump to prevent. elderly pt., kidney disease, cardiac disease pt at risk. |
phlebitis: | inflammation of where catheter is placed in vein. Looks red, vein is hard and red lines up arm. Needs to be taken out. |
speed shock: | happens when meds are given too fast into IV (IV push) and you get anaphylaxis. |
Blood administration: | Need two nurses, hang normal saline with blood, packed cells are good for 4 hours, whole blood is good for 6 hours. Prime tubing with saline not blood. |
Notes about blood administration: | Never run anything with blood (except normal saline), infuse over 3-4 hours per unit of WB or PRBCs, FFP and platelets may be infused quickly. |
Transfusion reactions: | 1.) hemolytic- ABO or RH incompatibility. Get a clotting reaction. 2.) allergic -sensitive to foreign plasma proteins. 3.) febrile- clients antibodies respind against transused WBC, PLTS or Plasma, pt will spike temp. |
Transfusion reactions part 2: | 4.) bacterial- blood contaminated with organisms. 5.) circulatory overload- CHF, need to run blood slower. Crackles will be heard and lasix are given. |