More IV Fluids
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| show | Maintenance, to replace or correct deficits, to restore ongoing loss, for meds, nutirtion, phlebotomy, transfusions or blood product therapy.
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| show | Colloids, plasma proteins, albumin
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| show | Blood pressure
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| show | 280 - 295 or approx. twice that of the serum Na level.
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| What can expand the intravascular compartment? | show 🗑
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| What is the problem with using hypertonic fluids? | show 🗑
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| What is a S/sx of fluids administered too fast? | show 🗑
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| show | Deplete the intravascular, decreasing BP and causing edema.
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| What are the two basic types of parenteral fluids? | show 🗑
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| show | An Electrolyte containing solution.
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| What are the three basic types of crystalloid fluids? | show 🗑
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| Why are crystalloid fluids called true solutions? | show 🗑
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| show | Contains proteins and starches.
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| What can't a Colloid fluid do? | show 🗑
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| Name three problems with IV fluid therapy. | show 🗑
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| show | cannot han, flush or change bags on a central line even if certified.
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| show | Cannot assign to LVN or supervise LVN with anything to do with a central line.
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| How do you determine whether it is a central line or a peripheral line? | show 🗑
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| show | D5W, LR and NS
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| show | It is hard for the renal system to process the elecetrolytes.
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| show | It metabolizeds the lactate to bi-carbonate which buffers acidosis
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| What are two common uses for Normal Saline (NS)? | show 🗑
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| Name a HypOtonic solution? | show 🗑
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| show | Use too long and it will lower BP. It is low in solutes so fluid will move out of the vascular space.
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| What makes Hyper tonic fluids different than the others? | show 🗑
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| What does a hypertonic fluid do? | show 🗑
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| What are hypertonic fluids used for? | show 🗑
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| What is dangerous about hypertonic dextrose saline solutions? | show 🗑
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| show | TPN and PPN. Nutrition.
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| show | 10% solutions can go peripheral but all others 20% and above must use a central line?
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| show | Because the fluids are very irritating to veins.
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| How do you infuse hypertonic dextrose saline solutions? | show 🗑
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| Plasma expanders are not considered what? | show 🗑
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| show | Type and cross match.
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| Which of the two main categories of fluids do plasma expanders fall into? | show 🗑
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| What are Colloids used for? | show 🗑
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| In which patients do you need to use colloid product with cautiously? | show 🗑
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| PPN is used in what type of line? | show 🗑
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| TPN is used in what type of line? | show 🗑
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| What are the components of TPN? | show 🗑
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| TPN usually come in a _____hour supply. | show 🗑
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| Name some indications for TPN. | show 🗑
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| How do you know TPN is working? | show 🗑
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| show | Must use the appropriate IV access for concentration of glucose, must use pump, don't play catch up, taper TPN, accu-checks, used micron filters
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| What should you monitor with TPN? | show 🗑
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| show | To make sure that they are excreting electrolytes.
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| show | to filter out bacterial growth.
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| show | To avoid hypOglycemic shock from cutting of the sugar.
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| show | No, don't mix with anything else.
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| What is an important consideration with albumin? | show 🗑
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| show | Fluid imbalances, metabolic acidosis, liver dysfunction, hyperglycemia and infection.
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| show | BUN
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| What is the first thing that you assess wtih a patient? | show 🗑
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| show | What type line, correct solution according to MAR, what time hung, how much left to infuse, correct rate, everything current?
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| show | 24 hours
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| How long is IV tubing good for? | show 🗑
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| How long is a peripheral site good for? | show 🗑
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| show | So you can be prepared and have the next bag order from pharm and ready.
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| show | Good indicatino of patent IV but not alwyas.
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| When you look up an IV drug what is an important item that you will check? | show 🗑
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| If you add another drung in and it becomes cloudy what is happening and what do you do? | show 🗑
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| What happens if you see crystals? | show 🗑
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| Who do you determine what is compatible in an IV? | show 🗑
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| How long do you continue a "continous or maintenance" infusion? | show 🗑
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| show | Usually by syringe.
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| show | Printed on the bag.
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| How is gravity or free flow regulated? | show 🗑
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| show | Higher
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| show | Time tape the bag.
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| show | It limits mobility because you have to take it with you and it is a fall risk.
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| What method of infusion should you not use with a central line? | show 🗑
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| What anti-biotic can you NOT use with gravity/free flow infusion? | show 🗑
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| Name three things you cannot use gravity free flow with.. | show 🗑
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| What does primary rate mean with a pump? | show 🗑
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| What does secondary rate mean with a pump? | show 🗑
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| What is the standard mix for Heparin with an IV? | show 🗑
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| One ml of Heparin for IV contains how many heparin units? | show 🗑
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| show | You check the dose with a second person.
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| what must you be careful about with the secondary rate of an IVPB? | show 🗑
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| What is positive pressure technique? | show 🗑
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| show | The roller clamp of the primary bag.
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| PCA administration can be programed for what three things? | show 🗑
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| What does the Dr order for PCAs? | show 🗑
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| show | Peripheral, central, HICKMAN® catheter, quinton, implanted ports and PICC.
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| What is an important intervention with epidural IV? | show 🗑
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| What is the routine flush times for a peripheral line? | show 🗑
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| show | To check patency.
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| How much is a routine flush of NS for a peripheral line? | show 🗑
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| Where is the central line placed? | show 🗑
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| show | Short term dialysis, longer and a shunt is placed instead.
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| show | Put in and taken out in the OR
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| show | implanted port.
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| show | Oncology
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| show | A right angled needle that you must be certified to use and accesses an implanted port.
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| What is a PICC? | show 🗑
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| Is a PICC used for short or long term therapy? | show 🗑
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| show | One or two, two is preferred
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| show | Informed Consent
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| You need to flush a PICC if there is no...what? | show 🗑
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| show | Speciality trained RN and dc'd by same.
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| What is the amount of NS used to flush a PICC? | show 🗑
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| show | 10 ml syringe
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| show | The brachial approach.
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| What is the problem with a PICC line and the brachial approach? | show 🗑
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| What are the seven complication of IV therapy? | show 🗑
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| What is infiltration? | show 🗑
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| What is the difference between infiltration and extravasation? | show 🗑
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| show | swelling, Coolness, pain, tigh, hard, blanch or red, maybe leaking due to pressure
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| What may be a first indication of infiltration? | show 🗑
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| show | loss of vein integrity , catheter dislodgement
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| show | dc IV, warm soaks, elevate, check pulse and cap refill,
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| Prevention of Infiltration.. | show 🗑
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| Patient education for infiltration? | show 🗑
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| Extrasavation is.. | show 🗑
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| A Vesicant is.. | show 🗑
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| An irritant is.. | show 🗑
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| Phlebitis is.. | show 🗑
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| S/Sx of Phlebitis.. | show 🗑
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| When phlebitis damages a vein it is permanent or temporary? | show 🗑
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| If the phlebitis shows erythema where is it usually? | show 🗑
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| show | Poor blood flow around cath, friction, iv left in too long, clotting.
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| What is the Tx for Phlebitis? | show 🗑
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| Infection causes: | show 🗑
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| S/Sx of infected IV | show 🗑
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| show | d/c IV, culture tip, call Dr
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| S/Sx of FVE | show 🗑
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| show | HOB high Fowlers, decrease EV rate temporarily, call Dr.
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| show | Montior rate, know risk population, watch out if you have a position IV
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| show | One that has multiple positions for drip rate on it. Check all positions for the drip rate to avoid FVE
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| show | CHF, valve replacement surg, new valves, bad valves
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| S/Sx of air embolism | show 🗑
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| show | Problem with Central line, very hard to geton a peripheral line as you need lots of air.
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| Tx for Air Embolism? | show 🗑
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| show | #1 is careful priming of IV tubing, dc central lines properly, careful clamping during tube changes, valsalva manuever during changes.
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| show | sudden increase in plasman level of a drug after administration
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| show | syncope( transient sudden loss of conciousness with inability to maintain upright posture) cardiac arrest and shock
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| Prevention of speed shock? | show 🗑
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| show | Vancomyacin
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| Home care considerations with IV therapy are? | show 🗑
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| show | PICC line
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