IV Solutions, Types of Catheters
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| show | Provides H20, electrolytes, & nutrientsAdminister medications & blood products.
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| show | 1. Crystalloids 2. Colloids
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| Able to pass through semipermeable membrane. Isotonic, hypotonic, hypertonic | show 🗑
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| Protein substances that cannot pass into extravascular space. Move fluid from interstitial space - Blood vessels | show 🗑
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| show | Isotonic Solutions
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| show | Isotonic Solutions
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| Lactated Ringers (common for surgery) | show 🗑
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| show | Isotonic Solutions
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| Pull fluid out of vascular space & into cells. 0.45% sodium chloride (half-normal saline) Ok to use in PIV | show 🗑
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| Main use: Replaces cellular fluid. Administer cautiously: Fluid shift from vascular system to cells, may lead to intravascular fluid depletion, may result in CV collapse & increased intracranial pressure | show 🗑
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| show | Hypertonic Solutions
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| Should be administered via central vein. 50% dextrose (D50) Only emergency such as hypoglycemia, | show 🗑
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| show | Total parental nutrition. Do not mix with meds. (Hypertonic solution)
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| Types of Venous Catheters | show 🗑
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| show | PIV
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| > 7 days Get order | show 🗑
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| > 6 months | show 🗑
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| show | Intraosseous (IO)
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| Over the needle catheter, most commonly used, lengths 0.75"-1.25", diameters: 12 gauge-24 gauge | show 🗑
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| Disadvantages of peripheral IV's | show 🗑
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| show | No might cause embolism
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| show | Peripheral IV's patient preparation
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| Not recommended for continuous infusions. Non-pliable, infiltrate easily. Uses: blood draws, short term infusions 1-4 hrs. | show 🗑
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| show | Midline Catheter
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| Midline Catheters should not be used for | show 🗑
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| show | Central venous catheters
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| show | Peripherally inserted central catheter (PICC), non tunneled catheter, tunneled catheter, implanted port
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| show | Antecubital vein-most common insertion site, Tip located in superior vena cava, 20-24 inches long
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| PICC advantages | show 🗑
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| PICC Disadvantages | show 🗑
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| show | Used for therapy <2 weeks, generally limited to 5-7 days, Commonly used in ICU/ER, Multi-lumen access, Neck, chest or groin
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| show | Infuse large volumes quickly, any medication or blood, hemodynamic monitoring, multi-lumen access
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| Non-Tunneled Central Lines Disadvantages | show 🗑
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| show | Skin-Tunneled Catheters
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| show | Skin-Tunneled Catheters
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| Indicated for frequent or continuous administration of IV substances, commonly called Port-a-Cath Central, long term | show 🗑
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| Surgically inserted under skin, minor surgical procedure, usually upper chest, sometimes in arm or abdomen | show 🗑
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| show | Implanted Ports
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| Implanted Ports Uses: | show 🗑
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| Implanted Port Risks: | show 🗑
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| show | Fluid overload/pulmonary edema, embolism, infection, allergic reaction
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| show | Dyspnea, tachypnea, crackles, tachycardia, edema, weight gain, pulmonary edema
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| show | Restlessness, tachycardia, dyspnea, cough, crackles on auscultation, frothy sputum
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| Fluid Overload Treatment | show 🗑
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| Fluid Overload Intervention | show 🗑
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| Fluid Overload Prevention | show 🗑
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| show | Embolism
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| Air embolism s/s | show 🗑
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| show | Clamp cannula, ABC'S, left-sided trendelenburg position, Notify RN/MD, Frequent assessment & vital signs, High-flow O2 if ordered
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| Air embolism Prevention | show 🗑
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| show | Inside of cells
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| Extracellular fluid | show 🗑
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| show | Septicemia
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| Bacteria on skin enters on catheter insertion, catheter movement at insertion site, external sources | show 🗑
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| show | Fever, backache, headache, malaise, tachypnea, signs of poor perfusion: delayed cap. refill, poor color
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| show | 24 hrs. due to infection
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| show | Hub contamination, wipe vigorously every time accessed, change cap every 7 days
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| show | Designed to continually release chlorhexidine over 7 days (antimicrobial & antifungal) Provides one inch zone of inhibition, infection decreased 60%
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| show | Preferred method of stabilization PICC lines
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| Allergic reaction s/s | show 🗑
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| show | Stop infusion immediately, maintain vascular access, notify RN/MD, frequent assessment including VS
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| Allergic reaction interventions | show 🗑
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| Local complications | show 🗑
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| show | Infiltration
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| show | Edema at insertion site, leaking at site, pain, site cool to touch, decreased rate of infusion, drip rate, blanching, can cause permanent damage
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| Extravasation | show 🗑
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| Extravasation s/s | show 🗑
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| show | Don't take IV out. Leave in place to administer antidote
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| Phlebitis s/s | show 🗑
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| Plebitis treatment | show 🗑
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| Phlebitis prevention | show 🗑
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| show | Inflammation of vein r/t chemical or mechanical irritation or both, catheter moving in and out
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| Hematoma | show 🗑
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| show | Opposite wall of vein perforated, catheter slipping out of vein, insufficient pressure to site after catheter removal
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| show | Ecchymois-bruising, immediate swelling, blood leaking at site
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| show | Clot or precipitate, kinked tubing, very slow infusion rate, allowing IV bag to run dry
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