ATI fundamentals ch 49 IV therapy – Flashcards

Adv: rapid absorption, maintains constant therapeutic bld levels, less irritation to subcutaneous and muscle tissue Disadv: fluid overload, immediate absorption leads to no time to correct errors, can irritate vein, increase risk of infection

100 ml/hr or 1,000 ml over 3 hrs

a large amt of IV fluid given in a short amt of time usually 1 hr, indications include dehydration, shock, hemorrhage, burns and trauma

18 gauge or larger

-with med mixed in a lg volume (500-1,000 ml) as continuous IV infusion ex potassium chloride or vitamins -med is in a premixed solution bag or can be added to IV bag by pharmacist -volume controlled infusions -IV bolus dose admin

-sm amt of solution 25-250 ml continuously or with saline or heparin lock system ex antibiotics -med is infused for short periods on a schedule bases -these infusions can be admin by secondary "piggyback" IV bag or bottle or tandem setup, volume control admin set, or mini infusion pump

-sm amt of solution and can be injected over short time (1-2 min) in emergent and nonemergent situations -can be delivered to peripheral IV or access port -make sure med is prepared according to DO conc and admin according to safe rate -use extreme caution and observe for redness, burning, pain

jugular or subclavian vein

older adults, anticoagulant or fragile veins

72 hrs

intermittent- 24 hr continuous- no more than 96 hr

As soon as no longer needed

because it can contaminate it

no longer than 24 hr unless its a closed system

16: trauma pt with rapid fluid volume 18: surgical pt with rapid bld admin 22-24: all other pt

-ck DO -ck allergies (med, tap, latex) -follow 6 rights -hand hygiene -examine bag for leaks, clarity, exp date -don gloves -assess veins

-apply tourniquet or BP cuff 4-6 in above site - choose vein (distal sites are preferred) -untie tourniquet -cleanse -remove cover from catheter, grasp plastic hub and examine for smooth edges -retie tourniquet -anchor vein below site -pull skin and hold it -warn pt for poke -insert catheter at 10-30 degree angle, look for flashback of bld -lower the hub of catheter to close to skin to prepare for threading to vein apx 0.25 in -loosen needle from catheter and pull back slightly on needle so that no longer extends past tip of catheter -use thumb to adv catheter into vein until hub resists against site -stabilize IV and release tourniquet -apply pressure 3 cm above site to stabilize -remove needle and activate safety device -maintain pressure above IV site and connect appropriate equipment to hub of catheter -apply dressing -doc't

-varicose -inner wrist (bumps are usually valves) -back of hand -sclerosed -in an extremity with impaired sensation

-date/time of insertion -site and appearance -catheter size -type of dressing -IV fluid and rate -number, locations, and conditions of site attempted catheterizations -pt response

-dont stop continuous infusion or allow bld to back up into catheter for any length of time, clots can form -edu pt not to manipulate flow rate device or lie on tubing -make sure dressing is not too tight flush intermittent IVs with every med or every 8-12 hr when not in use -monitor site and infusion every hr

-ck DO -hand hygiene -gloves -clamp IV -remove dressing -apply gauze pad over site without pressure (do not use alcohol) -use other hand to withdraw catheter by pulling straight back from site with hub parallel to skin -elevate and apply pressure to site for 2-3 min -assess site -tape and gauze -assess catheter for intactness -dispose catheter in sharps -document

SS: pallor, swelling at site, decreased skin temp by site, damp dressing, slower rate of infusion tx: stop infusion and remove catheter, elevate extremity, encourage ROM, apply warm or cold compress depending on solution, restart infusion prevention: carefully select site, secure catheter

SS: edema, throbbing, burning, pain to site, increased temp, erythema, red line up the arm, slow rate of infusion tx: DC infusion and remove catheter, elevate extremity, apply warm compress three times daily, restart infusion, culture site prevention: rotate site every 72 hr, avoid lower extremities, hand hygiene, surgical asepsis

ss: ecchymosis at site tx: NO alcohol, apply pressure after IV removal, use warm compress and elevation until bld stops prevention: minimize tourniquet time, remove tourniquet before starting IV infusion, maintain pressure after IV removal

ss: DJV, increased BP, tachycardia, SOB, crackles, edema tx: stop infusion, raise HOB, assess VS and ox sat, adjust rate, admin diuretics if prescribed prevention: use infusion pump, monitor I&O

ss: pain, warmth, edema, red streaking, fever, chills, malaise tx: DC and remove catheter, elevate extremity, apply warm compress thee times daily, obtain culture, admin antibiotics, analgesic, antipyretic prevention: rotate sites every 72 hr, avoid lower extremity, hand hygiene, surgical asepsis