question

Maintenance

answer

Replace insensible losses,-perspiration, fever; short time of 24 hours; 30 ml per kilogram of body weight is estimated body fluid requirement. Water is the necessity,

question

Replacement (usually 48 hours)

answer

Replace loss of fluid and electrolyte volumes lost due to serious problems -hemorrhage, clotting factors, vomiting and diarrhea, and starvation.

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Restoration

answer

Ongoing, concurrent losses of fluid and electrolytes, assess every 24 hours with draining fistulas, abscesses, nasogastric tubes, burns, and abdominal wounds.

question

Components of Parenteral Solutions

answer

water, glucose (dextrose), amino acids (build proteins), vitamins, electrolytes, pH,

question

Osmolarity

answer

concentration of solution; osmotic pressure based on concentration; tonicity, can kidneys filter,

question

Isotonic Solution

answer

250 to 375 mOsm/L, same as cells,

question

Hypotonic Solution

answer

250 mOsm/L or below, less than cells,

question

Hypertonic Solution

answer

above 375 mOsm/L; assess for circulatory overload and give slowly to prevent circulatory load, more than cells,

question

Acidic Solutions

answer

irritate the vein; assess frequently

question

Hypertonic

answer

More concentrated than cells, fluid moves from inside cell to interstitial space (cell shrinks) and 3rd spaces into the blood vessels. Treat intravascular dehydration with intracellular and interstitial fluid overload.

question

Isotonic

answer

Same as the cell interior, no movement of fluid, stays in vascular space. Treat intravascular dehydration with isotonic.

question

Hypotonic

answer

Less concentrated than the cells, fluid moves from interstitial space inside cell (cell swells) and out of the blood vessels. Treat cellular dehydration with hypotonic.

question

Colloid Solution

answer

not form true solution; solute not dissolve in solution; molecules may be suspended and distributed in fluid - blood products, Dextran, Albumin, Mannitol, Hetastarch,

question

Crystalloid Solutions

answer

true solutions with solutes dissolving; move across membrane, Dextrose, Sodium Chloride, Hydrating, Electrolytes, Ringers/Lactated R.., Alkalizing, Acidyfying, Potassium Chloride,

question

Cretanation

answer

no water movment, shrinking of the cell,

question

Hanging an IV infusion 1

answer

1. check md order, 2. gather equipment; iv fluid and infusion set, 3. check fluid 3 times/5 checks; compatability, color, consistency, expiration date, leaks,

question

Hanging an IV Infusion 2

answer

4. Select an infusion set appropriate for to be infused and pump. 5. Remove infusion bag and set from wrappers. 6. Invert infusion bag.

question

Hanging an IV Infusion 3

answer

7. Remove cap from infusion bag port; don't touch port after cap removed. 8. Remove cap from infusions set spike; "" 9. Spike infusion bag, invert. 10. Hang bag, prime line.

question

IV Pointers

answer

-lysis: cell breaking open and leaking leading to edema, -check IV compatibility with drug reference, -stop roller clamp before climbing, -squeeze chamber to fill half-way to still count drops,

question

Primary Infusion

answer

The Primary infusion is generally a large volume, crystalloid solution that will infuse over a longer period of time or continuously.

question

Piggyback Infusion

answer

Small volume medication that will infuse through primary line over short period of time. It should hang higher than Primary.

question

Before You Pump

answer

-avoid introducing air in line, -if air introduced, clear it by prime or gravity as disconnected, flick to release bubbles -plug in red outlet, enough charge, -clean extension set, unlock from extension set,

question

Ready to Pump

answer

-instructions on set, -attach infusion to IV cath hub; clean, -set infusion rates, -set the VTBI/VTBD, -Run, -spend few min in patient's room to troubleshoot, hourly checks,

question

Before IV Push

answer

-5 rights/hand hygiene, -check compatibility if multiple medications given, -check rate of push/dilution, -maintain aseptic technique, -pinch off tubing or clamp, -proximal port; flush before and after,

question

Administering IV Push

answer

-clean IV hub w/ alcohol, -flush 3-5ml NS, -administer at prescribed rate, -flush 3-5ml NS in between and after meds, -assess pt. and evaluate outcomes, -morphine = 1mg/min, -pepcid = 10 min, can dilute,

question

What is the difference between hypotonic and hypertonic solution?

answer

Hypotonic = less particles than the body's cells normally have, would push water through cell, treat cellular dehydration. Hypertonic = more particles than the body's cells normally have, will pull water from cell, treat cellular edema.

question

When administering IV fluids, it is especially important to know which organs are functioning correctly?

answer

Kidneys and Heart

question

How does the amount of water differ between a body comprised of more lean muscle mass and less adipose tissue than a body comprised of more adipose tissue and less lean muscle mass?

answer

Muscle contains more water than fat tissue.

question

TRUE OR FALSE: Older adults have a higher concentration of water than younger adults.

answer

False. Older adults have more adipose tissue, which contains less water than muscle mass.

question

Which of the following types of fluid contains large, bulky molecules: Crystalloid, Colloid, Interstitial,

answer

Colloid; interstitial, in between cells.

question

Name two fluids that are first line choices for fluid resuscitation.

answer

Normal saline and Dextrose

question

How is D5W considered both an isotonic and physiologically hypotonic solution?

answer

The less dextrose the more hypotonic a solution is. It can be hypotonic depending on how the body takes in the dextrose

question

Is the wall of the vein or artery thicker?

answer

Artery

question

Routinely initiate venipuncture in the ________ areas of the upper extremities.

answer

Distal

question

Subsequent cannulation should be made ________ than the previously cannulated site/s.

answer

Higher

question

5 techniques to facilitate vein dilation

answer

-warm blanket, -fist pumping, -double tourniquet, -palpating vein to surface, -hydration, relaxing,

question

RBC needle gauge

answer

18 to 20

question

Documentation post implementation of infusion therapy should include the number of attempts for a successful start. T or F

answer

true

question

Patient education for initiation of IV therapy

answer

-what kind of medicine, -how it will feel, -what to watch for in signs of infection, how to care for it, -how long it will need to be in,

question

Intravenous administration set that's used for parenteral nutrition with fat emulsions should be changed every _______ hours.

answer

24

question

5% Dextrose in water

answer

Isotonic, but physiologically hypotonic, -provides free water necessary for renal excretion of solutes, -replace water loss, -treat hypernatremia, 170 cal, -NO electrolytes,

question

10% Dextrose in water

answer

Hypertonic, -free water only, NO electrolytes, -340 cal,

question

0.45% saline

answer

Hypotonic, -free water, Na+, and Cl-, -replace hypotonic fluid loss, -maintenance solution, no daily loss or electrolytes, no calories

question

0.9% saline

answer

Isotonic -used to expand intravascular volume and replace extracellular fluid losses, -only solution with BLOOD, -has Na+, Cl-, -no free water, no calories, no electrolytes, -can cause intravascular overload,

question

3.0 % saline

answer

Hypertonic, -treats symptomatic hyponatremia, -administered SLOWLY with CAUTION = can cause intravascular overload and pulmonary edema,

question

5% dextrose in 0.225% saline

answer

Isotonic, -provides Na+, Cl-, and free water, -used to replace hypotonic fluid losses, treats hypernatremia, -170 cal,

question

5% dextrose in 0.45% saline

answer

Hypertonic, - same as 0.45% NaCl but 170 cal,

question

5% dextrose in 0.9% saline

answer

Hypertonic, -same as 0.0% NaCl but 170 cal,

question

Ringers solution

answer

Isotonic, -similar in composition to plasma, -no free water, calories, -expand intravascular volume, -replace extracellular fluid losses,

question

Lactated Ringers (Hartmann's) solution

answer

Isotonic, -similar in composition to plasma, -treat losses from burns and lower GI, -treat mild metabolic acidosis NOT lactic acidosis, -no free water, calories,

question

Venipuncture MD order

answer

Check MD order -indicaitons: fluid resuscitation, meds, protocol, -contraindications: AV fistuala/graft, mastectomy, cellulitus, stroke, trauma

question

Venipuncture Equiptment

answer

-catheter, -IV start kit: tourniquet, skin cleanser, transparent dressing/date/time/initials, tape to secure, gauze, -alcohol, flush, IV extension, IV tubing + solution, towel,

question

14-16", 18", 20", 22", 24"

answer

-white or grey stay away, trauma, -18 green mean, large, fluid, blood, -pink, blood, fluid, elderly, -blue 22, hard sticks, -yellow little fellow, infants, clots easily,

question

Radial Mastectomy

answer

-take out lymph nodes, -if you insert an IV on that side, fluid will accumulate and stay there,

question

Venipuncture patient prep

answer

-intro and patient ID, -patient readiness and education, -extremity examination, -positioning, room: lighting, height, over bed table/clean, arrange supplies,

question

Vein vs Artery

answer

Vein: feel for pulse first, purply red blood, Artery: don't want to access, bright red blood,

question

Universal Precautions

answer

-hand washing, -gloves, -recap needles,

question

IV Site Integrity

answer

-keep sterile, don't disconnect tubes, -cleans ports 15 sec, -assist ADLs, -avoid restraints, -saline flush q shift, -inspect/document site and dressing integrity q shift, -change equipment per policy

question

IV infiltration

answer

edema, no blood return, discomfort, slow or stoppage of flow DUE TO DISLODGE OF NEEDLE FROM VEIN, surrounding area is cool, swollen, pale and leaking fluid

question

IV Sepsis

answer

-fever; chill, systemic, -for infiltration and sepsis: d/c IV, document location, cath size and integrity, IV solution, temp of skin, pain level, notify physician if >6 inches, occurence report

question

Phlebitis

answer

Vein inflammation, -circumferential measurement to see if there's swelling, document size, -document location, size, cord extent, cath size, IV solution, notify HCP,

question

Extravasion

answer

-may need antidote if the fluid infiltrates or extravates with caustic treatments,

question

Discontinuation of Peripheral IV

answer

-confirm, -gauze, tape, -prep and identifiers, -hand hygiene, gloves, stabalize, -inspect cath, -firm pressure, -Document: IV D/C'd, IV catheter grossly intact, skin site,

question

Functions of Water

answer

-transport system for nutrients, gases, and wastes in/out cells, -facilities elimination of wastes thru kidneys, Gi, skin, lungs, -regulates body temp through skin evaporation,

question

Osmolality and Osmolarity

answer

-Osmolality: # of milliosmols per Kg of solution, -Osmolarity: # of milliosmols per Liter of solution, both are =,

question

Greater % of water content..

answer

-lean body build, muscular body build, male, neonates,

question

Colloids

answer

-large particles remain in intravascular space, -expands INTRAVASCULAR volume by drawing fluid from extravascular space via high osmotic pressure,

question

Crystalloids

answer

-small molecules flow easily across membrane from blood to cells, -increases fluid in INTERSTITIAL and INTRAVASCULAR spaces,

question

Isotonic

answer

-same osmotic pressure in and out, -stays in extracellular fluid compartment where it distributes to INTRAVASCULAR and INTERSTITIAL spaces,

question

Hypotonic

answer

-lowers serum osmolality with vascular space, -causes fluid to shift from intravascular to INTRACELLULAR and INTERSTITIAL, spaces, hydrates dehydrated CELLS,

question

Hypertonic

answer

-draws water out of intracellular space, -increases EXTRACELLULAR fluid volume, used as volume expander,

question

Nursing Considerations for Isotonic solutions

answer

-monitor for s/s of hypovolemia, -educate patient/family about s/s of volume overload and dehydration, -monitor for s/s of hypervolemia,

question

Nursing Considerations for Hypotonic solutions

answer

-can cause decrease in vascular bed volume, -monitor for s/s of fluid volume defecit, -don't give to patients at risk for ICP,

question

Nursing Considerations for Hypertonic solutions

answer

-potential for causing intravascular fluid overload, -shouldn't be given indefinitely, -patient should notify nurse if develop breathing difficulties or tachycardia,

question

Nursing Considerations for Albumin

answer

-18 gauge needle, -elevate HOB, -monitor for s/s of hypervolemia,

question

Advantages and Disadvantages of using hydroxyethalstarches

answer

A: doesn't interfere with blood typing/crossmatching, hemodynamic fluid replacement, synthetic less expensive, last 24-36hr, D: contraindicated w/ liver, cardiac, renal disease, sever anaphylactic reaction?

Purposes of IV Therapy – Flashcards

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