ATI fundamentals ch 49 IV therapy – Flashcards

Unlock all answers in this set

Unlock answers
question
Indications for IV therapy
answer
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
question
0.9% sodium chloride should be infused at
answer
100 ml/hr or 1,000 ml over 3 hrs
question
IV bolus
answer
a large amt of IV fluid given in a short amt of time usually 1 hr, indications include dehydration, shock, hemorrhage, burns and trauma
question
What gauge is used to maintain a rapid rate for a fluid bolus to an adult
answer
18 gauge or larger
question
Ways IV infusions may be admin
answer
-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
question
Volume controlled infusions
answer
-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
question
IV bolus dose admin
answer
-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
question
Central venous access sites
answer
jugular or subclavian vein
question
Instead of touniquet use a BP for what kind of pt
answer
older adults, anticoagulant or fragile veins
question
How often should IV sites be changed
answer
72 hrs
question
How often to change intermittent vs continuous infusion tubing
answer
intermittent- 24 hr continuous- no more than 96 hr
question
When should a catheter be removed
answer
As soon as no longer needed
question
Why should writting on a IV bag be avoided
answer
because it can contaminate it
question
Fluid should hang for how long
answer
no longer than 24 hr unless its a closed system
question
What size gauge? 16, 18 or 22-24
answer
16: trauma pt with rapid fluid volume 18: surgical pt with rapid bld admin 22-24: all other pt
question
Preprocedure IV start
answer
-ck DO -ck allergies (med, tap, latex) -follow 6 rights -hand hygiene -examine bag for leaks, clarity, exp date -don gloves -assess veins
question
Intraprocedue for IV start
answer
-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
question
Veins to avoid for IV start
answer
-varicose -inner wrist (bumps are usually valves) -back of hand -sclerosed -in an extremity with impaired sensation
question
Documentation after IV insertion
answer
-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
question
IV care
answer
-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
question
Removal of IV
answer
-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
question
Infiltration SS, tx, prevention
answer
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
question
Phlebitis SS, TX, prevention
answer
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
question
Hematoma ss,tx, prevention
answer
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
question
Fluid overload r/t IV infusion ss, tx, prevention
answer
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
question
Cellulitis ss, tx, prevention
answer
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
Get an explanation on any task
Get unstuck with the help of our AI assistant in seconds
New