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this is used to maintain blood volume, deliver medications quickly, provide nutrition or rehydration or reestablish homeostasis when acid-base imbalance

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IV therapy

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IV therapy is often used to correct potentially life-threatening

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electrolyte imbalance

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isotoic, hypotonic, hypertonic is classified as

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IV solutions

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this solution, such as 0.9% sodium chloride (normal saline) have the same concentration of solutes as blood plasma. This is used to restore vascular volume

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isotonic

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this solution, such as 0.9% sodium chloride with 5% dextrose, have a greater concentration of solutes than plasma

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hypertonic

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this solution, such as 0.45% sodium chloride, have a lesser concentration of solutes

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hypotonic

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the purpose of this is to providing nutrition, replacing electrolytes, or expanding blood volume

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IV solutions

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this solution contain carbohydrate in the form of dextrose. The calories and fluid help to prevent dehydration and ketosis.

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nutrient solutions

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this solution is used to replace fluid and electrolytes for clients with continuous losses, such as gastric suction or wound drainage

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electrolytes solutions

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this solution contains sodium, chloride, potassium, and calcium

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ringer's solutions (LRS)

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dextran, plasma, and human serum albumin are common

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volume expanders

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this solution is used to increase the blood volume after a severe loss of blood (hemorrhage) or a loss of plasma (severe burns)

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volume expanders

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these solutions expand the intravascular compartment. Monitor the clieen for signs of fluid overload, particulary if the client has hypertension or CHF

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isotonic

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avoid giving d5w to a client at risk for

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increased intracranial pressure (ICP)

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do not give this if the client has liver disease

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LRS

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these solutions contain less sodium than ICF. they move water into cells, causing cells to swell and possibly burst

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hypotonic solutions

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do not give to clients at risk for ICP, cerebrovascular accident, stroke, head trauma, or neurosurgery

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hypotonic solutions

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avoid this solutions for clients at risk for third spacing fluid shifts such as burns, trauma, or low serum protein levels

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hypotonic solutions

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these solutions greatly expland the intravascular compartment. Monitor the client for circulatory overload

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hypertonic solutions

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this solutions pull fluid from the ICF compartment. Avoid these solutions in clients with diabetic ketoacidosis

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hypertonic solutions

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avoid these solutions in clients with impaired heart or kidney function because these clients are unable to manage extra fluid

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hypertonic solutions

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placed in veins of the forearm and hands of adults; in children feet may be used; in infants scalp veins may be used

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peripheral iv line

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tip of the catheter is in the superior vena cava at the right atrium

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central iv line

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tip of the catheter is advanced no further than the distal axillary vein in the upper arm; catheter is 3 to 8 inches in length

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midline iv line

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how often is an iv container changed

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24 hours

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two types of infusion systems that are used

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glass or plastic

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plastic container are made of

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polyvinyl chloride (PVC)

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disadvantages of these bags are that determining the fluid level is more difficult, and the bag can puncture easily

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plastic

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disadvantages of these bags are breakage, storage difficulties, rigidity, and difficult disposal

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glass

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what should never be used to write on the bag because the ink could be absorbed into the plastic

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marker

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primary set are also called

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macrodrip

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the pedatric set are also called

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microdrip (60)

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buretrol and burettes are used to deliver precise amounts of fluid and prevent fluid overload in these sets

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pediatric (microdrip, 60)

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these sets are the basic administration sets used for infusion of prmary parenteral fluids

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primary (macrodrip)

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these sets are larger, so the drops are fewer in number but bigger in size

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macrodrip

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these are smaller sets with smaller drips, so more drips are needed to release an equivalent amount

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microdrip (60)

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this set is called a piggyback set or a volume controlled set and can be added to the primary line

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secondary set

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primary and secondary continous adminstration sets must be changed every

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72 hours

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spike, flange, drog orifice, drip chamber, tubing, clamp, injection port, check valve, hub, filter are

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administration set components

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sharp plastic end designed to be inserted into the IV fluid container. Connected to the flange, drop orifice, and drip chamber

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spike or piercing pin

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a flexible clear plastic tube that encloses the drop orifice an dis connected to the tubing

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drip chamber

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this removes foreign particulate from the solution

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filter

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purposes of IV fluid administration, needed equipment, interventions, documentation

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preparing IV solution

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butterfly or scalp vein needles are what type of infusion device

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short-term therapy

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over the needle catheter, groshong, hickman, boviac are what type of infusion device

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long-term therapy

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these needles are used for infants, children, elderly people, and adults with small veins

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butterfly (scalp vein) needles

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the point of the needle extends beyond the tip of the catheter, so that after the venipuncture, the needle is withdrawn and discarde, leaving the flexible catheter in the vein is also called

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stylet

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some disadvantages for these are an increased risk of phlebitis, a risk of puncture because the stylet is long and inflexible, and difficulty of taping some hubs

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catheters with wings taped

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these catheter is inserted into the subclavian vein or the internal jugular vein

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central venous

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the central venous catheter tip end may be positioned into the

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superior vena cava or in the right atrium

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groshong, hickman, and broviac are

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central venous tunneled catheters

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medi-port, port-a-cath, infuse-a-port are

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implanted ports

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this type can be inserted by a trained RN and is often used for acute, long-term, and home care settings

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peripherally inserted central catheter (PICC)

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this gauge is used for multiple trauma, heart surgery, and transplants

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14-16

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this gauge is used for major surgery or trauma and blood administration

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18

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this gauge is used for minor surgery or trauma and blood administration

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20

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this gauge is used for pediatric clients, clients with small veins, for platelets and plasma

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22-24

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central catheters typically have how many lumes

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double or triple

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the lpn who have completed their training in IV therapy can change the site dressing on a

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central line, PICC line, or midline catheter

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the two basic groups of electronic infusion devices are

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controllers and pumps

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this is a mechanism to regulate IV flow rate by gravity rather than by exertion or pressure

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controller

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disadvantages of this are that they are unable to detect an infiltration and that the flow rate is affected by the height of the IV bag in relation to the IV site

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controller

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is a positive-pressure pump. these pumps are programmed to provide fluid more accurately than the controller and should be check every 1-2 hours

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infusion pump

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deliver fluids at a set preprogrammed rate and are almost always used for TPN

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infusion pump

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operate by gravity but regulate flow using a drop sensor as an electronic feedback mechanism

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rate controllers

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this must be only half full to allow the sensor to monitor the drip rate; most sensors are placed at the top of the chambers

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drip chamber

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this should be inverted for priming

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tubing cassette

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this do not take the place of nursing assessment

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rate regulation device

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all solutions should be labeled with

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flow strip tubing

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this administration sets increase the risk of introducting air bubbles. place them above the air detector device

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piggyback

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always check the package instructions to determine if a filter is

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compatible with a pump or controller

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if alarm goes off in resulf of an infiltration

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remove and restart IV in another location

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if the electronic device's alarm is going off, check for the most obvious problems in a

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systematic way: follow the tubing from the insertion site to the IV bag

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this device maintains venous access in clients who must recieve IV medications regularly bur do not require a continuous flow fluids

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intermittent infusion device

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routine this is necessary to ensure and maintain the patency of the cannula and it also prevents mixing of medications and solutions that are incompatible

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flushing

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this includes the date, time, amount given, patency of the site, condition of the site, client's tolerance of procedure

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documentation

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these types of nurses can instill a minute amount of heparin or normal saline into an intermittent infusion lock

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LPN

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the CDC recommends that heparin be used only when intermittent infusion devices are being used for

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blood sampling

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purpost of IV, insertion process, and distraction techniques are teaching to minimized client's

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fear and anxiety

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this cream is often used for all children to reduce or eliminate pain from iv insertion. take 15-20 minute for pain relief and should not be used in an emergency situaiton

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EMLA (eutectic mixture of local anesthetic)

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tunica adventitia, tunica media, tunica intima are

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3 layers of the vein walls

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the outermost layer, surrounds and supports the vessel

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tunica adventitia

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the middle layer, is composed of the muscle and elastic tissues that constrict and distend the vein

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tunica media

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pain and partially occluding the vessel

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venospasm

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the innermost layer, is thin and supports the valves pointing toward the heart, which prevent blood backflow

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tunica intima

I.V. Therapy notes – Flashcards

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