IV therapy-ATI ch.49 – Flashcards

involves administering fluids via an IV catheter for the purpose of administering medications, supplementing fluid intake, or providing fluid replacement, electrolytes or nutrients

Large-volume IV infusions are administered on a ....?

What type of IV infusions are administered on a continuous basis?

-rapid absorption & onset of action -maintains constant therapeutic blood levels -less irritation to subcutaneous & muscle

-circulatory fluid overload is possible if the volme of solution is large &/or if the infusion rate is rapid -immediate absorption leaves no time to correct errors -solution & IV catheter can cause irritation to the lining of the vein -failure to maintain surgical asepsis can lead to local infection & septicemia

-prescribes the type of IV fluid, the volume to be infused, & either the rate at which the IV fluid should be infused or the total amount of time it should take for the fluid to be infused

regulates the IV infusion to ensure the appropriate amount is administered -can be done w/ IV pump or manually

are administered on a continuous basis, such as 0.9% soldium chloride IV to infuse at 100mL/or or 0.9% sodium chloride 1,000mL to be given IV over 3 hr

is a large amount of IV fluid given in a short period of time, usually less than 1 hr. Given to rapidly replace fluid loss that could be caused by dehydration, shock, hemorrhage, burns, or trauma -a large gauge (18 or large) is needed to maintain the rapid rate necessary to give a fluid bolus to an adult

-admin intermittenly in small amount of solution through continuous IV system, w/ saline or heparin lock systems -infuse for short periods on scheduled basis -can be admin by secondary ("piggy back") IV bag or bottl eor tandem set up, volume-controlled admin set, or by mini-infusion pump

-typicall yin small amounts of solution, concentrated or diluted, that can be injected over short time (1-2 min) in emergent or nonemergent situations -admin directly into peripheral IV or access port to achieve an immediate med level in the blood stream, such as pain med -make sure med is prepared according to recommended concentration & admin according to safe recommended rate -use extreme caution & observe for complications such as redness, burning, or increasing pain

-IV access can be via peripheral or central venous access device -central venous access devices can be peripherally inserted or directly inserted into jugular or subclavian vein

Never admin IV med through tubing that is infusing blood, blood products, or parenteral nutritional solutions

-certain meds, such as potassium chloride, can cause serious adverse reactions. They should be infused on an IV pump for accurate dosage control, & never admin by IV bolus -never admin IV meds through tubing that is infusing blood, blood products, or parenteral nutritional solutions -verify the compatability of meds before infusing a med through tubing that is infusing another medication

-be familiar w/ IV insertion equipment -avoid using needles when needless systems are available -use protective safety devices when available -dispose of needles immediately in designated puncture-resistance receptacles -do not break, bend, or recap needles

-avoid use of tourniquets (use a BP cuff instead) -do not slap the extremity to visualize veins -avoid rigorous friction while cleaning the site

-apply digital pressure over the selected vein to displace edema -apply pressure w/ swab of cleaning solution -cannulation must be quick

may require the use of anatomical landmarks to find veins

-perform hand hygeine before & after handling the IV system -use standard precautions -change IV sites according to facility policy (usually 72 hr) -change continugious infusion tubing no more frequently than every 96 hr, & change intermittent infusion tubing every 24 hr according to facility policy -remove catheters as soon as no longer clinically indicated -change catheter if any break in surgical aseptic technique is suspected, such as emergency insertions -use a sterile needle/catheter for each insertion attempt -avoid writing on IV bags w/ pens or markers, b/c ink can contaminate the solution -change tubing immediately if contaminiation is known or suspected -fluids should not hang more than 24 hr unless its a closed system (pressure bags for hemodynamic monitoring) -wipe all ports w/ alochol or an antiseptic swab before connecting IV lines or inserting a syringe to prevent the introduction of micro-organisms into the system -never disconnect tubing for conveinence or to position the client

How often should you change IV sites?

Change continuous infusion tubing no more frequently than every _____ hr, and change intermittent infusion tubing every ___ hr according to facility polocy.

When should you remove catheters?

Change tubing ______ if contamination is known or suspected

Fluids should not hang more than ____ hr unless it is a closed system

should you ever disconnect tubing for convenience or to position the client?

What is the correct catheter size for trauma clients, rapid fluid volume?

What is the correct catheter size for surgical clients, rapid blood admin?

What is the correct catheter size for all other clients (children, adults)

-IV start kit -correct size catheter -correct tubing -prefilled syringe containing 1-3 mL of 0.9% sodium chloride solutions -infusion pump, if indicated -clean gloves -scissors or electric shaver for hair removal

-check the provider's perscription (solution, rate) -assess the client for allergies to products used in initiating & maintaining IV therapy (latex, tape) -follow the 6 rights of med amin (including compatabilities of all IV solutions) -perform hand hygeine -examine the solution to be infused for clarity, leaks, or expiration date -don clean gloves -assess extremities & veins. If hair removal isneeded, clip w/ scissors or shave w/ electric shaver

-identify the cleint & explain the procedure -place the client in a comfortable position

Should many inches above the proposed insertion site should you apply a clean touniquet or BP cuff to compress only venous blood flow?

Select the vein by choosing ____ veins first on which hand?

-select the vein by choosing distal veins first on nondominant hand -a site that is not painful or bruised & will not interfere w/ activity -a vein that is resilient w/ a soft, bouncy, sensation when palpated -additional methods to enhance venous access include gravity, fist clenching, friction w/ cleaning solution, & heat

How should you cleanse the area?

Anchor the vein _____ the site of insertion

pull the skin ____ & hold it

You should inset the catheter into the skin with the bevel up or down? at what angle?

What will confirm placement in the vein?

After removing the needle, you should maintain pressure above or below the IV site?

If a continuous IV infusion is prescribed, regulate IV infusion rate according to what?

-the date & time of insertion -the insertion site & appearance -catheter size -type of dressing -IV fluid & rate -the number, locations, & conditions of site-attempt catheterizations -the clients response

6/1/2013, 1635, #22-guage IV catheter inserted into left wrist cephalic vein (1 attempt) with sterile occlusive dressing applied. IV 5% dextrose in lactated ringer's infusing at 100mL/hr per infusion pump without redness or edema at the site. Tolerated without complications. S. Velez, RN

*Mainaining patency of IV access: -do not stop a continuous infusion or allow blood back into the catheter for any length of time. Clots can form at the tip of the needle or cathered & can be lodged against the vein wall, blocking the flow of fluid. -instruct the client not to manipulate the flow rate device, change the setting on IV pu,p, or lie on tubing -make sure IV insertion site dressing is not too tight -flush intermittent IV catheters w/ appropriate solution after every medication admin or every 8-12 hr when not in use -monitor the site & infusion rate at least every hr