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66 Cards in this Set
- Front
- Back
examples of isotonic solutions
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NS (0.9% saline in water)
D5W LR |
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examples of hypotonic solutions
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1/2NS (0.45% saline)
1/3NS (0.33% saline) |
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examples of hypertonic solutions
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D10W
5%D/NS 5%D/1/2NS D5LR |
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examples of crystalloids
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LR
NS |
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examples of colloid-plasm expanders
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Albumin
Dextran Plasma |
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reasons to choose LR
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treat hypovolemia
burns fluid loss due to diarrhea mild metabolic acidosis |
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reasons to choose NS
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expand extracellular compoartment if circulatory insufficiency
treate diabetic ketoacidosis |
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reasons to choose D5W
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supplies calories, glucose
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reasons to choose 1/2 NS
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treats hypernatremia
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indications for hypotonic solutions
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treat cellular dehydration
promote waste elimination in kidneys |
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indications for using hypertonic solutions
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stabilize BP
incr urine output reduce edema |
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reasons to use crystalloids
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support BP from blood loss
contain electrolytes use for fluid vol replacement |
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reasons for using colloid-plasma expanders
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pulls fluid from interstitial to vascular compartments
incr vascular volume rapidly in cases of hemorrhage, hypovolemia or loss of plasma |
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3 types of IV delivery methods
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continuous infusion
intermittent infusion IV push |
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why is continuous infusion used
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careful regulation of amt of fluid over prolonged pd of time
maintain constant therapeutic drug level less risk of contamination/infection |
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why is intermittent infusion used
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more flexible
drugs administered over a specified period of time at varying intervals to maintain therapeutic blood levels |
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why is direct injection/IV push used
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drug directly into a vein
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good info regarding site selection
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-begin distal & work proximal
- consider type of sol to be given - consider duration of therapy -consider pt age, preference & activity |
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most common veins for venipuncture for IV
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basilic, cephalic & metacarpals
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most common needle gauge size
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20 gauge
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escape of nonvesicant solution into tissue
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infiltration
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escape of vesicant solution into tissue
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extravasation
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infection of the skin
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cellulitis
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inflammation of vein, caused by mechanical or chemical injury
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phlebitis
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inflammation caused by clot formation
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thrombophlebitis
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s/s of infiltration
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coolness of skin
taut skin slowing infusion rate |
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s/s of extravasation
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coolness of skin
taut skin slowing infusion rate tissue necrosis |
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s/s cellulitis
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pain
redness edema taut skin |
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s/s phlebitis
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site is warm, red, painful
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s/s thrombophlebitis
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site is warm, red, painful
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intervention for infiltration
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d/c IV
elevate cool-warm compress |
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intervention for extravasation
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d/c IV
notify MD |
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intervention for cellulitis
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d/c IV
warm compress notify MD |
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intervention for phlebitis and thrombophlebitis
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d/c infusion
warm compress call MD |
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intervention for hematoma
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d/c infusion
apply pressure warm compress |
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reasons why IV meds are ordered
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-rapid therapeutic effect needed
-GI tract can't absorb the med -NPO -controlled admin rate needed |
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benefits of IV meds
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rapid response
effective absorption |
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what's on a med label
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pt name
room # date name & amt of IV solution & drugs infusion rate |
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benefits of central venous therapy
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access to central veins
rapid infusion of meds or large amts of fluids long term therapy draw blood samples, measure venous pressure |
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risks of CVT
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pneumothorax
sepsis thrombus formation perforation of vessels & adjacent organs risk of air embolism |
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insertion points for CVT
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subclavian vein
internal/external jugular cephalic, basilic veins so tip rests in the: superior vena cava inferior vena cava right atrium of heart |
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two types of tunneled catheters
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groshong
hickman |
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list some risks of CV therapy
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pneumothorax, hemothorax, chylothorax or hydrothorax
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s/s of risks with CV therapy
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chest pain
dyspnea cyanosis decr breath sounds on affected side abnormal CXR |
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causes of pneumothorax, hemothorax
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lung puncture during insertion
large vessel puncture infiltration of solution into chest cavity |
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s/s air embolism
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dyspnea
unequal breath sounds weak pulse hypotension change in LOC |
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causes of air embolism
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air intake during insertion
cap/tubing change catheter cut or broken |
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interventions for air embolism
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clamp catheter immediately
turn pt to left side, head down (air enters right atrium, not pulmonary artery) O2 call MD document |
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s/s thrombosis
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edema at punctured site
erythema ipsilateral edem of arm neck & face fever pain malise tachycardia |
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causes of thrombosis
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sluggish flow rate
composition of catheter material preexisting limb edema cv disease |
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s/s local infection
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erythema
tenderness edema exudate rash fever chills |
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causes of local infection
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not maintaining aseptic technique
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intervention for local infection
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check temp
culture site re-dress treat w/antibiotics remove catheter document |
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PICC general information
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for long term use - up to 6 mo
antithrombogenic properties |
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general info implanted port
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catheter tip is in subclavian vein or internal jugular with proximal end of port implanted in subcutaneous pocket of upper chest wall
require minimal care |
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which central venous catheter system is associated with the lowest risk for catheter related bloodstream infection
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implanted port
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name several reasons why IV therapy is used
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rehydration
blood fast delivery of meds NPO TPN anesthesia diagnostic tests |
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isotonic solution to expand extracellular fluid would include
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NS
LR D5w |
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iv solution to help expand plasma volume & incr cardiac output in hemorraging pt
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colloid plasma expanders:
albumin dextran plasma |
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3 types of crystalloid solutions
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NS
LR Ringers Solution |
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universal precautions for inserting/caring for IV
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clean gloves
perform hand hygiene |
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what factors to keep in mind when starting an IV
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length of infusion
type & amt of infusion vein size & needle gauge age of pt |
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how often are venipuncture sites rotated
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every 72 hrs
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what info needs documented on IV site dressing
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date/time changed
needle gauge RN initials |
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pt requiring long-term antibiotic therapy at home could use what type of IV catheter/delivery systems
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PICC line
Implantable Port Hickman Groshong |
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how long can a bag of solution be infused before needing changed
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24 hrs
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