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60 Cards in this Set
- Front
- Back
Purpose of Intravenous Therapy (IV)
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administer fluids
electrolyte balance medications chemotherapeutic agents transfuse blood and blood products deliver parenteral nutrients and nutritional supplements use for when people cannot take oral route more accurate dosing of medications immediate effect |
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Risks of IV therapy
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Bleeding
blood vessel damage fluid overload infiltration Infection Overdose too fast or too slow incompatibility of drugs and solutions allergic responses to substances mobility issues |
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Hemostasis is
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the body’s way of maintaining normal fluid volume and composition.
A balance of fluid between the intercellular space and the extracellular space |
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Human body is composed of mostly fluid. In an adult about __% is fluid in a infant about __%.
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60%
80% |
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______ adults also have less total body water than ______ adults.
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Elderly
younger |
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ECF
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extracellular fluid- outside the cell 1/3 of our total water
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ECF is composed of
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plasma volume and interstitial space
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Interstitial space
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around the cell- also called 3rd space- made up of lymph, blood (intravascular), bone, connective tissue water and transcellular fluids (cerebrosopinal fluid, synovial fluid, peritoneal fluid and pleural fluid
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ICF
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Intracellular Fluid- Fluid within the cell- 2/3 total body water
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Body fluids are made up of _____ (a solvent) and dissolved _____ (solutes) like ______ (Na, K) and ___ ________ (proteins)
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water
substances electrolytes non electrolytes |
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Isotonic
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2 solutions have the same osmolarity as your blood- will not change
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Avg adult daily fluid intake and output
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2,400-3,200 ml
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Where do we get our fluids for intake?
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1- Liquids 1,400-1,800ml
2- Water in foods 700- 1,000 ml 3- Water of oxidation (from respiratory system) 300-400 ml |
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How do we produce fluid output?
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Lungs 600-800ml
Skin (Perspiration) 300-500 ml Kidneys 1,400- 1,800 Intestines 100 ml |
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How do we regulate our fluids??
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Hormones and thirst mechanism
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What hormones help to regulate our fluid volume?
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Antidiurectic hormone (ADH) and aldosterone
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How is the thirst mechanism for an elderly patient?
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Not as effective as younger patients
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signs and symptoms of fluid deficits
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Weight loss
HR up, BP down Skin tugor poor, sunken eyes, pale cool skin, Poor capillary refill, thirst, dry mouth, cracked lips, Changes in mental status, weakness Decresed urine output, Increased HCT, electrolyes,BUN, serum osmolarity |
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signs and symptoms of fluid overload
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Weight gain
BP up, bounding pulse, JVD, Increased resp rate Crackles or rhonchi, Edema, puffy eyelids, Slow emptying of had veins when arm lifted Decreased HCT, electrolytes, BUN, serum osmolarity |
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IV Fluids are used to regulate __________
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Electrolytes
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__________ are chemical compounds that dissociate in solution into electrically charged particles or ions. They work like wires that conduct electrical currents. We use them for normal cell function
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Electrolytes
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List the six electrolytes (lytes)
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Sodium
Potassium Calcium Chloride Phosphorus Magnesium |
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Potassium normal values
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3.5 - 5.0 mEq/L
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Calcium normal values
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8.4 - 10.2 mEq/dl
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Sodium normal values
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135-145 mEq/L
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Omosis
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Movement of water from a higher concentration to a lower
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Osmolarity (concentration)Normal
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270-300
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The effect of an IV solution depends on the solutions ______
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osmolarity
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Isotonic
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(same osmolarity or tonicity) as serum, stays intravascular.
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Hypotonic
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(less than 270) shift fluids from blood to cells.
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Hypertonic
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(over 300) Pulls fluids from cells to blood.
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Examples of Isotonic IV fluids
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NS, D5W or LR
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Examples of hypotonic IV fluids
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½ NS
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Examples of hypertonic IV fluids
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D5 ½ NS, D5LR, 25% albumin
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Primary/Continuous Infusion
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Continuous, can give large volumes, over a prolonger period. Constant drug dose
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What type of infusion is parenteral nutrition on?
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continuous infusion pump
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Intermittent or Secondary Infusion
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Used to add a second infusion to a primary line. Over a specific time. Like antibiotics
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Direct Injection
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Sometimes called IV push (IVP). To deliver a single dose (bolus)
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Bolus
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a single dose
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Saline Lock
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Used with intermittent IV therapy or IVP.
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Macrodrip
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10, 15 or 20 gtt/ml
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Microdrip
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60 gtt/ml
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What to document when starting an IV
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Device used, Date & Time, Location, type of dressing, cond. Of site, type of solution, rate, flow controller, patients response, number of attempts, patient teaching and understanding
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What to document when maintaining an IV
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Site cond, site care, dressing changes, tubing and solution change, teaching
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What to document when d/c an IV
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time, date, reason for DC, assesment of site before and after DC, pt. reaction, integrity of device, dressing
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pt teaching for IV
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procedure and why it’s needed, solution and time of infusion, activity restrictions, potential discomfort, may use pamphlets, videotapes, iv equipment demo.
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Which type of solution raises serum osmolarity and pulls fluids and electrolytes from the intracellular and interstitial compartment into the intravascular compartment?
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Hypertonic
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Intravascular infections can be prevented by which of the following precautions?
Securing the venous access device with gauze Changing insertion sites according to facility policy Applying the tourniquet 6-8” above the insertion site Washing your hands after insertion |
B. Changing insertion sites according to facility policy
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Signs of speed Shock include...
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Light headedness, chest tightness, flushed face, irregular pulse
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Signs of catheter embolism include...
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Decreased blood pressure, pain along the vein, weak rapid pulse
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Infiltration
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catheter is no longer in vein- sipped out
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Signs of Infiltration include...
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pale, swollen at or above insertion site, tight skin, coolness, tenderness, fluid leaking from puncture site
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Signs of phlegitis include...
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Pain at site, vein red and inflamed, vein may be hard and cordlike
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Stacy has just come on shift when a client rings the bell to say that her IV is leaking all over the bed. Which action should Stacy do first?
A. Check the rate of infusion. B. Assess vital signs. C. Tape any tubing with a hole. D. Assess the insertion site. |
D. Assess the insertion site.
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Who is at risk for fluid overload?
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CHF and renal pts
kids, babies, elderly |
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How often to check and document on IV site?
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Q 2 hrs
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How to prevent hematoma when D/C IV?
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Put pressure on location for 2-3 minutes
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S/S of infected IV site?
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red, warm, swollen, painful
fever, high WBC, purulent drainage |
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What should an MD order for an IV contain?
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amount, solution name + any additives and amounts of adds
rate (ml/hr), frequency (continuous) and start and end time/date |
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What 2 places do we document IV?
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MAR and I&O
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