Parenteral Fluids- Kaplan

  1. Tonicity definition?
    Concentration of fluid
  2. Isotonic definition?
    Same tonicity as body fluid
  3. Hypertonic def?
    Greater concentration than body fluid
  4. Hypotonic def?
    Lower concentration than body fluid
  5. Isotonic fluid examples
    • 0.9% NS
    • D5W
    • LR
  6. Hypotonic fluid example
  7. Hypertonic fluid example
  8. How often is IV tubing changed?
  9. How often do you check Pts IV?
  10. How often do you change your IV bag?
  11. Infiltration symptoms?
    • Cool skin
    • Swelling
    • Pain
    • Decrease in flow rate
  12. Infiltration interventions?
    • DC IV
    • Warm compress
    • Elevate arm
    • Start new IV proximal to old one
  13. Extravasation of an IV?
    Infiltration with a med that causes blisters and tissue sloughing
  14. Medications that can cause extravasation?
    • Gentatmicin
    • Penicillin
    • Vancomycin
    • Dilantin
    • Antineoplastice
    • Calcuim
    • Potassium
    • Epinephrine
  15. Extravasation intervention?
    • DC IV
    • Aspirate back on catheter as pulling it out
    • Notify physician
    • Cool compress on almost all except 1 antineoplastic (vinco?)
  16. Phlebitis/thrombophlebitis symptoms?
    • Redness
    • Warm
    • Tender
    • Swelling
    • Leukocytosis
  17. Phlebitis/thrombophlebitis interventions?
    • DC IV
    • Warm moist compress
    • Restart new IV
  18. Hematoma symptoms?
    • Ecchymosis
    • Swelling
    • Leakage of blood
  19. Hematoma interventions?
    • DC IV
    • Apply pressure
    • Ice bag for 24 hours
    • Restart IV in opposite extremity
  20. Clotting of IV symptoms?
    • Decreased flow rate
    • Back flow of blood into tubing
  21. Clotting of IV interventions?
    • DC IV
    • Do not irrigate it
    • Do not milk it
    • Do not increase flow rate
    • Do not aspirate cannula
    • Inject Urokinase (possibility)
  22. Where is a PICC (peripheral inserted venous catheter) line most commonly put in?
    In dominant side extremity because movement of arm is needed for good blood flow around catheter
  23. How long can a PICC line stay in place?
    6 months
  24. What are complications related to PICC lines?
    • Pneumothorax
    • Dysrythmias
    • Nerve/Tendon damage
    • Respiratory distress
  25. How often is PICC line dressing changed?
    2-3 times a week
  26. When is a PICC line flushed?
    • Anytime it is used
    • Flush with 2mL NS followed by 5mL heparin in each lumen
  27. What is unique about a mid line catheter (MLC)?
    It increases up to 2 gauges and lengthens by about 2.5cm after insertion over a period of a few hours
  28. Where is a MLC placed?
    About same area as a PICC line
  29. How long is a MLC left in place?
    2-3 weeks
  30. How is a client positioned when placing a Percutaneous central catheter?
    Supine in head-low position to lessen risk of air embolism
  31. What do you ask client to do when placing a Percutaneous central catheter?
    Valsalva maneuver
  32. What are each of the lumens generally used for in a Percutaneous central catheter?
    • Proximal: Blood transfusions or medications
    • Distal: Blood draws
    • Middle: TPN or medications
  33. How often do you change the site of Percutaneous central catheters?
    q 4 wks
  34. How often do you change dressing on Percutaneous central catheters?
    2-3 times a week
  35. What position is the client placed in when changing the Percutaneous central catheter dressing?
    Low Fowler's
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Parenteral Fluids- Kaplan