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IV Stuff

  1. isotonic defined
    same effective osmolality as body fluids
  2. when would you use an isotonic solution
    -when you don't want any shift in fluids going on in cells

    -EVC replacement to prevent or treat EVC deficit
  3. list of isotonic fluids
    • 0.9% NS(NS)
    • D5W(5% dextrose and H2O)
    • LR
  4. Hypotonic defined
    effective osmolality is less than body fluids
  5. when would you use a hypotonic solution
    to shift fluids from vascular system to cells
  6. hypotonic solutions
    • 1/2(0.45%)NS
    • 1/4(0.225%)NS
  7. Hypertonic defined
    osmo greater than body fluids
  8. when would you use hypertonic solutions
    increase osmo and pull h2o out of cells and into veins causing them to shrivel
  9. isotonic fluid condition examples
    surgery, metabolic acidosis, shock burn, fluids to veins
  10. isotonic condition examples

    NS
    LR
    D5W
    • NS: pump fluid to veins, not good long term
    • LR: surgery, electrolytes, metabolic acidosis, shock, burn
    • D5W: metabolize D, becomes hypotonic
  11. hypotonic condition examples
    dehydration, DKA
  12. hypertonic condition emamples
    icu setting, increase risk for pulmonary edema
  13. peripheral iv
    • -short term
    • -fluids after surgery
    • -short term AB
  14. central iv
    • -location of cath tip
    • -long term
    • -more effective
    • -large volumes,
  15. change iv tubing every
    4 days
  16. what to inspect on an iv bag
    • expiration
    • clear
    • leaks
  17. hypertonic solutions
    • D5 1/2 NS
    • D5 NS
    • D5 LR
    • 3% NS
    • D10W
  18. when you have two lines which bag gets hung lower
    primary
  19. what is manual regulation
    • use roller clamp
    • time drops from drip chamber
    • gtt/min
  20. macrodrip drop factor consists of
    • flow rate
    • drop factor
    • gtt/ml
  21. flow rate defined
    calculated using the drop factor found on each manufactures iv tubing
  22. drop factor defined
    the number of drops per ml of liquid that an iv tubing set will drip into its drip chamber
  23. macrodrip tubing 3 sizes
    • -10 gtt/ml
    • -15 gtt/ml
    • -20 gtt/ml
  24. microdrip tubing drop factor
    only 60 gtt/ml
  25. microdrip explained
    • precise
    • one size
    • uncommon
  26. manual iv infusion calculation
    rate(ml/hr) X Drop factor (gtt/ml) X Time(1hr/60min)= Flow rate (gtt/min)
  27. calculating flow rate with a pump
    total volume(ML) divided by # of hours = flow rate (ml/hr)
  28. bolus
    • -large amount of fluid
    • -rapid
    • -therapeutic effect
    • - usually administered over 1-30 min
  29. maintenance dose
    a dose of a drug that is given via an iv infusion to produce a steady plasma concentration

    • AKA* continuous or basal rate
    • PCA pump
  30. Loading dose
    high dose of medication that is given to achieve an immediate therapeutic action

    ALWAYS A ONE TIME ORDER
  31. when starting an iv, you should start
    distally and work proximally
  32. before you poke think about
    • why
    • size of cath
    • how long they need it
    • condition of pt
  33. phlebitis
    inflammation of the vein caused by mechanical trauma from needle or cath or chemical from solution
  34. infiltration
    escape of fluid into the sq tissue caused by dislodged cath or needle penetrating vessel wall
  35. scrub everything for
    15 seconds
  36. pca pump 3 components
    • basal rate
    • bolus rate
    • lockout rate
  37. basal rate
    mg/hr continuous rate
  38. bolus rate
    the dose the pt will receive when they push the button (mg)
  39. lockout rate
    the prescribed time between doses(min)
  40. flush a saline locked PIV Q___
    8 hrs
  41. iv sites are checked Q___
    2 hrs
  42. what is changed every 4 days
    tubing, caps, sites and bags
  43. bags are changed
    q 24 hours
  44. 5 types of CVC
    • tunnled
    • nontunnled
    • PICC
    • portacath(implanted)
    • quinton cath(permacath) dialysis
  45. tunnled cath
    • surgical
    • long term
    • 1-3 lumen
    • month-years
  46. tunnled cath

    two types
    • hickman
    • groshong
  47. tunnled cath

    2 cuffs and what they do
    AB cuff: prevent infection

    Darcon cuff: help keeps in place
  48. hickman
    port packed with heparin to prevent clots
  49. groshong
    • valve at tip
    • no packing just NS
  50. non tunnled
    • short term
    • cxr
    • quick access
    • lidocain
  51. pnemo S/S
    • sob
    • chest pain
    • increase HR
    • diminished breath sounds
  52. portacath
    • surgical
    • long term
    • sterile to access
    • packed with heparin
  53. portacath insertion sites
    IJ and subclavian
  54. how do you acces portacath
    • hubber needle
    • sterile
  55. PICC 

    which veins
    basillic or cephallic
  56. PICC
    • sterile dressing changes
    • stat lock
    • CXR
    • 1-3 lumens
    • long cath
    • bipatch
  57. power port
    can withstand contrast
  58. quinton dialysis cath
    • heparin packed
    • clamped to prevent bleed out
    • NEVER FLUSH DRAW BLOOD OR USE THESE
    • red and blue cap
    • two lumens
  59. daily care of CVC
    flush each lumen with 10ml of NS Q 8-12hr
  60. when flushing CVC
    • aspirate to check placement
    • push pause with NS
  61. what to use to unclot CVC lines
    TPA
  62. embolism S/S
    • weak rapid pulse
    • chest pain
    • low bp
    • increase HR
    • SOB
    • cyanosis
    • LOC
  63. Cath related infection S/S
    • fever
    • red
    • drainage
  64. cath migration S/S
    • sluggish infusion
    • no aspiration
    • swelling
  65. never mix meds with __ or __
    blood or blood products
Author
ChelseaL
ID
342061
Card Set
IV Stuff
Description
IV Stuff
Updated

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