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How often should the IV container be changed
q24h
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How Often should the IV tubing be replaced
q48-72h
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How often should the IV dressing be changed
q48-72h
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How often should the IV site be changed?
q48-72h
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What is the most ideal gauge for blood products
20
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If there is blood in the tubing, what has happened?
IV has gone dry
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Why should you not administer cold medications IV?
Cold causes vasoconstriction. Sometimes room temperature is too cold.
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Which vein is a PICC usually inserted in?
Antecubital Fossa
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PICCs are good for TPN and?
longterm medications
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What kind of technique is used for a central line dressing change?
Sterile technique
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What are the S/S of infiltration?
Signs of infiltration: cool, swelling, redness, pt complaint of pain, (tingling, numbness = nerve damage)
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What should you do if you are not sure if the line has been infiltrated
- Check for blood return, flush, ask another nurse, or wait 15 minutes and assess again
- Do not need a dr. order to pull out a peripheral line
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what is extravasication?
Leakage of a vesicant IV solution or medication into the extra vascular tissue
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What does a red streak over a the skin indicate?
phlebitis
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Pyrogenic Reaction
- Abrupt rise in temp(104-105), severe chills, shaking, increase HR, RR, headache
- most common cause is a contaminated line
- if not corrected, pt can go into septic shock
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What postition should you put a pt in when you suspect an air embolism
- left lateral modified trandelenberg
- (prevents air from going to the lungs. air will get trapped in Right atrium)
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Chest pain, SOB, decrease BP, increase HR, cyanosis, anxiety, confusion,and hypoxia are signs of what?
Air Embolism
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A pt with an increase in BP, distended neck veins, and SOB is suspected to have?
Circulatory Overload
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If a pt is suspected to have Circulatory Overload, What should be done
First address airway. Increase head of the bed. Put oxygen on, now you can call doctor, and doctor will order lasix
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If a drug is given too fast what happens
- Speed Shock
- dizziness, chest tightness, flushed face, irregular pulse
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List 4 Isotonic Solutions
- .9% NSS
- D5W
- 5% dextrose in 0.225% saline
- Ringers Lactate
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List 5 Hypertonic Solutions
- D10W
- 5% Dextrose in 0.9% Saline
- 5% dextrose in 0.45% saline
- 5% Dextrose in Ringers Lactate
- 3% Sodium Chloride
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What Composes HAL?
- electrolytes
- vitamins
- minerals
- protien
- high concentration of dextrose
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Intralipids
- Fat emulsion
- High calorie in low volume
- Isotonic
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What are the S/S of hyperglycemia due to TPN?
- polyuria (excessive urination
- polyphagia (excessive hunger)
- polydipsia (excessive thirst)
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What are the S/S of hypoglycemia due to TPN?
- S/S: shakiness, diapherisis, headache, tremors, confusion(later symptom)
- Infection because of high sugar content is great place for infection to grow
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What are the advantage and disadvantages of IV push?
- works very fast
- you will be standing there if pt has any rxn
- but you need to know how much to push and how fast you can push it
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What are the advantages and disadvantages of IV piggback?
- Advantage: not as fast, not as high concentration
- Disadvantage: prob not going to be there if he has a reaction to the med
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The nurse assess the IV flids via gravity and notices that it is running slowly the nurse should first
Check the tubing for kinks
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After assessing the patency of pts catheter, the nurse attempts to flush the catheter and meets resistance. What does nurse do next?
Stop the flush and discontinue the IV
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The Nurse finds that The TPN bottle is infusing at 60 ml/hr and has run out, and solution is not avail. What action should nurse take.
Infuse 10% dextrose and water at 60 ml/hour (in order to prevent hypoglycemia)
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