IV therapy part 1 - exam 1? Flashcards

• intravenous- into the vein
• administration of substances (fluids) directly into the vein
• parenteral route

• perform venipuncture, insert peripheral IV'S
• discontinue peripheral IV's
• administer IV fluids
• administer & maintain TPN, PPN, lipids
• may NOT administer (antineoplastic agents, blood products, titrated medications, IV push medications)

• fluids & electrolytes
• medications
• nutrients
• blod products

1. Bioavailability is immediate (drug enters circulation immediately, permits access to site of action)
2. absorption into bloodstream is complete and reliable
3. large doses can be delivered at a continuous rate
4. no "first pass" effect in the liver (no biotransformation)

• adverse reactions may occur-can be life threatening
• if medication is administered to quickly, allergic reaction can occur
• increased risk of complications

• carry blood away from the heart
• branch off into smaller arteries and eventually into capillaries
• carry OXYGENATED blood

• carry blood to the heart
• blood from the capillaries flow into veins
• carry UNOXYGENATED blood

innermost layer, continuous with the endocardium

middle layer- smooth muscle and elastic tissue

tough outer layer

• thick walls
• no valves
• pulsates
• bright red blood
• high pressure
• carry oxygenated blood

• thin walls
• valves approximately every 3 inches
• no pulsation
• dark red blood
• lower pressure
• carry unoxygenated blood

veins

located in peripheral veins of upper (and sometimes lower) extremities

-can be placed by nursing (LPN AND RN)

-smallers veins

-slower blood flow

-easy access

located in large vessels near heart- superior veins cava

• inserted via subclavian , internal jugular, femoral
• can only be placed by physicians or specially trained nurses/practitioners

true

• not commonly used
• made for medications that cannot be in plastic
• easy to visualize the solution & see calibrations
• easier to break
• REQUIRES tubing with a vent (vent must be open to run from a bottle )

• most common
• atmospheric pressure collapses bag and forces fluid out
• can be punctured
• ALWAYS inspect before use ( check for discoloration/sediment/cloudiness, expiration date, and compatibility if hanging with other medication)

• most commonly used for hydration
• corrects fluid and electrolytes imbalances
• ex: saline solutions, dextrose solution, lactated ringers, plasmalyte

• volume expanders
• pull fluid into intravascular space
• can be used to treat low BP or shock
• ex: albumin (most common colloid, plasma protein, considered a blood product)

• blood/blood products are used to restore blood volume or components of blood
• packed red blood cells (acute blood loss)
• fresh frozen plasma (replaces coagulation factors
• platelets (used to control bleeding
• whole blood (restores blood volume)

dangerous, RBC's attacked by immune system- cells burst

• bleeding (urine)., chest pain, back pain, low BP, chills
• may be a delayed reaction, usually immediate

N/V, fever, chills, headache, chest pain

itching, SOB, wheezing , possible rash

Dangerous

• wheezing/stridor, SOB, low BP, cyanosis, anxiety

Low SP02, Tachycardia, high BP, dyspnea

IV infusion of amino acids, vitamins, electrolytes, and minerals

• usually high dextrose concentration
• high dextrose concentration (>10%) can damage veins
• given via central line
• monitor blood sugar levels closely (every 4-6 hours)
• used when GI system cannot be used for feeding
• must be ran on pump-lan can administer

• lower concentrations
• can be given via peripheral IV line
• patient is also getting nutrition from other sources

• IV infusion of fat/fatty acids
• essential fatty acid is linoleic acid which is needed for proper metabolism
• lipids are white
• can be administered with TPN/PPN- they are compatible to run together

• fluids inside the cells
• 2/3 of body water
• high concentrations of potassium (K+), phosphate and magnesium ions

• fluids outside the cells
• compartments consist of interstitial and intravascular
• high concentration of sodium, chloride and bicarbonate ions
• 1/3 of body water

movement through semi-permeable membrane (SPM) from an area of lower concentration to an area of higher concentration

• SPM is a barrier that will only allow some molecules to pass through; blocks others
• regulates fluid and electrolyte balance

the osmolarity or concentration of an IV solution

• the amount of solute in a fluid (ex)-dextrose, sodium, etc

• concentration is the same as blood
• no osmosis takes place/no fluid shifts
• no change in solute or water in the blood
• increases the amount of extracellular fluid (ECF)

• replace fluid loss
• dehydration
• mixed with IVPB's

• fluid has a higher concentration/ osmolality than blood
• osmosis pulls fluids OUT of cells
• cells shrink
• fluid shifts from intracellular to extracellular spaces (to balance the concentration)

• 0.9% NS,NSS
• ISOTONIC-osmolality same as blood
• No calories
• standard IV flush solution
• standard solution for hydration

• contain dextrose and free water
• available in different concentrations
• cannot be administered with blood/blood products
• closely monitor diabetic patients

• isotonic solution
• crystalloid
• contains potassium, sodium, chloride, and calcium
• lactate is added as a buffer
• SHORT-TERM USE
• used for fluid loss, dehydration and electrolyte replacement

• isotonic solution
• crystalloid
• combination of: sodium chloride, sodium acetate, sodium gluconate, potassium chloride, and magnesium chloride
• monitor electrolytes (BMP)

• can be continuous or intermittent
• continuous- maintenance infusion of a solution with potassium added
• intermittent-"K-rider" mini bag of potassium infused over 1-2 hours
• MUST be on an IV pump
• caustic to veins, monitor IV site often
• if infused too fast it can result in hyperkalemia which can lead to cardiac arrest

• not interrupted
• run at ordered rate
• large volume bag of solution administered continuously over time
• meant to maintain fluid and electrolyte balance

• not continus
• intermittent infusion that us connected to the highest port of the continuous primary IV line
• be sure to check compatibility with primary infusion prior to hanging an IVPB medication
• IV piggy bank (ivpb)

• medications delivered within minutes
• pushed through saline lock manually- must flush the line with NSS before and after administering an IVP medication
• delivery is immediate
• must be administered by the RN, LPNS are not allowed to give IVP's -not in scope of practice

• LPN can perform saline flushes
• flush directly into the IV line
• flush saline locks at least every 8 hours or per facility policy to maintain patency of the IV line
• 3-10 mL of NSS

peripherally inserted central catheter

port of Cath

triple lumen catheter

central venous catheter

heparin lock

saline lock

potassium chloride

calicum gluconate

magnesium sulfate