| back 1 - intravenous- into the vein
- administration of
substances (fluids) directly into the vein
- parenteral
route
|
| back 2 - 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)
|
front 3 indications for IV therapy | back 3 - fluids & electrolytes
- medications
- nutrients
- blod products
|
| back 4 - Bioavailability is immediate (drug enters circulation
immediately, permits access to site of action)
- absorption
into bloodstream is complete and reliable
- large doses can
be delivered at a continuous rate
- no "first pass"
effect in the liver (no biotransformation)
|
front 5 disadvantages of IV therapy | back 5 - adverse reactions may occur-can be life threatening
- if
medication is administered to quickly, allergic reaction can
occur
- increased risk of complications
|
| back 6 - carry blood away from the heart
- branch off into
smaller arteries and eventually into capillaries
- carry
OXYGENATED blood
|
| back 7 - carry blood to the heart
- blood from the capillaries
flow into veins
- carry UNOXYGENATED blood
|
front 8 blood vessel wall
Tunica intima | back 8 innermost layer, continuous with the endocardium |
front 9 blood vessel wall
tunica media | back 9 middle layer- smooth muscle and elastic tissue |
front 10 blood vessel wall
tunica adventicia (externa) | |
front 11 arteries vs veins
arteries | back 11 - thick walls
- no valves
- pulsates
- bright red blood
- high pressure
- carry
oxygenated blood
|
| back 12 - thin walls
- valves approximately every 3 inches
- no pulsation
- dark red blood
- lower
pressure
- carry unoxygenated blood
|
front 13 what is used for iv therapy and recommended distal to proximal when starting? | |
| back 14 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 |
| back 15 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
|
front 16 central ALWAYS need x-ray verification before using ANY central line
-usually located in subclavian vein or internal jugular vein (IJ)
(T/F) | |
front 17 iv solution
solution containers- bottles | back 17 - 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 )
|
front 18 iv solution containers - plastic | back 18 - 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)
|
front 19 type of solution
crystalloids | back 19 - most commonly used for hydration
- corrects fluid and
electrolytes imbalances
- ex: saline solutions, dextrose
solution, lactated ringers, plasmalyte
|
front 20 type of solutions
colloids | back 20 - 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)
|
front 21 types of solutions
blood and blood products | back 21 - 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)
|
front 22 types of solution: transfusions reaction
hemolytic | back 22 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
|
front 23 types of solution: transfusions reaction
Febrile | back 23 N/V, fever, chills, headache, chest pain |
front 24 types of solution: transfusion reaction
allergic | back 24 itching, SOB, wheezing , possible rash |
front 25 types of solution: transfusion reactions
anaphylaxis | back 25 Dangerous
- wheezing/stridor, SOB, low BP, cyanosis, anxiety
|
front 26 types of solution: transfusion reactions
circulatory overload | back 26 Low SP02, Tachycardia, high BP, dyspnea |
front 27 Total parenteral nutriton (TPN) | back 27 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
|
front 28 peripheral/partial parental nutrition (PPN) | back 28 - lower concentrations
- can be given via peripheral IV
line
- patient is also getting nutrition from other
sources
|
| back 29 - 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
|
| back 30 - fluids inside the cells
- 2/3 of body
water
- high concentrations of potassium (K+), phosphate and
magnesium ions
|
| back 31 - fluids outside the cells
- compartments
consist of interstitial and intravascular
- high
concentration of sodium, chloride and bicarbonate ions
- 1/3
of body water
|
| back 32 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
|
| back 33 the osmolarity or concentration of an IV solution
- the amount of solute in a fluid (ex)-dextrose, sodium,
etc
|
front 34 Iv Solution:
isotonic fluids | back 34 - 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)
|
| back 35 - replace fluid loss
- dehydration
- mixed with
IVPB's
|
front 36 IV solutions:
hypertonic fluids | back 36 - 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)
|
| back 37 - 0.9% NS,NSS
- ISOTONIC-osmolality same as blood
- No calories
- standard IV flush solution
- standard solution for hydration
|
| back 38 - contain dextrose and free water
- available in different
concentrations
- cannot be administered with blood/blood
products
- closely monitor diabetic patients
|
front 39 electrolyte solutions:
Lactated ringers | back 39 - 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
|
front 40 electrolyte solutions:
Plasmalyte | back 40 - isotonic solution
- crystalloid
- combination of:
sodium chloride, sodium acetate, sodium gluconate, potassium
chloride, and magnesium chloride
- monitor electrolytes
(BMP)
|
front 41 IV solutions:
potassium chloride (KCL) | back 41 - 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
|
front 42 types of infusions: continuous | back 42 - not interrupted
- run at ordered rate
- large
volume bag of solution administered continuously over time
- meant to maintain fluid and electrolyte balance
|
front 43 types of infusions :
intermittent- IVPB | back 43 - 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)
|
front 44 Types of infusions: intermittent- IV push | back 44 - 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
|
| back 45 - 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
|
| back 46 peripherally inserted central catheter |
| |
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