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15 Cards in this Set
- Front
- Back
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What are the goals of Intravenous Therapy-
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1. Prevent and/or correct fluid (dehydration or fluid overload)
2. Maintain immediate IV access for medication administration (potential code or code symptoms, IV antibiotic administration). 3. Treat electrolyte disturbances (Smith, 2000, 842) ( Potassium, Calcium, Magnesium, Sodium, Chloride, Bicarbonate and Phosphate) 4. Administer nutrition (Dextrose, Total Parenteral Nutrition) |
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RN Role
in intravenous therapy |
1. Initiating IV access for peripheral IV sites or assisting with insertion of central lines. (PICC, {peripherally inserted central catheter} lines are inserted by specially trained RNs. )
2. Administering prescribed IV solutions, medications and blood products 3. Evaluating patient's response to prescribed therapy. 4. Maintain and observe for complications |
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list the different gauges that an IV catheter can be and what are they used for
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A. 16: trauma; people giving blood donations
B. 18: patients receiving multiple blood transfusions; ER patients; surgery patients C. 20: large volume IV fluids; diagnostic procedures D. 22: adults with small veins; geriatric patients receiving IV fluids or medications E. 24: pediatric; geriatrics |
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Intravenous Therapy-
Nursing Implications |
1. Not on side of a mastectomy
2. Not on extremity of hemodialysis access 3. Distal end of vein should be selected first, reserving more proximal sites for future IV therapy. 4. Elderly have thin skin and lack of support tissue. |
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Define these three solution types and give examples
Isotonic - Hypotonic - Hypertonic - |
Isotonic solutions have the same number of solutes when compared to another solution. In the body, an isotonic solution would have the same osmolality (concentration of solutes) as body fluids. Isotonic solutions are used to expand the extracellular fluid compartment
example: 0.9% Normal saline Hypotonic solutions have a lower number of solutes when compared to another solution. In the body, a hypotonic solution would have the lower osmolality (concentration of solutes) as body fluids. Fluids that have an osmolality of lower than 250 mOsm/L are hypotonic fluids Fluid will move into cells If too much hypotonic fluid is given, it can deplete the circulatory system Hypotonic solutions are given to lower sodium levels Examples: 0.45% normal saline and 0.33% normal saline. hypertonic solutions have a higher number of solutes when compared to another solution. In the body, a hypertonic solution would have the higher osmolality as body fluids. Fluids that have an osmolality of higher than 375 mOsm/L are hypertonic fluids. These fluids should be given slowly because they can lead to circulatory overload and are contraindicated for patients with cardiac and renal disease because of the risk of heart failure Examples: 5% dextrose in 9% normal saline; 5% dextrose, and lactated ringers. |
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What are some Complications that can happen from giving Intravenous Therapy-
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Complications-
Infection- Redness at site, warmth at site, tenderness at site Change tubing and site q 72 hours, Change IV solutions q 24 hours, may use filters Phlebitis – Pain along the vein, tenderness, erythema – red streak at vein site. Edema at insertion site Sluggish flow rate, area is warm to touch Infiltration of fluid – Edema around insertion site- blanching of infusion site – coolness of skin around site - no backflow of blood Extravasation of medication |
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Which of the following solutes is the greatest contributor to the osmolality of a fluid?
Sodium Water Potassium Calcium |
Sodium
Solutes found in the osmolality of a fluid include sodium, glucose, and urea. Sodium comprises the major part of the osmolality of a fluid. |
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Which of the following solutions has a greater concentration of solutes than blood?
Isotonic Hypertonic Hypoosmolar Hypotonic |
Hypertonic
Normal plasma is isotonic. Hypertonic solutions have a greater concentration of solutes than plasma. |
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Which of the following mechanisms is the most important regulator of fluid intake?
Thirst Electrolytes Renin-angiotensin Kidneys |
Thirst
Thirst is the most important regulator of fluid intake |
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Which of the following solutions is used to correct hypovolemic shock secondary to severe burns?
Ringer's Lactate Albumin Dextran 40 Plasma protein |
Dextran 40
Dextran, a synthetic polysaccharide, doubles the plasma volume within hours and acts as a volume expander. |
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Which of the following nursing interventions is most important when caring for a client receiving a plasma volume expander? C. result from lack of good situational support
Assess the client for a deep vein thrombosis Observe for signs of fluid overload Encourage fluid intake Monitor arterial blood gases |
Observe for signs of fluid overload
Dextran 40, a plasma volume expander, causes fluid to rapidly move from the tissues to vascular spaces which places the client at risk for fluid overload. |
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The client's serum sodium value is 149 mEq/L. Which of the following nursing interventions is most appropriate for this client?
Encourage the client to eat a low-salt diet Administer a 0.45%NaCl intravenous solution Hold all doses of glucocorticoids Advise that the sodium values are within normal limits |
Encourage the client to eat a low-salt diet
Hypernatremia is defined as serum sodium levels > 148 mEq/L. A slight increase in sodium can be managed by diet. |
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Which of the following solutions would be administered intravenously to manage a client with a serum sodium level of 130mEq/L?
5% D5W 0.9% NaCl Lactated Ringers D5W with KCl |
0.9% NaCl
Hyponatremia is defined as serum sodium levels < 136 mEq/L. Mild hyponatremia is usually treated with intravenous infusions of NaCl |
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The client complains of muscle cramping in the calves, paresthesias of the toes and the sensation of the heart skipping a beat. These symptoms can be symptoms of which of the following imbalances?
Hypernatremia Hypercalcemia Hypoglycemia Hyperkalemia |
Hyperkalemia
Hyperkalemia, serum potassium level >5mEq/L, predisposes the client to cardiac and muscle irregularities. |
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The client's arterial blood gases (ABG) reveal metabolic acidosis. Which of the following medications is indicated?
Sodium chloride Ammonium chloride Sodium bicarbonate Potassium chloride |
Sodium bicarbonate
Sodium bicarbonate acts by directly raising the pH of body fluids. It is the drug of choice to restore the pH of the plasma to normal limits. |
