Term
| What are the contraindications to IV therapy? |
|
Definition
active skin infection
thrombophlebitis |
|
|
Term
| Where should an IV be placed if there is an area of pre-existing thrombophlebitis present? |
|
Definition
| IV lines should not be inserted distal to any area of preexisting thrombophlebitis |
|
|
Term
| What type of venipuncture should be avoided in elderly pts and in pts with PVD? |
|
Definition
| Lower extremity venipunctures |
|
|
Term
| What determines the gauge of the needle that should be used for an IV? |
|
Definition
| The rate of fluid administration is directly proportional to the bore of the catheter and inversely proportional to its length |
|
|
Term
| What type of IV fluids are isotonic? |
|
Definition
|
|
Term
| What is the risk of using isotnic fluids? What conditions should you use these with caution? |
|
Definition
Risk of fluid overload
CHF, HTN |
|
|
Term
| When are hypotonic solutions helpful? |
|
Definition
Helpful when cells dehydrated
- dialysis pt on diuretics
- hyperglycemic conditions
- diabetic ketoacidosis |
|
|
Term
| What IV solutions are considered hypotonic? |
|
Definition
| . 45% NaCl, 2.5% dextrose |
|
|
Term
| When is the use of hypertonic solution dangerous? |
|
Definition
| Dangerous in the setting of cell dehydration |
|
|
Term
| What IV solutions are considered hypertonic? |
|
Definition
D5%
.45% NaCl,
D5% LR,
D5% NS,
blood products,
albumin |
|
|
Term
| With crystalloid solution, what is there a risk for? |
|
Definition
|
|
Term
| What should IV crystalloid solutions generally be followed by? |
|
Definition
| Should generally follow with blood (after 2 L) |
|
|
Term
| What IV solutions are crytalloids? |
|
Definition
|
|
Term
| According to new data, which IV solution is best to use in trauma victims with massive hemorrhage? |
|
Definition
|
|
Term
| What IV fluids are good at reducing edema? |
|
Definition
|
|
Term
| Which type of IV solution is described as hypertonic, containing molecules that are too large to cross vascular membranes? |
|
Definition
|
|
Term
| Which type of IV solution is good for pulmonary edema and cerebral edema? |
|
Definition
|
|
Term
| Which IV solution must be used cautiously as dramatic fluid shifts may occur? |
|
Definition
|
|
Term
| What IV solution is considered colloid? |
|
Definition
|
|
Term
| When selecting a vein for an IV, where should you begin? |
|
Definition
| distally in non-dominant upper extremity |
|
|
Term
| When placing an IV, what are the indicators that you are in an artery, not a vein? |
|
Definition
Bright red blood
High pressure
Withdraw catheter
Apply gauze pad
Firm pressure at least 5 min |
|
|
Term
| What type of IV drip set is good for medication administration or pediatric fluid delivery? How many drops per mL? |
|
Definition
|
|
Term
| What IV drip set is described as great for rapid fluid delivery? How many drops per mL? |
|
Definition
| Macrodrip; 10 to 15 drops/ML |
|
|
Term
| What is the formula for finding drops per min? |
|
Definition
volume in mL x drip set
________________________
time in minutes |
|
|
Term
| What are the complications of IV therapy? |
|
Definition
bruising
cellulitis
infiltration
extravasation
phlebitis
systemic (sepsis, pulmonary thromboembolism, air embolism, catheter fragment embolism) |
|
|
Term
| Which veins provide a greater risk of Pulmonary thromboembolism with an IV? |
|
Definition
|
|
Term
| How can the complication of an air embolism when using an IV be avoided? |
|
Definition
|
|
Term
| What type of IV equipment is especially useful in children? |
|
Definition
|
|
Term
| What special consideration should be taken with IV lines in the elderly population? |
|
Definition
use smallest catheter possible
careful securing IV on fragile skin
AVOID LE IVs |
|
|
Term
| What areas should be avoided when performing a venipuncture? |
|
Definition
Extensive scars from burns and surgery
UE on the ipsilateral side of a previous mastectomy
Hematoma
Ipsilateral side of IV therapy/blood transfusion
Cannula/fistula/heparin lock
Edematous extremities |
|
|
Term
| Which vessels are MC used for venipuncture? |
|
Definition
| median cubital and cephalic veins of the arm |
|
|
Term
| What must accompany each blood sample submitted to the lab? |
|
Definition
|
|
Term
| What is the order for blood draw tube types? |
|
Definition
1st - blood culture tubes (yellow/black stopper)
2nd - non-additive tubes (red stopper or SST)
3rd - Coagulation tube (light blue)
4th - Additive tubes (Everything else) |
|
|
Term
| Which tube type should never be drawn first? |
|
Definition
|
|
Term
| What is MANDATORY to check before blood draw? |
|
Definition
| Identification of Pt: Don't draw blood if armband is missing |
|
|
Term
| How can a hematoma be prevented? |
|
Definition
Puncture only one wall of vein
Remove tourniquet before removing needle
Use major superficial vein
Make sure needle fully penetrates upper most wall of vein
Apply pressure to venipuncture |
|
|
Term
| How can you prevent test error with blood samples when an indwelling line or catheter is present? |
|
Definition
| Discard a sample at least three times the volume of the line before a specimen is obtained for analysis |
|
|
Term
| What may an increased concentration of larger molecules & formed elements in a blood sample be due to? |
|
Definition
Prolonged tourniquet application (no more than 2 minutes)
Massaging, squeezing, or probing a site
Long-term IV therapy
Sclerosed or occluded veins |
|
|
Term
| How can increased exercise affect blood samples? |
|
Definition
| Can increase CK, AST, LDH, platelet count |
|
|
Term
| How can stress affect a blood sample? |
|
Definition
| Transient elevation in WBCs, cortisol and catecholamines |
|
|
Term
| What effects can an anxiety attack have on a blood sample? |
|
Definition
| may cause acid-base imbalances, & increased lactate |
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