Term
| Why is intravenous therapy, or IV therapy, commonly referred to as a "drip". |
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Definition
Many systems of administration employ a drip chamber, which prevents air entering the blood stream (air embolism) and allows an estimate of flow rate. |
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Term
| Can TPN be administered via IV? |
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Definition
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Term
| There are two types of intravenous line, what are they? |
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Definition
| peripheral IV and a central IV line |
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Term
| A peripheral IV line consists of? |
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Definition
short catheter (a few centimeters long) inserted through the skin into a peripheral vein (any vein that is not inside the chest of abdomen), usually in the hand or arm
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Term
| What does a Central IV line consists of? |
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Definition
They flow through a catheter with its tip placed in a large vein (e.g. subclavian, internal jugular, inferior vena cava) |
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Term
| What are the advantages of a central IV line over a peripheral line? |
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Definition
It can deliver fluids/medications that are overly irritating to peripheral veins (eg. some chemo drugs, TPN, higher concentrations of potassium)
They can contain multiple parallel compartments (or lumens) within the catheter so multiple medications can be given at once even if they would not be chemically compatible within a single catheter
Can measure central venous pressure and other hemodynamics (cardiac output, etc.) through a central line
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Term
| Name some disadvantages of central IV lines |
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Definition
higher risk of bleeding, infection, and thromboembolism and they are more difficult to insert correctly (require expertise and may be placed by a physician or trained staff if a PICC)
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Term
| Name a commonly used central line? |
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Definition
| peripherally inserted (central catheter, or PICC line) |
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Term
| When is a PICC line needed? |
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Definition
PICC lines are used when access to the vein is required for a prolonged period of time or when infused substance would damage a peripheral IV line |
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Term
| Where are PICC normally inserted? |
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Definition
The line is inserted into a peripheral vein, typically in the upper arm, and advanced until the catheter tip terminates in a larger vein in the chest near the heart to obtain intravenous access |
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Term
| Intravenous medication require the use of what for administration? |
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Definition
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Term
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Definition
Smart IV infusion pumps have drug libraries with standardized concentrations for commonly used drugs, which allow them to provide point - of -care decision support feedback for excessively high or low rates and doses. These devices may be programmed to provide "soft" alerts that cannot be overridden. These have been shown to reduce medication errors
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Term
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Definition
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Term
| Name vasopressors given IV |
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Definition
Dopamine
Epinephrine
Norepinephrine
Phenylephrine |
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Term
| How does dobutamine work? |
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Definition
| primarily B1 agonist causing increased contractility and heart rate |
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Term
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Definition
selective phosphodiesterase inhibitor in cardica and vascular tissue, resulting in vasodilation and inotropic effects with little chronotropic effects |
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Term
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Definition
endogenous precursor of norepinephrine (NE) that stimulates different receptors at different doses |
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Term
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Definition
| Statement. Not a question. |
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Term
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Definition
Extravasation: leakage of I.V. into surrounding tissue
Extravasation of vasopressors/inotropes can cause tissue damage and necrosis |
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Term
| How to treat extravasation with vasopressors? |
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Definition
phentolamine (Regitine), an α - adrenergic blocker that antagonizes the effects of vasopressors.
Dilute 5-10 mg of phentolamine in 10ml of NS and give SC to infiltrated area. |
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Term
| Name vasodilators that are given IV? |
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Definition
Nitroglycerin
Sodium Nitroprusside (Nipride) |
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Term
| Sodium Nitroprusside is very sensitive to? |
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Definition
| light; wrap in aluminum foil to protect from light |
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Term
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Definition
| Statement. Not a question. |
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Term
| Name some other drugs that are given IV (vague question, I know) |
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Definition
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Term
| What is the go-to source for IV compatibilities? |
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Definition
| Trissel's Handbook on Injectable Drugs |
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Term
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Definition
occurs when a product/solution is modified because of storage conditions (i.e. time, temperature, light, absorption). A product is considered unstable when it loses more than 10% of its labeled potency from the time of preparation |
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Term
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Definition
Incompatibility: occurs when one product is mixed/combined with another and changes occur that make the product unsuitable for patient use (i.e. degradation, precipitation, a change in pH &c.) |
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Term
| Name common IV admixtures that are not compatible! |
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Definition
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Term
| To reduce the potential for errors, smart pumps should possess what? |
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Definition
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Term
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Definition
If the smart pump drug library is bypasses, and the infusion rate and volume is manually entered, the dose error reduction software will not be in place to prevent a potential error.
The software also cannot replace independent double checks
And independent double check is warranted for certain identified high alert medications
Too many concentration options for each drug increase the potential for the wrong concentration to be selected
Soft stop alerts can be easily overrideen
Consistent monitoring and support for process change is required
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