IV therapy
______ is maintained when fluid and electrolytes are delivered to cell bodies and wastes are removed
Homeostasis
IV therapy slide 11
A pt presents having 0.45% NaCl drip attached to their IV. What is this most likely being used to treat?
Hypernatremia
IV Therapy slide 25
What are the general nursing responsibilities?
Oriented to machine and alarms
Know med used (usual dose, concentration, compatibility, and rate)
Important to always monitor IV site
IV Med slide 6
What are the 2 potential risks of IV infusion?
IV infiltration, Extravasation.
IV Meds slide 7
What causes Shock?
Inadequate tissue perfusion.
Shock slide 3
Adequate Tissue Perfusion Requires what 3 things?
Adequate cardiac pump, intact circulatory system, sufficient blood volume.
Shock slide 5
A pt presents with recent polyuria, polydipsia and has lost 30 lbs last month. These are all S/S of ______?
Type 1 DM
DM slide 4
A pt presents with Polyuria, polyphagia, and has noted some numbness and tingling in their feet. These are S/S of ______?
Type 2 DM
DM slide 6
Oral drugs work on 3 defects of type 2 DM, what are they?
Insulin resistance, decreased insulin production, increased hepatic glucose production.
DM slide 18
A rarely used inhaled insulin:______. What should we know about it?
Afrezza
Cant give if respiratory condition.DM slide 27
A pt is going to surgery, which gauge angio should be inserted?
a. 20 gauge
b. 18 gauge
c. 24 gauge
b 18 gauge
IV therapy slide 10
Fluids that contain protein or starches that remain in vascular space and increase osmotic pressure_____?
Colloids.
IV therapy Slide 32
What are the nurse's 3 considerations of administering meds by IV.
Absorption, Compatibility, Asepsis
IV Med slide 11
What are the 3 methods of IV Med Administartion?
Primary IV Infusion, IV Push(bolus), Intermittent Infusion.
IV Med slide 13
What is Hypovolemic shock?
Decreased intravascular volume due to external fluid loss or internal fluid shift.
Shock Slide 14
Pt presents in shock with hypotension. What would you expect the body to do in an attempt to maintain homeostasis?
A. Decrease HR, Increase RR
B. Increase HR, Increase RR
C. Increase HR, Decrease RR
D. Decrease HR, Decrease RR
B. Increase HR, Increase RR
Shock slide 4
The 5 things included in a treatment regiment for DM Dx. What is the goal of treatment?
Nutrition, Exercise, Education, Medication, Self monitoring.
Maintain normal BS as possible and decrease incidence of complications.
DM slides 10,11
Normal fasting BS.
74-106
DM slide 7
Glipizide(Glucotrol), and glyburide(DiaBeta) are examples of ________?
Sulfonylureas
DM slide 18
Liraglutide(Victoza), dulaglutide(Trulicity), exenatide(Byetta) are medications that are SQ injected. They are all examples of ______? Be specific.
Incretin Memetics.
DM slide 20.
Type of solution used to treat dehydration?
Hypotonic
IV Therapy slide 20
The only solution to adm with Blood products?
o.9% NS/0.9% NaCl
IV therapy slide 24
The professors put 3 examples of meds that might be administered via IV push, what are they?
furosemide(Lasix), hydromorphone (Dilaudid), ondansetron (Zofran).
IV med Slide 15
The nurse is preparing an IV bolus of Lasix 20 mg. to be administered over 2 min. How many mL would be given every thirty seconds?
A. 0.3 mL
B. 0.5 mL
C. 0.2 mL
D. 1.5 mL
B. 0.5 mL
IV med slide 21
A pt is in Septic shock, what is happening to them?
Vasodilation, Maldistribution of blood flow, Myocardial depression( resp failure, organ shutdown).
Shock slide 11
A pt suffers a massive MI. Which type of shock should the nurse be aware of?
A. Cardiogenic
B. Hypovolemic
C. Neurogenic
D. Septic
A. Cardiogenic
Shock Slide 16
The 8 factors that Raise BS.
Illness, Fatigue, stress, lack of exercise, food, growth, medications, menstrual cycle.
DM slide 9
6 Factors that Lower BS.
Insulin, oral antibiotic meds, exercise, fasting, delay meal eating, medication side effects.
DM slide 9
Repaglinide(Pradin) is an example of a _______. What should we know about this med?
Meglitinides.
do not take if a meal was skipped.
DM slide 18
What do we need to know about Amylinomimetics, now give an example.
SQ injection, do not give in arm, risk of severe hypoglycemia, keep fast-acting glucose on hand.
pramlintide(Symlin)
DM slide 20
You are evaluation a pt after a surgery that went well, what type of solution is the pt most likely on?
Isotonic
IV therapy slide 21
List the electrolyte solutions a pt could be given.
LR (Lactated Ringers), D5LR (5% Dextrose in Lactated Ringers), Ringers Injection, D5R (5% Dextrose in Ringers), Potassium Chloride (KCL) as an additive
IV therapy slide 28
SASAS is an acronym they gave us for maintaining the Patency of a saline lock, what does it mean?
Saline
Aspirate
Saline
Administer med
Saline
IV Med slide 28
Flushing and locking is essential to ensure _______ and prevent _________.
Patency, occlusion.
IV med slide 32
How does Epinephrine & norepinephrine Increase the BP?
Causes vasoconstriction/ Increased HR
Shock slide 19
What is the goal when treating Cardiogenic shock? What treatments do we use?
Goal: to restore heart function and balance between oxygen supply and demand y reducing the workload on the heart.
Treatments: restore blood flow through revascularization, medication or an LVAD
Shock slide 13
What possible 8 things should pts with DM know about exercise?
Increas use in muscles, increase insulin sensitivity, low BS levels, lower insulin regularly, 30min/5xweek, promotes weight loss, monitor for s/s hypoglycemia, fast-acting glucose nearby.
DM slide 31
A pt has recently had blood work done. Their HgbA1c came back 3%. This is indicative of what?
Good control 2-5%
Fair Control 6-8%
Poor control >8%
DM slide 17
Thiazolininedione.
adverse cardiovascular reactions.
DM slide 18
Sodium-Glucose Co-transporter 2 Inhibiter treat DM by________. An example is _______.
blocking glucose reabsorption in the kidney, increases urinary glucose excretion.
empagliflozin(Jardiance)
DM slide 19
A pt has increased swelling in his legs and abdomen. Which solution type would be most beneficial?
Hypertonic
IV Therapy Slide 31
Which electrolyte requires the verification of kidney function prior to administering?
Potassium.
IV therapy slide 38
After preparing and and attaching an IVPB to the upper port, what must a nurse do?
Back prime secondary tubing.
IV Med slide 36
A nurse is administering an IV bolus through a saline lock. List the steps according to correct procedure.
A. Assess site, alcohol lock, flush, aspirate, flush, alcohol lock, administer med, alcohol lock, flush
B. Alcohol lock, flush, alcohol lock, administer med, flush
C. Assess site, alcohol lock, flush, administer med.
A. Assess site, alcohol lock, flush, aspirate, flush, alcohol lock, administer med, alcohol lock, flush
IV Med slide 32
What does the renal system do to help maintain homeostasis while the body is in shock?
Increase ADH for fluid retention, Aldosterone for NA & fluid retention, Angiotension for vasoconstriction.
Shock slide 25
What are the 4 stages of Shock in order?
1. Initial
2. Compensatory
3. Progressive
4. Refractory
Shock Slide 21
The 14 S/S of Hypoglycemia.
BS <70, Cold and clammy skin, pallor, shakiness, nervousness, diaphoresis/weakness, dizziness, hunger, tachycardia, difficulty speaking, irritability, inability to concentrate, numbness in fingers, headache, unsteady gait.
DM slide 35
The 10 S/S of Hyperglycemia.
Elevated BS, Extreme thirst, increase urination, increase appetite, blurred vision, weakness/fatigue, headache, Glycosuria, Nausea/vomiting, abdominal cramps.
DM slide 34
Metformin(Glucophage) is a ________. And may cause ______?
Biguanides
moderate weightloss.
Dm slide 18
Lantus is an example of_______.
Long-acting insulin product.
DM slide 28
A pt who has had an IV of NaCl is experiencing an irregular, weak pulse, muscle cramps, and constipation. what is the pt most likely suffering from and relate it to something.
Hypokalemia rt sodium increase from IV
IV therapy slide 39
A pt's IV sight is swollen, Blanched, and spongy when palpated what has happened?
Infiltration.
IV Therapy slide 49
Controlled Analgesia is what?
Safe method for pain management, med administered by pt at a set interval.
IV Med slide 51
What are the three types of PCA pump modes? Describe them.
Basal mode: pt receives a continuous infusion of a low dose of med to achieve pain relief
Demand mode: pt receives dose intermittently when a button is pushed by pt
Demand w. Basal mode: both used for additional pain control.
IV Med slide 52
Nurse notes BP WNL, cold, diaphoretic skin, decreased bowel sounds and confusion in the pt. This may indicate which stage of shock?
A. Initial
B. Compensatory
C. Progressive
D. Refractory
B. Compensatory
Shock slide 33
Nursing management of shock involves what 8 things?
Prevention and early detection, relieve anxiety, proper position, )2 2-6L NC, Insert 2 large gauge needles for IV fluid and blood replacement, Foley with urometer, Strict I&O Q1-2H, Obtain Venipuncture assess labs
Shock slide 42
What 16 topics need to be HT to a pt with DM?
Assess perception of what it means to be diabetic, monitor & record BS, follow meal plan, regular exercise, quit smoking, control BP, limit salt, limit alc, Medication knowledge, S/S hyper/hypoglycemia, inspect feet daily, regular eye exams, regular dental visits, regular doctor visits, medi-alert, source of fast-acting glucose.
DM slides 32,33
What are the 10 complications of Diabetes they give us?
Stroke, Hypertension, coronary artery disease, atherosclerosis, nephropathy, retinopathy/cataracts/glaucoma/blindness, Peripheral vascular disease/neuropathy, Neurogenic bladder, infections, gangrene.
DM slide 38
Dipetidyl Peptidase-4 Inhibitors are also known as _______. An example of these meds:
Incretin Modifiers
sitagliptin(Januvia)
DM slide 18
Novolin R, Humulin R are example of _______.
Short-acting insulin products.
DM slide 28