IVAD
Most common type of IVAD. Used for short term, usually inserted in hand or forearm.
Peripheral IV.
What are the two types of fluid replacement products?
Crystalloids & Colloids
Pain and discomfort at site. Sluggish flow rate, swelling around site, redness and warmth along vein. Prevntable by maintaining asepsis.
Phlebitis
The provider orders 100 mL of normal saline to infuse over 2 hours using an IV pump. What is the hourly rate?
50mL/hr
How many milliliters of normal saline (NS) is used to flush a peripheral line?
3-5 ml
Inserted in upper arm, ends near axilla. Used for antibiotic therapy up to 4 weeks, no TPN.
Midline catheter.
A client with blood loss following surgery is prescribed IV fluids to increase intravascular volume. The nurse recognizes that which type of IV solution will expand ECF.
Isotonic Solution
Accumulation of fluid in tissue surrounding IV site. S/S: site is cool and hard, swollen. Caused by penetration of vein wall by catheter itself.
Infiltration
The primary care provider (PCP) has ordered D5W to infuse at a rate of 100 mL per hour. Determine how long it will take for 1 liter of the solution to infuse at this rate.
10 hours
What technique is used to set up a secondary IV line by allowing the primary fluid to fill the secondary tubing?
A patient is receiving long-term IV antibiotics. The provider orders an IV device that terminates in the superior vena cava and can remain in place for months. Which device does the nurse anticipate?
PICC Line
Very strong hypertonic solution. Must be given through a central venous catheter to allow for rapid mixing and dilution.
Total Parenteral Nutrition- (TPN)
Presence of a blood clot and vein inflammation due to trauma of vein.
Thrombophlebitis
The primary care provider (PCP) has ordered Lactated Ringer’s solution to infuse at a rate of 150 mL per hour. Using IV tubing with a drop factor of 20 gtt/mL, calculate the flow rate in drops per minute (gtt/min).
50 gtt/min
A patient receiving IV fluids develops dyspnea, crackles in the lungs, bounding pulse, and edema. These are cues indicating which IV complication?
Circulatory Overload
When administering IV medications through a central line, what technique should the nurse use when flushing the line to prevent catheter occlusion?
Pulsatile (Push-Pause) with 10mL
When a patient is given a hypertonic solution, what are some nursing implications?
VS (BP!), Neuro+ Resp assessment, I&O, Labs.
What are S/S a nurse can recognize with a patient experiencing circulatory overload?
SOB, Cough, engorged neck veins, moist lungs sounds, and edema.
A client weights 165 lbs. The order is to bolus with heparin sodium 100 units/kg. The vial contains 10,000 units/ml. Find heparin bolus dosage in units/ml. Round to hundreths place.
0.75 ml
A nurse is reviewing IV solutions and notes that D5W changes its effect after administration. How does the tonicity of D5W change once it enters the body?
D5W starts as isotonic but becomes hypotonic after dextrose is metabolized.
A nurse is caring for a patient with DKA who presents with dry mucous membranes, poor skin turgor, and a serum sodium of 155 mEq/L. The nurse anticipates which type of IV solution will most likely be prescribed?
Hypotonic fluids (0.45% NaCl)
The primary care provider (PCP) has ordered 4 units of packed red blood cells (PRBCs) to be infused, with each unit to be administered over 6 hours. Each unit contains 200 mL. Calculate the infusion rate in mL/hr for each unit. Using an IV tubing set with a drop factor of 15 gtt/mL, determine the flow rate in gtt/min for each unit of blood.
Infusion Rate: 33.3 ml/hr
Flow rate: 8 gtt/min