RNSG 1216 IV Start, Prime, PB, Push Exam Questions & Answers Solved 100%

What is an IV? - Answer Intravenous infusion administration of fluids into a vein by means of a steel needle or plastic catheter. why is an IV administered - Answer used to maintain fluid and electrolyte balance, or to correct fluid volume deficits in patients unable to take sufficient volumes orally. Also used for prolonged nutritional support of patients with gastrointestinal dysfunction (total parenteral nutrition). CATS PRRR - Answer C = compatibilities, A = allergies, T = tubing correct, S = site checked, P = pump safety checked, R = right rate, R = release clamps, R = return and reassess the patient. NS 0.9% NaCl - Answer Expand volume, dilute medications and to keep the vein open, Isotonic. NS is just like your body and similar to the medicine that's in the IV push. Lactated Ringers - Answer Used for fluid resuscitation D5 1/2 NS D5NS - Answer Used for Na and volume replacement CAUTION go slow and monitor BP, pulse rate, and quality of lung sounds as well as serum Na and urine output. D5W - Answer isotonic until administered into the body. after ___ metabolizes glucose it becomes hypotonic Don't give D5W to... - Answer infants or patients with head injury bc of the risk to cerebral edema what is given by IV? - Answer chemotherapy drugs Antibiotics Antifungals pain medications drugs for hypotension immunoglobulin medications how to check compatibility - Answer Confirm the compatibility of the secondary piggyback IV fluid with the primary IV fluid and the compatibility of the secondary piggyback IV medication with the primary IV fluid composition. Nutrition Therapy: Parenteral Nutrition - Answer = affords the provision of energy and nutrients intravenously Parenteral Nutrition indications for use - Answer Preserved for severely malnourished pts undergoing chemo, unable to digest food through any part of GI tract &/or major surgery Consideration prior to initiating TPN - Answer GI dysfunction, severity of malnutrition, degree of hypercatabolism (excessive metabolic breakdown) , medical prognosis, pt wishes Components of parenteral nutrition solutions - Answer -carbohydrates -amino acids parenteral nutrition solutions: carbohydrates - Answer Dextrose yields 3.4 kcal/g because of its hydrated form Concentrations greater than 10% are hypertonic; must be delivered via central parenteral nutrition (CPN) parenteral nutrition solutions: amino acids - Answer Mixture of crystalline amino acids PPN (Peripheral Parenteral Nutrition - Answer via peripheral intravenous access lower concentration than TPN TPN (Total Parenteral Nutrition) - Answer Highly concentrated dextrose solution Hyperosmolar Solution (severe hyperglycemia, extreme dehydration) Delivered through central vein What is a saline lock? - Answer the cap that goes onto an iv insertion catheter. it allows you the ability to stop giving iv fluids and then start again at a later time without having to do another venipuncture risk for saline lock - Answer occlusion -check for patency frequently Intermittent venous access (saline lock) advantages - Answer -Cost savings resulting from the omission of continuous IV therapy -Effectiveness of nurse's time enhanced by eliminating constant monitoring of flow rates -Increased mobility, safety, and comfort for the patient Intermittent venous access (saline lock) BEFORE administration - Answer Assess the patency and placement of the IV site Intermittent venous access (saline lock) AFTER administration - Answer Access must be flushed with a solution to keep it patent (Locked with Saline Flush) Administering Medications by IV Bolus, Piggyback, Intermittent Infusion Sets, and Mini-Infusion Pumps - Answer -An IV bolus introduces a concentrated dose of a medication directly into a vein via IV access -Usually requires a small fluid volume -Common in emergencies to deliver a fast-acting medication quickly -Patients must be monitored closely for adverse reactions Large volume infusion - Answer -Safest and easiest method of IV administration. -Large volumes (500 or 1000 mL) are used. -If infused too rapidly, patient is at risk for overdose and fluid overload. best practices of Large volume infusion - Answer -Standardized concentrations and dosages -Standardized procedures for ordering, preparing, and administering IV medications -Ready-to-administer doses when possible Intravenous bolus - Answer Introduces a concentrated dose of medication directly into the systemic circulation. Advantageous when the amount of fluid that a patient can take is restricted. why is IV bolus dangerous - Answer The most dangerous method for medication administration because there is no time to correct errors. how to give medicine through IV bolus - Answer Confirm placement of the IV line in a healthy site. Determine the rate of administration by the amount of medication that can be given each minute. Volume-Controlled Infusions - Answer Uses small amounts (50 to 100 mL) of compatible fluids. -Volume-control administration -syringe pump -Three types of containers Volume-control administration - Answer Small (150-mL) containers that attach just below the primary infusion bag or bottle syringe pump - Answer Battery operated Allows medications to be given in very small amounts of fluid (5 to 60 mL) within controlled infusion times using standard syringes Volume-Controlled Infusions: Three types of containers - Answer volume-control administration sets, piggyback sets, and syringe pumps. Advantages of volume-controlled infusion: - Answer -Reduces the risk of rapid-dose infusion by IV push -Allows for administration of medications that are stable for a limited time in solution -Allows control of IV fluid intake piggyback - Answer A small (25 to 250 mL) IV bag or bottle connected to a short tubing line that connects to the upper Y-port of a primary infusion line or to an intermittent venous access Administration of IV therapy in the home - Answer -Usually patients have a central venous catheter. -Home care nurses assist with monitoring. -Carefully assess patients and their families to determine their ability to manage this therapy at home. -Begin instruction on IV care management while the patient is still in the hospital. Teach family and patient: pt teaching of Administration of IV therapy in the home - Answer -To recognize signs of infection and complications -When to notify the home care nurse or health care provider -How to maintain IV administration equipment Never administer an IV medication through tubing that is infusing.. - Answer blood or blood product, a parenteral nutrition solution (banana bag), or insulin. -you can kill a pt. To prevent a potentially fatal air embolism, always.. - Answer remove air from the IV bag before infusing fluid under pressure. Rapid infusion of room-temperature or colder solutions (such as blood) may result in.. - Answer hypothermia, acidosis, and coagulopathy. Warming the fluid is strongly recommended. Ensure continuous monitoring of fluids infused under pressure so that bags are.. - Answer replaced promptly as needed. Ensure maximum flow rate by - Answer limiting the use of needleless connectors when possible documentation - Answer Document Amount of Medication administered Method of drug administration Flush if indicated and compatible Flush solutions documented on I& O flow sheet IV site status Clients response to medication Parameters such as VS as indicated considerations with pediatric patients - Answer -Children's veins are much smaller -It is more difficult to keep children still during the procedure. -Ask nurse or parent to help with immobilization -You can ALSO use infants' scalp and foot veins for IV -Use an arm board or commercially available protective device to help prevent accidental removal. considerations with older adults - Answer -Skin tends to be thinner and their veins more fragile and superficial with a tendency to roll -When inserting the catheter, be sure to pull the skin below the insertion site taut to stabilize the vein -Try to avoid the veins in the hand and the dominant arm -Use a small catheter -Use mesh dressing Select an IV Site - Answer -Veins on Dorsal and Ventral surfaces of upper extremities (e.g. cephalic, basilic, and median veins) -Use most distal site in non-dominant arm if possible. -Patients with IV's in their dominant hand have decreased ability to perform activities of daily living (ADLs). Verify MAR & Supplies - Answer 1. Compare MAR with MD orders using 6 rights: (Pt/Med/Dose/Time/Route/Documentation) (Verbalize) 2. Initial/Date MAR in LEFT column, then sign bottom with name and credentials 3. Perform Hand Hygiene Identify, Gather, and Prepare equipment and Supplies 1. Working from verified MAR.... 2. Perform Hand Hygiene 3. Gather the necessary equipment and supplies: gloves, IV pole, primary tubing, extension tubing, IV start kit, appropriately sized cannula, IV solution 4. Perform Med Check #1 when pulling out of drawer (state the six rights) 5. Inspect IV solution for color, clarity, and expiration date 6. Perform med calculations (KVO = 30 ml/hr) (Formula V/T x gtt factor) 7. Perform Hand Hygiene