NR-2267 Fluid7 Administration7 &7 Acid7 Base7 Balance,7 PreWork7 67 &7 77 Exam7 II
7 7
2. Guidelines7 for7 preventing7 Intravenous7 infections:7 #17-7Hand7Hygiene
• Gloves
• Standard7Precautions
• Tubing7Changes
• Do7Not7Write7on7Bags
• Sterile7insertion
• Maintain7asepsis
3. Protection7of7Skin7and7Veins7of7Older7adults7During7Intravenous7Therapy:7•7Use7the7
smallest-
gauge7catheter7or7needle7possible7(e.g.,7227to7247gauge).7Veins7are7very7fragile,7and7a7smaller7gauge7allows7better7blood7flo
w7to7provide7increased7hemodilution7of7the7intravenous7(IV)7fluids7or7medications
• Avoid7the7back7of7the7hand,7which7may7compromise7a7patient's7need7for7independence7and7mobility.
• Avoid7placement7of7IV7line7in7veins7that7are7easily7bumped7because7older7adults7have7less7subcutaneous7support7tissue
• Avoid7vigorous7friction7while7cleaning7a7site7to7prevent7tearing7fragile7skin.
• If7a7patient7has7fragile7skin7and7veins,7use7minimal7or7no7tourniquet7pressure
• If7using7a7tourniquet,7place7it7over7the7patient's7sleeve7or7use7a7blood7pressure7cutt.
, NR-2267 Fluid7 Administration7 &7 Acid7 Base7 Balance,7 PreWork7 67 &7 77 Exam7 II
• With7loss7of7supportive7tissue,7veins7tend7to7lie7more7superficially;7lower7the7insertion7angle7for7venipuncture7to7107to7157d
egrees7after7penetrating7the7skin
• Veins7roll7away7from7the7needle7easily7because7of7loss7of7subcutaneous7tissue.7To7stabilize7a7vein,7apply7traction7to7the7 skin7
below7the7projected7insertion7site
• Secure7IV7site7with7a7catheter7stabilization7device,7avoiding7excessive7use7of7tape7on7fragile7skin;7consider7covering7the7 site7
additionally7with7surgical7stretch7mesh
• Numerous7medications7and7supplements7(e.g.,7anticoagulants,7antibiotics,7glucocorticoids,7and7garlic)7increase7the7 like
lihood7of7bruising7and7bleeding
4. Rotate7peripheral7IV7site7every:7q727hours
5. Can7the7same7needle7be7used7again7if7the7nurse7missed7the7first7stick?:7NO!7new7n
eedle
-needs7to7be7sterile
, NR-2267 Fluid7 Administration7 &7 Acid7 Base7 Balance,7 PreWork7 67 &7 77 Exam7 II
6. How7 should7 the7 nurse7 proceed7 if7 he7 needs7 to7 write7 something7 on7 an7 IV7b
ag?:7use7a7sticker;7Write7on7the7sticker/label7and7place7it7on7the7IV7bag
-Never7write7directly7on7an7IV7bag
7. Change7 IV7 fluids7 every:7 q247hours7to7prevent7infections
8. What7must7be7done7if7nurse7needs7to7access7a7port?:7clean7it7for7157seconds7w/7alcohol7
wipe.
9. A7 nurse7 must7 clean7 the7 port7 for7 seconds,7 unless7 it7 has7 a7 :7 157seconds;7cap
10. Describe7the7Cap7of7an7IV7port:7it7is7a7cap7on7the7port,
-they7have7alcohol7in7them7and7stay7on7the7port
-w/in757minutes7of7being7on7port,7the7alcohol7sterilizes7the7port
11. define7Infiltration:7fluid/7meds7that7were7intended7to7go7intravenously,7have7now7infiltrated7into7the7tissues7(i
nterstitially)
-If7vesicant7(cytotoxic)7med7this7can7be7dangerous.
-depending7on7meds,7may7need7an7antidote
-Call7pharmacist,7explain,7they7will7inform7you7if7you7need7to7apply7cold7or7heat7to7site
-establish7new7site
12. What7does7the7site/skin7look7like7w/7Infiltration?:7Taut,7pale,7blanched,7cool,7Edema,7painful,7Ala
rm7on7pump7will7sound7cuz7its7hard7to7push7fluid7in7(infusion7may7slow7/7stop)
7 7
2. Guidelines7 for7 preventing7 Intravenous7 infections:7 #17-7Hand7Hygiene
• Gloves
• Standard7Precautions
• Tubing7Changes
• Do7Not7Write7on7Bags
• Sterile7insertion
• Maintain7asepsis
3. Protection7of7Skin7and7Veins7of7Older7adults7During7Intravenous7Therapy:7•7Use7the7
smallest-
gauge7catheter7or7needle7possible7(e.g.,7227to7247gauge).7Veins7are7very7fragile,7and7a7smaller7gauge7allows7better7blood7flo
w7to7provide7increased7hemodilution7of7the7intravenous7(IV)7fluids7or7medications
• Avoid7the7back7of7the7hand,7which7may7compromise7a7patient's7need7for7independence7and7mobility.
• Avoid7placement7of7IV7line7in7veins7that7are7easily7bumped7because7older7adults7have7less7subcutaneous7support7tissue
• Avoid7vigorous7friction7while7cleaning7a7site7to7prevent7tearing7fragile7skin.
• If7a7patient7has7fragile7skin7and7veins,7use7minimal7or7no7tourniquet7pressure
• If7using7a7tourniquet,7place7it7over7the7patient's7sleeve7or7use7a7blood7pressure7cutt.
, NR-2267 Fluid7 Administration7 &7 Acid7 Base7 Balance,7 PreWork7 67 &7 77 Exam7 II
• With7loss7of7supportive7tissue,7veins7tend7to7lie7more7superficially;7lower7the7insertion7angle7for7venipuncture7to7107to7157d
egrees7after7penetrating7the7skin
• Veins7roll7away7from7the7needle7easily7because7of7loss7of7subcutaneous7tissue.7To7stabilize7a7vein,7apply7traction7to7the7 skin7
below7the7projected7insertion7site
• Secure7IV7site7with7a7catheter7stabilization7device,7avoiding7excessive7use7of7tape7on7fragile7skin;7consider7covering7the7 site7
additionally7with7surgical7stretch7mesh
• Numerous7medications7and7supplements7(e.g.,7anticoagulants,7antibiotics,7glucocorticoids,7and7garlic)7increase7the7 like
lihood7of7bruising7and7bleeding
4. Rotate7peripheral7IV7site7every:7q727hours
5. Can7the7same7needle7be7used7again7if7the7nurse7missed7the7first7stick?:7NO!7new7n
eedle
-needs7to7be7sterile
, NR-2267 Fluid7 Administration7 &7 Acid7 Base7 Balance,7 PreWork7 67 &7 77 Exam7 II
6. How7 should7 the7 nurse7 proceed7 if7 he7 needs7 to7 write7 something7 on7 an7 IV7b
ag?:7use7a7sticker;7Write7on7the7sticker/label7and7place7it7on7the7IV7bag
-Never7write7directly7on7an7IV7bag
7. Change7 IV7 fluids7 every:7 q247hours7to7prevent7infections
8. What7must7be7done7if7nurse7needs7to7access7a7port?:7clean7it7for7157seconds7w/7alcohol7
wipe.
9. A7 nurse7 must7 clean7 the7 port7 for7 seconds,7 unless7 it7 has7 a7 :7 157seconds;7cap
10. Describe7the7Cap7of7an7IV7port:7it7is7a7cap7on7the7port,
-they7have7alcohol7in7them7and7stay7on7the7port
-w/in757minutes7of7being7on7port,7the7alcohol7sterilizes7the7port
11. define7Infiltration:7fluid/7meds7that7were7intended7to7go7intravenously,7have7now7infiltrated7into7the7tissues7(i
nterstitially)
-If7vesicant7(cytotoxic)7med7this7can7be7dangerous.
-depending7on7meds,7may7need7an7antidote
-Call7pharmacist,7explain,7they7will7inform7you7if7you7need7to7apply7cold7or7heat7to7site
-establish7new7site
12. What7does7the7site/skin7look7like7w/7Infiltration?:7Taut,7pale,7blanched,7cool,7Edema,7painful,7Ala
rm7on7pump7will7sound7cuz7its7hard7to7push7fluid7in7(infusion7may7slow7/7stop)
