Term
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Definition
large amount of IV fluid given in a short period of time, usually less than an hour.
Given to rapidly replace fluid loss that could be caused by dehydration, shock, hemorrhage, burns or trauma
A large-gauge angiocatheter (18gauge or higher) is needed to maintain the rapid rate in an adult |
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Term
| Volume controlled infusions |
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Definition
Some meds such as antibiotics are given intermittently in a small about of solution through a continuous IV system or with saline or heparin lock systems.
The medications infuse for short periods on scheduled basis.
Infusions can be administered by secondary IV bag/bottle/tandem, volume-control set, or by a mini infusion pump |
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Term
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Definition
Small amounts of solution (concentrated or diluted) injected within 1-2 minutes.
Some are given directly into the peripheral IV/port
Watch for redness, burning, or increasing pain
Never give meds that cause adverse effects such as potassium chloride |
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Term
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Definition
mixed in a large volume of fluid (500-1000ml) and given continuously.
i.e. Potassium chloride |
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Term
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Definition
for older adult clients, clients taking anticoagulants or clients with fragile veins:
Avoid tourniquets
Use BP cuff
Do not slap extremity to visualize vein
Edema in extremities:
Apply digital pressure over selected vein to displace edema
Apply pressure with alcohol pad
Cannulation must be quick
Anatomical landmarks may be needed for obese clients |
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Term
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Definition
-standard precautions
-Change catheter: if any break in surgical asepsis is suspected, according to policy (72hrs)
-Avoid writing on bags with pen/marker; ink could contaminate; change tube if contamination
-use sterile needle/catheter each attempt
-fluid shouldnt hang over 24 hrs unless closed system
-wipe all ports with alcohol or antiseptic swap before connecting IV lines or syringe; dont leave exposed to air
-Never disconnect for convenience or to position client |
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Term
| Selecting vein for IV catheter |
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Definition
-First choose distal veins on nondominant hand
-nonpainful site without bruising and will not interfere with activity
-a resilient vein with a soft, bouncy feeling when palpated
-Avoid veins: varicosed, inner wrist with bifurcations, flexion areas, near valves, lower extremities, in antecubital fossa, sclerosed or hard, in an extremity with impaired sensitivity
-enhance access: gravity, fist clenching, friction with alcohol, heat, percussion with gentle tapping |
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Term
| IV catheter procedure (clean gloves) |
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Definition
-Apply tourniquet/BP cuff
-Select vein and untie it
-Cleanse the site using friction in a circular motion starting at the middle with alcohol, iodine or chlohexidine, allow 1-2 dry
-Remove catheter cover and grasp hub, checking for smooth edges and retie T/BP
-Anchor vein below site of insertion, pull the skin taut and hold
-Insert bevel up at 10-30d until flashback of blood
-Lower hub close to skin to prepare threading into vein 1/4in
-Loosen needle and advance catheter using thumb/index, release t/bp
-Apply pressure 3cm above and remove needle; activate safety
-apply dressing, set up rate by order |
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Term
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Definition
clean gloves; prescription
-Remove tape/dressing; stabilize and clamp tubing
-Apply sterile gauze pad over site with no pressure or alcohol
-With other hand withdraw by pulling straight back
-Elevate extremity and apply pressure for 2min
-Assess, apply tape over gauze or pressure pad if needed and document |
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Term
| IV Complications of Infiltration |
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Definition
Infiltration:
-Pallor, local swelling, decreased skin temp at site, damp dressing, slow infusion
Treatment:
-Stop infusion, remove catheter
-Elevate extremity
-Apply warm compress 3-4 times/day
-Restart infusion proximal to site or in another extremity
Secure cather |
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Term
| IV Complications of Phlebitis/Thrombophlebitis |
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Definition
Edema; throbbing, burning or pain at site; increased skin temp; erythema (reddening); red line up arm with palpable band; slow infusion
Treatment:
-Promptly discontinue infusion and remove catheter
-Elevate extremity
-Apply warm compress 3-4 times/day
-Restart infusion proximal/other extremity
-Culture the site if drainage
-Rotate the site at least every 72 hours; Avoid lower extremities; use surgical asepsis |
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Term
| IV Complications of Hematoma |
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Definition
Ecchymosis at site (discoloration from bleeding underneath)
Treatment:
-Do not apply alcohol
-Apply pressure after IV catheter removal
-Use warm compress and elevation AFTER bleeding stops
Prevention:
-Minimize tourniquet time
-Remove T before starting IV infusion
-Maintain pressure after removal |
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Term
| IV Complications of Cellulitis |
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Definition
Pain; warmth; edema; induration; red streaking; fever, chills and malaise
Treatment:
-Promptly discontinue infusion/remove catheter
-Elevate extremity
-Apply warm compress 3-4 times/day
-Obtain a specimen for culture at the site and at catheter if drainage
-Administer as prescribed: Antibiotics, Analgesics, Antipyretics
Prevention:
-Rotate site at least every 72 hrs
-Avoid lower extremities
-Use surgical aseptic technique |
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Term
| IV Complications of Fluid Overload |
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Definition
Distended neck veins, increased BP, tachycardia, SOB, crackles in lungs, edema
Treatment:
-Stop infusion
-Raise head of the bed
-Assess vital signs
-As prescribed: adjust rate, administer diuretics
Prevention:
-Use infusion pump
-Monitor I&O |
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Term
| IV Complications of Catheter Embolus |
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Definition
Missing catheter tip when discontinued; sever pain at site with migration or no symptoms if no migration
Treatment:
-Place T high on extremity to limit venous flow
-Prepare for removal under xray or surgery
-Save catheter to determine cause
Do not reinsert the stylet into the catheter |
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Term
| Side/Adverse med effects on CNS |
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Definition
CNS stimulation: may be at risk for seizure
CNS depression: advise not to drive/participate in dangerous activities
Extrapyramidal symptoms EPS: involuntary fine motor tremors, rigidity, restlessness, spastic movements within hrs or months: often associated with meds affects CNS like mental health |
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Term
| Side/Adverse med effects of anticholinergics/cardiovascular |
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Definition
Anticholinergic: block muscarinic; effect mainly eye, smooth muscle, exocrine glands and heart: teach liquid use for dry mouth, sunglasses for photophobia; urinating before medicine to help urinary retention
Cardiovascular: Antihypertensives can cause orthostatic hypotension: teach signs of postural hypotension and sit or lie down/move slowly |
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Term
| Side/Adverse med effects of GI/Hematologic |
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Definition
GI: irritation of tract, vomiting can cause adverse effects; NSAIDs can cause this and should be taken with food
Hematologic: can be life threatening with some groups of beds: bone marrow depression/supression with anti cancer meds; hemorrhagic disorders with anticoagulants and thrombolytics.
-Educate on s.s. of bleeding (bruising, discolored urine/stool, bleeding gums) |
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Term
| Side/Adverse med effects of Hepatotoxicity/Nephrotoxicity |
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Definition
Hepatotoxicity: damage to liver cells impairs metabolism causing accumulation, producing adverse effects: 2 or more hepatotoxic increased liver damage risk, intitial and periodic liver tests
Nephrotoxicity: NSAIDs often cause; kidney damage causes accumlation due to lack of excretion: Aminoglycosides may cause renal damage; monitor serum creatinine and BUM levels |
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Term
| Side/Adverse med effects of toxicity/allergic reaction |
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Definition
Toxicity: excessive dose and sometimes at TL; liver damage with tylenol overdose or chronic alc use; antidote acetylcysteine (Mucomyst) may be used to minimuze liver damage
Allergic reaction: immune response; mild rashes/hives: benadryl; before administering any meds, obtain complete med history |
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Term
| Side/Adverse med effects of anaphylactic reaction and immunosuppression |
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Definition
Anaphylactic: life threatening immediate allergic reaction causing resp distress, severe bronchospasm, cardiovascular collapse: treat with epinephrine, bronchodilators and antihistamines; notify and prove resp support
Immunosuppression: decreased or absent immune response: glucocorticoids depress immune response and increase infection risk; monitor clients and check for s.s. |
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Term
| Medication-Food interactions |
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Definition
foods may alter med absorption
-Foods with tyramine should be avoided when taking MAOIs
-Consistent intake of VitK should be maintained when taking warfarim (coumadin)
-Tetracycline(Tetracyn) should not be taken within 2 hours of consuming dairy
-Grapefruit juice should be avoided if taking oral meds |
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Term
| Fetus Risk by US Food and Drug Administration |
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Definition
Category A: There is no evidence of risk to fetus during pregnancy
B: No evidence of risk to animal fetus based on studies in pregnant women
C: Adverse effects have been demonstrated on animal fetuses. No adequate and well controlled studies in preg women but use of med during preg may be warranted based on potential benefits
D: Adverse effects have been shown on human fetus from investigational/marketing experience, may be warranted on potential benefits
X: Adverse effects have been demonstrated on human and animal fetus based on studies and investigational or marketing experience. Use is contraindicated. Risks outweigh potential benefits. |
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Term
| Factors Affecting Med Dosages and Response |
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Definition
-body weight: higher body mass may need higher dose-absorbed/distributed in body tissue
-Age: children/older adults have lower kidney/liver function
-Gender: body fat/hormones
-Biorhythmic cycles: responses very by cycles of the body; hypnotic meds work better given at usual sleep time
-Tolerance: congenital or acquired
-Accumulation: decreased renal function is the major cause in older adults leading to toxicity
-Psychological: emotional state/expectations. Placebo effect: positive med effects from psych factors
-Medical Condition |
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Term
| Children med administration |
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Definition
Pediatric dosages are based off body weight or body surface area! BSA
1m-12m: immature liver/kidney, alkaline gastric juices, immature blood brain barrier, decreased serum protein binding sites
Children
-Decreased gastric acid production and slower gastric emptying
-decreased first pass
-increased absorption of topical meds
-lower BP (more flow to liver/brain, less to kidneys)
-Higher body water content (dilutes water soluble)
Most meds arent tested on children and may require dilution, calculation, preperation and very small doses; limited IV sites |
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Term
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Definition
Pregnancy: meds are distributed to the fetus as well; all should be considered as potentially harmful; weight risks.
Meds common: nutritional supplements and nausea/vomiting/gastric acidity and mild discomfort treatment.
Chronic conditions like DM and hypertension must be managed with careful maternal fetal monitoring.
Live virus vaccines are contraindicated-teratogenic effects (MMR, polio, yellow fever)
Lactation: meds are secreted in breast milk; avoid drugs with extended half life and take meds immediately after breastfeeding if safe to minimize med concentration in feeding |
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Term
| Required abilities for self-monitoring blood glucose levels |
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Definition
-Alertness or the ability to comprehend and give a return demonstration
-Adequate finger dexterity
-Adequate visual acuity |
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Term
| Interpretation of blood glucose findings |
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Definition
Hyperglycemia: level above 250 mg/dL
Hypoglycemia: level below 70 mg/dL
Poor storage: false readings: vial at room temperature |
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Term
| Preprocedure Nursing Actions for blood glucose test |
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Definition
-Check clients record: frequency and type of test, norms and ranges, actions based on results
-Review med profile; note: anticoagulant usage, times/dose of hypoglycemic agents; use of steroids/meds that elevate levels
-Gather materials
-Review manufacturer instructions
-Check expiration dates
-Calibrate and test if new bottle
-Explain procedure
-Evaluate site for skin integrity and compromised circulation
-Don gloves/hand hygiene |
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Term
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Definition
Usually done at home to check for keytones which indicates uncontrolled glucose. Positive above 180 mg/dL
-Sterile urine sample bottle; assist if needed
-Dip reagent strip in sample
-Compare color change with ranges on container (1-5s)
-Document |
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