Med Surg 1 > infusion therapy > Flashcards

infusion therapy Flashcards

(46 cards)

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1
Q

infusion therapy

A

delivery of medications in solutions and or fluids by parenteral route

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2
Q

use of infusion therapy

A
  • maintain or correct fluid balance and electrolyte balance
  • administer medications
  • replace blood or blood products
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3
Q

isotonic

A
  • equal solute concentrations

- no fluid shifts

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4
Q

hypotonic

A

lower solute concentrations

- fluids shifts into the cell

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5
Q

hypertonic solutions

A
  • higher solute concentrations

- fluids shift out of the cell

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6
Q

types of infusion

A
  • blood components

- iv drug therapy

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7
Q

what should be included in an order

A 
drug name 
specfic dose and route 
frequency of admin 
times of admin 
length of time for infusion
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8
Q

milliters per hour equation

A

ordered volume (ml)/ number of hours

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9
Q

drops per min

A

volume (ml)/ time (min) x drop factor (gtts/ml)

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10
Q

modes of Iv infusion

A
  • continuous
  • intermittent
  • direct injection/ iv push (IVP)
  • patient controlled analgesic (PCA)
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11
Q

vascular access devices (VAD)

A
  • peripheral IV therapy (PIV)
    • short infusion catheter
  • midline catheters
  • central IV therapy (CVC)
    • peripherally inserted central catheter (PICC)
    • nontunneled central venous catheters
    • tunneled central venous catheters
    • implanted ports
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12
Q

peripheral IV therapy

A

catheter components

  • stylet (needle)-insertion
  • cannula- continous access

position
- within peripheral vessels

size (gauge)
- 26 gauge (smallest) to 14 gauge (largest)

duration of uses
- rotate sites based on clinical indication

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13
Q

best practice considerations for peripheral IV therapy

A
  • avoid areas of joint flexion
  • choose mosy distal site possible
  • avoid dominant side if possible
  • do not use side of mastectomy, av fistula,, lympth node dissection or paralysis
  • limit unsuccessful attempts to 2 per clinician
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14
Q

midline catheters

A

catheter components
- single or doible lumen

position

  • inserted into median antecubital, basilic or cephalic vein
  • tip resides no further than axillary vein

size

  • 3-8 inches long
  • 3-5 french

duration of use
- 6-14 days

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15
Q

best practice considerations for midline catheters

A
  • do not infuse parenteral nutrition
  • do not use to draw blood
  • do not admin incompatible drugs if double lumen
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16
Q

central venous catheters

A
  • VAD placed in central circulation

placement confirmation

  • CXR
  • magnet tip locator electrocardiogram
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17
Q

peripherally inserted central catheters (PICCC)

A

catheter components
- single dual or triple lumen

position

  • basilic preferred, cephalic okay
  • tip resides in SVC

size

  • 18-29 inches
  • 2-6 fr

duration
- months

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18
Q

best practice considerations for peripherally inserted central catheters (PICCC)

A
  • contrats injection- power PICCC only

- 10ml barrel syringes only

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19
Q

non tunneled

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A
  • inserted percutaneously
  • cath exits skin near cannulation site
  • subclavian or internal jugular
  • resides in SVC or IVC
  • short term use
  • up to 5 lumens
20
Q

tunneled

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A

portion of catheter under subcu tissue

  • seperates where catheter enters vein and exits skin
  • reduces risk of infection
  • long term use
  • single dual or triple lumen
21
Q

implanted ports

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A
  • long term use: 1 year +, chemo

catheter components:

  • portal body, dense septum over a reservoir and catheter
  • subq pocket house the port body

access

  • no part of catheter is visible
  • need non-coring needle
22
Q

primary admin set

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A

allows for continous ir intermitted infusion direct from container to catheter

23
Q

secondary admin set

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A

piggy back

- delivery of intermittent medications

24
Q

infusion pumps

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A

typically seen in acute and longterm care centers

  • measure volume of fluid being infused
  • each pump requires dedicated tubing specific to pump
25
syringe pumps
- largest syringe inserted into pump - electronic or battery powered piston to push plunger - for small volumes only
26
ambulatory pumps
- home care | - usually programable
27
needlestick saftey and prevention act
safety needles - retractable needle or shielding needles needlesless connection devices - luer lock connectors - vigorously scrub connector"hub" for a minimum of 10 seconds with alc - scrub the hub
28
considerations for older adults: skin integrity
- thins, looses sub q fat ----> decreased elasticity - increase risk for infilitration/ extravasation d/t fluid leakage - increase skin tears
29
considerations for older adults: cardiac renal changes
- poor perfusion/circulation - risk for circulatory overload - decreased filtration/ excretion - decrease dosing may be needed
30
complications of infusion therapy
- local - systemic - cvc dwell
31
local complications
- occur near catheter site
32
systemic complications
- involve entire vascular system | - may affect multiple systems
33
cvc dwell complications
complications specifc to central line insertion or dwelling
34
examples of local complications
- infiltration - extravasation - thrombosis - site infection - phelbitis
35
infiltration
complication: leakage of nonvesicant solution causes - inflammation - puncture of opposite vessel wall clinical manifestations - skin- cool, tight, tender - fluid leaking from the puncture site interventions - stop infusion, remove site - elevate extremity - cold compress prevention - stabilize catheter - avoid pressure - assess frequently
36
extravasation
complication - leakage of vesicant solution causes - same as infiltration clinical manifestations - in attrition to those associated with infiltration - blistering/ tissue sloughing intervention - stop infusion - surgical intervention may necessary prevention - see infiltration
37
phlebitis
complication - inflammation causes - mechanical- insertion technique - chemical- fluid or medications pathogenic-break in aseptic technique clinical manifestations - pain at site - skin- red, inflammed, potentially hard interventions - remove site if possible - head and elevate extremity prevention - choose smallest guage necessary - avoid flexion sites
38
thrombosis
blood clot within vein causes - damage to endothelial linning - traumatic or multiple venipunctrues - too large a catheter for size vein clinical manifestations - swollen extremitiy - tenderness/redness slowed stopped infusion interventions - stop infusion, apply cold compress - elevate extremity - potential need for surgical intervention prevention - use ebp ventipuncture techniques
39
site infection
infection at insetion point, port pocket or sub c tunnel causes - break in aspetic technique - lack of hand hygiene clinical manifestations - site- red swollen warm - potential purelent or ordor interventions - clean exit site, remove catheter, send for culture, cover with dry sterile dressing prevention - aseptic technique - hand hygiene
40
circulatory overload
- excess fluid in circulatory system - infusion rate greater than pt. system can accommodate - SOB, cough, increased bp
41
speed shock
- systemic reaction to rapid infusion of unfamiliar substances - drugs reach toxic levels - change in loc, irregular pulse, chest tightness
42
catheter embolism
- piece of catheter breaks off into circulation - anything the damages catheter - potentially life threatening
43
cvc migration
- Movement of catheter tip to another vein - Changes in intrathoracic pressure - Coughing, sneezing, heaving lifting Clinical manifestations - dependent on vein migration - -STOP Infusion, Notify HCP
44
cvc dislodegemnt
- Movement of catheter from insertion site - Inadequate catheter securement - Changes external catheter length - STOP Infusion, NEVER Readvance, Notify HCP
45
occlusion
- Lumen is partially or totally blocked - Precipitate from medications, blood clots, inadequate flushing - Increased resistance, difficulty administering fluids/drawing blood, infusion pump stops/alarms - Administer appropriate medications to dissolve precipitate or blood clot PREVENTION!!! - FLUSH, FLUSH, FLUSH Before, between and after
46
catheter related bloodstream infection
Occurs when pathogenic organism invades patients' circulatory system Clinical Manifestations - Fever, HA, Chills, malaise Tachycardia, hypotension, decreased U/O Treatment - Determine Cause - Infusate – change entire infusion system, send to lab - Catheter – remove, send catheter tip to lab PREVENTION H.A.N.D.S
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