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Questions and Answers
What is a potential issue that can occur due to a central venous catheter (CVC) placement?
What is a potential issue that can occur due to a central venous catheter (CVC) placement?
What should be done to prevent a blockage in a central line?
What should be done to prevent a blockage in a central line?
Which of the following is a rare but serious complication associated with central line placement?
Which of the following is a rare but serious complication associated with central line placement?
What action should be taken if a central line dressing is found to be loose?
What action should be taken if a central line dressing is found to be loose?
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Which of the following is NOT a type of central line?
Which of the following is NOT a type of central line?
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What is the maximum osmolality for a hypotonic solution?
What is the maximum osmolality for a hypotonic solution?
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Which of the following solutions is hypotonic?
Which of the following solutions is hypotonic?
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What is a primary identifier of an isotonic solution?
What is a primary identifier of an isotonic solution?
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What is the primary concern when administering a hypertonic solution?
What is the primary concern when administering a hypertonic solution?
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What is the recommended time frame to change primary IV tubing?
What is the recommended time frame to change primary IV tubing?
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Which type of IV tubing is most commonly used in pediatric care?
Which type of IV tubing is most commonly used in pediatric care?
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What is the maximum duration before changing secondary/intermittent IV tubing?
What is the maximum duration before changing secondary/intermittent IV tubing?
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What should be monitored when administering hypotonic solutions?
What should be monitored when administering hypotonic solutions?
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Study Notes
Hypo/Iso/Hypertonic Solutions
- Hypotonic: Lower solute concentration than body fluids (250 mOsm/L or less). Fluid moves into cells, causing them to swell. Used with caution in patients with burns, liver failure, or trauma. Examples: 0.45% sodium chloride, 0.33% sodium chloride, 2.5% dextrose in water, 0.2% sodium chloride.
- Isotonic: Same solute concentration as body fluids (250-375 mOsm/L). No fluid shifts. Used to treat dehydration, vomiting, diarrhea, shock, and metabolic acidosis. Examples: 0.9% sodium chloride, lactated Ringer's solution, 5% dextrose in water, Ringer's Solution.
- Hypertonic: Higher solute concentration than body fluids (375 mOsm/L or greater). Fluid moves out of cells, causing them to shrink. Used cautiously in dehydrated patients. Examples: D5W, 0.45% sodium chloride, D10W, 3% sodium chloride.
Intravenous Tubing Administration
- Micro Tubing: 60 gtts/min, commonly used in pediatric or neonatal patients for small fluid amounts over long periods.
- Macro Tubing: 10, 15, or 20 gtts/min, used for routine primary infusions.
IV Tubing Change Frequency
- Primary: Every 72-96 hours.
- Secondary/Intermittent: Every 24 hours.
- Blood Products: 4 hours or 4 units (whichever comes first).
- Fat Emulsion: Every 24 hours.
- Important Note: All IV tubing changes must be done with sterile technique, considering the type of tubing, time in use, and solution type. Coordinate tubing changes with IV solution changes whenever possible.
Central Line Risks
- Pain: Discomfort during or after insertion.
- Bleeding: Bruising or bleeding around insertion site.
- Infection: Infection risk; hygiene protocols are important.
- Blockage: Clots can block the line. Flush regularly or use medication as needed.
- Blood Clots: Clots can form in the vein where the central line is, needing monitoring.
- Migration/kinking: The line may move or twist, require repositioning.
- Accidental Removal: Secure the line and use caution, especially around children or pets.
- Collapsed Lung (Pneumothorax): Rare complication that can happen when a lung is punctured.
Peripheral IV vs Central Lines
- IV Types: Peripheral IVs, central venous catheters, midline catheters, implanted ports, tunneled catheters, PICCs.
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Description
Test your understanding of hypotonic, isotonic, and hypertonic solutions, including their definitions, uses, and examples. This quiz will also cover intravenous tubing administration methods. Enhance your knowledge about fluid management in medical scenarios.
