Hypo/Iso/Hypertonic Solutions Quiz

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Questions and Answers

What is a potential issue that can occur due to a central venous catheter (CVC) placement?

  • Increase in urine output
  • Decreased blood pressure
  • Pain or discomfort (correct)
  • Fluid overload

What should be done to prevent a blockage in a central line?

  • Regularly flush the line (correct)
  • Use larger bore catheters
  • Keep the area dry at all times
  • Avoid any manipulations of the line

Which of the following is a rare but serious complication associated with central line placement?

  • Localized infection at the insertion site
  • Allergic reaction to the catheter
  • Vascular spasm
  • Pneumothorax (correct)

What action should be taken if a central line dressing is found to be loose?

<p>Notify the medical team immediately (A)</p> Signup and view all the answers

Which of the following is NOT a type of central line?

<p>Midline catheter (B)</p> Signup and view all the answers

What is the maximum osmolality for a hypotonic solution?

<p>Less than 250 mOsm/L (C)</p> Signup and view all the answers

Which of the following solutions is hypotonic?

<p>0.33% sodium chloride (A)</p> Signup and view all the answers

What is a primary identifier of an isotonic solution?

<p>Has an osmolality of 250-375 mOsm/L (A)</p> Signup and view all the answers

What is the primary concern when administering a hypertonic solution?

<p>Intravascular fluid volume overload (A)</p> Signup and view all the answers

What is the recommended time frame to change primary IV tubing?

<p>Every 72-96 hours (A)</p> Signup and view all the answers

Which type of IV tubing is most commonly used in pediatric care?

<p>Micro tubing (D)</p> Signup and view all the answers

What is the maximum duration before changing secondary/intermittent IV tubing?

<p>24 hours (D)</p> Signup and view all the answers

What should be monitored when administering hypotonic solutions?

<p>Hypotension (C)</p> Signup and view all the answers

Flashcards

Hypotonic solution

A solution with a lower concentration of solutes than the body's fluids, causing fluid to shift into cells.

Isotonic solution

A solution with the same concentration of solutes as the body's fluids, maintaining cell size.

Hypertonic solution

A solution with a higher concentration of solutes than the body's fluids, causing fluid to shift out of cells.

Micro tubing

IV tubing with a higher drop factor (60 gtts/min), used for small fluid volumes over extended time.

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Central line risks

Potential complications from central venous catheter (CVC) placement, including pain, bleeding, infection, blockage, blood clots, migration, accidental removal, and collapsed lung.

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Macro tubing

IV tubing with a lower drop factor (10, 15, or 20 gtts/min), used for routine infusions.

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Primary IV tubing change

Change primary IV tubing every 72-96 hours.

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Central line infection

Increased risk of infection at the CVC insertion site; prevent through hand hygiene and reporting of changes to the dressing or symptoms like fever or chills.

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Blood product IV tubing change

Change blood product IV tubing every 4 hours or 4 units (whichever is sooner).

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Central line blockage

Obstructions in the central line, often due to blood clots; address by flushing the line and potentially using medications to clear it.

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Fat emulsion tubing change

Change IV tubing for fat emulsions every 24 hours.

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Blood clots risk (central line)

Clots can form in the vein near a central line, causing swelling and redness in affected areas. Immediate notification to the team is crucial.

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Accidental central line removal

Central lines can be unintentionally pulled out. Securing the line with proper measures (tape, bandages) reduces this risk but vigilance is required.

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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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