IV Therapy and Parenteral Nutrition

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary purpose of isotonic fluids?

To promote diuresis

To decrease edema and increase output

To treat cellular dehydration

To manage hypotension and hypovolemia (correct)

Which of the following fluids is considered hypotonic?

0.45% NaCl (correct)

0.9% sodium chloride

Lactated Ringer’s

D5 ½ NS

Hypertonic fluids are primarily used for which of the following conditions?

To nourish patients who cannot use their GI tract

Decreased gastric motility

Hypotension

To decrease edema and increase circulatory volume (correct)

What is a common complication of using hypotonic fluids in patients at risk for increased ICP?

Cerebral edema Signup and view all the answers

When administering IV fluids, what should a nurse consistently assess?

The necessity of the prescribed fluid Signup and view all the answers

What type of IV fluid is classified as isotonic?

Normal saline (0.9% NaCl) Signup and view all the answers

Which patient scenario would most likely require parenteral nutrition?

A cancer patient with extensive burns Signup and view all the answers

Which of the following actions should a nurse avoid during routine care associated with administering IV fluids?

Disconnecting the IV for routine care Signup and view all the answers

What components are included in Total Parenteral Nutrition (TPN)?

Water, Lipid emulsion, Trace elements Signup and view all the answers

Which IV fluid is categorized as hypertonic?

D5NS Signup and view all the answers

What is a common complication associated with intravenous nutrition delivery?

Blood clots Signup and view all the answers

How should a nurse administer IV antibiotics that cannot be piggybacked with an insulin infusion?

Change IV sites to start a new line for the antibiotics Signup and view all the answers

What intervention should be recommended for a client experiencing low blood sugar after stopping an infusion of D25?

Add a continuous dextrose infusion Signup and view all the answers

What is the appropriate drip rate for an infusion using a macrodrip set (15 gtts/mL) when infusing 1 liter over 5 hours?

50 gtts/min Signup and view all the answers

What is the primary reason for using a central venous access catheter for TPN?

To allow for long-term access Signup and view all the answers

Which fluid is considered isotonic?

0.9% NaCl Signup and view all the answers

Study Notes

IV Therapy and Parenteral Nutrition

IV therapy is a medication prescribed by primary care providers (PCPs) based on patient presentation, vital signs, and lab results.
Intravenous fluids (IVF) are important for accurate intake management.
Do not disconnect IVF for routine care.
Assess patient response and for complications, as with any medication.
Prescribed IV fluids should be administered based on client condition.

Types of IVF

Isotonic: Isotonic fluids have an osmolality similar to blood serum. Used to treat hypotension and hypovolemia. Common isotonic fluids are 0.9% sodium chloride (normal saline, NS) and Lactated Ringer's (LR). Monitor patients at risk for fluid overload.
Hypotonic: Hypotonic fluids have an osmolality lower than blood serum and are used to treat cellular dehydration (e.g., hyperglycemic conditions). Common hypotonic fluids include 0.45% NaCl (1/2 normal saline, ½ NS), 0.33% NaCl (1/3 NS), and 0.2% NaCl (1/4 NS). Avoid for patients at high risk of increased intracranial pressure (ICP) as these can cause/exacerbate cerebral edema.
Hypertonic: Hypertonic fluids have an osmolality higher than blood serum and are used to decrease edema, increase urinary output, and increase circulatory volume. Common hypertonic fluids include D5NS (5% dextrose and 0.9% sodium chloride), D5 0.45%NS (5% dextrose and 0.45% sodium chloride), 3% NaCl, 5% NaCl, and 10% dextrose in water (D10W).

Parenteral Nutrition (PN)

PN is a method of feeding clients who cannot be nourished sufficiently through the GI tract.
Conditions requiring PN include severe malnutrition, extensive burns, trauma, and cancer.
GI issues requiring bowel rest also necessitate PN.
Components of PN include water, glucose, amino acids, essential fatty acids, vitamins, minerals, trace elements, and lipid emulsion.
PN is usually administered through an infusion pump.
Common PN delivery methods include central venous access catheters, peripherally inserted central catheters (PICCs), and peripheral lines.
Potential complications of PN include infection, septic shock, blood clots, liver dysfunction, gallbladder disease, and altered blood glucose.

PN Order & Components

Nurses should check the PN formula, including amino acids, dextrose, lipids, vitamins, and minerals/trace elements, as per the doctor's order.
Assess IV access, lab values, and daily caloric needs.

Additional Notes

A question asks about clarifying an order for D5W with 20 mEq of KCl IV at 125 mL/hr. This order requires clarification
Another asks about administering antibiotics (Cefoxitin) separately from an insulin infusion
Yet another asks about a patient receiving high volumes of D25 that cause blood sugar drops after discontinuation.
One question asks for decisions on PN delivery sites when both angiocatheter and a port-a-cath are available.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz covers the essential principles of IV therapy and the administration of intravenous fluids. It includes information on isotonic and hypotonic fluids, their uses, and monitoring patient response to treatment. Test your knowledge on managing patient care with IV therapy.