Med-Surg Nursing I: IV Therapy

Study Notes

Here are the study notes for the text:

Crystalloid:
- Water and dissolved crystals (e.g., salt, glucose, dextrose)
Colloid:
- Water and molecules of suspended substances (e.g., blood cells, albumin)

Isotonic Solutions (e.g., D5W, LR):
- Fluid has the same concentration of solute as plasma (ECF)
- Purpose: maintains fluid balance when NPO, expands ECF volume
Hypotonic Solutions (e.g., 0.45% NaCl, 0.33% NaCl):
- Fluid has less solute than plasma (ECF)
- Purpose: rehydrates clients in fluid volume deficit, causes fluid shift into cells
Hypertonic Solutions (e.g., D10W, D50W, 3-5% NS, 3-5% NaCl):
- Fluid has more solutes than plasma (ECF)
- Purpose: treats hypovolemia and hyponatremia, draws water from cells into plasma

Primary:
- Used for administering large volumes of IV solution over a longer period
Secondary:
- Shorter tubing, used for administering small amounts of solution (usually medicated) through a port in the primary tubing
Y-tubing:
- Used for administering blood products, with a filter that removes clotting/cellular debris
Vented:
- Used for medications/solutions packaged in glass bottles (e.g., nitroglycerin)
Filtered:
- Contains a filter on the tubing to help filter crystallizing medications (e.g., dilantin)

Spike:
- Site of insertion into the product, must remain sterile
Drip Chamber:
- Holds a small amount of fluid, where you can count the gtts rate
Length of Plastic Tubing:
- Connects the solution to the catheter
Ports:
- Access site to instill IV medications/additional solutions
Roller Clamp:
- Regulates the flow/rate of infusion

Continuous:
- Regulate flow of solution over long periods
Intermittent:
- Solution (medication) given over a short period, through a secondary line
Direct:
- IV push, delivers a single dose of medication directly into the vein
Hypodermoclysis:
- Allows IV solutions to infuse into subcutaneous tissue, used to treat dehydration at home

Peripheral:
- Venipuncture site in superficial veins, most common sites are forearm and back of hand
Central:
- Access to larger veins, used for long-term IV therapy or when peripheral IV is not attainable
- Types: Midline Catheter, Peripherally inserted central catheter (PICC), Hickman/Broviac/Groshung, Implantable venous port (Port-a-Cath)

Infection:
- At IV insertion site or systemically
- Signs and symptoms: redness, tenderness, swelling, purulent drainage, malaise, fever, hypotension, tachycardia
Infiltration:
- IV needle/catheter slips out of vein or not inserted into vein, causing fluid buildup in extravascular tissue
- Signs and symptoms: swelling, pain, redness, decreased infusion rate, coolness at site
Phlebitis:
- Inflammation of vein from prolonged use of vein or irritating solution
- Signs and symptoms: redness, heat, swelling, pain along vein
Thrombophlebitis:
- Inflammation of vein with blood clot formation
- Signs and symptoms: pain, tenderness, redness, swelling, heat along vein path
Extravasation:
- Administration of irritant solutions into surrounding tissue
- Signs and symptoms: pain, burning, redness, blistering, inflammation, necrosis
Hematoma:
- Blood leakage into tissue around insertion site
- Signs and symptoms: ecchymosis, swelling, bleeding
Occlusions:
- Caused by clot due to inadequate flushing protocol or infusion rates too slow to keep vein open
- Signs and symptoms: sluggish flow rate, inability to flush or infuse IV solution or meds