Podcast
Questions and Answers
What sign indicates infiltration of IV fluid into the surrounding interstitial spaces?
What sign indicates infiltration of IV fluid into the surrounding interstitial spaces?
- Increased heart rate
- Edema and coolness at the site (correct)
- Increased respiration rate
- Elevated blood pressure
What should be done if an air embolism is suspected during IV fluid administration?
What should be done if an air embolism is suspected during IV fluid administration?
- Withdraw the IV catheter immediately
- Clamp the tubing and place the client in Trendelenburg’s position (correct)
- Position the client flat on their back
- Circumvent the IV flow until the bag is changed
What can cause decreased venous back pressure during IV administration?
What can cause decreased venous back pressure during IV administration?
- Excessive heat applied to the IV site
- Obstruction from a blood clot or venospasm (correct)
- Over-hydration of the client
- Administering fluids too quickly
What is the appropriate action if there is a cessation of flow in an IV line?
What is the appropriate action if there is a cessation of flow in an IV line?
Which method can help secure an IV cannula effectively?
Which method can help secure an IV cannula effectively?
What is the appropriate action when discontinuing parenteral nutrition to prevent hypoglycemia?
What is the appropriate action when discontinuing parenteral nutrition to prevent hypoglycemia?
Which symptom is indicative of hypoglycemia that should be monitored for in a patient receiving parenteral nutrition?
Which symptom is indicative of hypoglycemia that should be monitored for in a patient receiving parenteral nutrition?
What is the most critical reason to use strict aseptic techniques when dealing with parenteral nutrition?
What is the most critical reason to use strict aseptic techniques when dealing with parenteral nutrition?
What should be done if a patient shows signs of sepsis while on parenteral nutrition?
What should be done if a patient shows signs of sepsis while on parenteral nutrition?
What is the recommended monitoring practice after discontinuing parenteral nutrition to ensure patient safety?
What is the recommended monitoring practice after discontinuing parenteral nutrition to ensure patient safety?
What is the primary cause of phlebitis?
What is the primary cause of phlebitis?
Which sign is NOT typically associated with thrombophlebitis?
Which sign is NOT typically associated with thrombophlebitis?
What should be done if phlebitis is suspected during IV therapy?
What should be done if phlebitis is suspected during IV therapy?
What is the recommended action when using an IV cannula?
What is the recommended action when using an IV cannula?
In the event of thrombophlebitis, which of the following actions is incorrect?
In the event of thrombophlebitis, which of the following actions is incorrect?
What symptom indicates phlebitis rather than thrombophlebitis?
What symptom indicates phlebitis rather than thrombophlebitis?
What is a key consideration when choosing a venipuncture site?
What is a key consideration when choosing a venipuncture site?
Which intervention is recommended for managing phlebitis symptoms?
Which intervention is recommended for managing phlebitis symptoms?
When is it appropriate to use an armboard or splint during IV therapy?
When is it appropriate to use an armboard or splint during IV therapy?
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Study Notes
Hypoglycemia Management
- Abrupt discontinuation of Parenteral Nutrition (PN) can lead to hypoglycemia.
- Monitor blood glucose levels; consider levels below 70 mg/dL (3.9 mmol/L) as hypoglycemic.
- Symptoms of hypoglycemia include anxiety, diaphoresis, hunger, shakiness, and weakness.
- Administer IV dextrose to manage low blood glucose levels.
- Infuse 10% dextrose at the same rate as PN for 1-2 hours post-discontinuation.
- Check glucose levels one hour after PN is stopped.
Infection Risks
- Poor aseptic technique and catheter contamination can lead to sepsis.
- Monitor for chills, fever, elevated white blood cell count, and drainage at insertion site.
- Strict aseptic practices are essential due to high glucose concentration in PN, which supports bacterial growth.
- Prepare for catheter removal and notify the Primary Healthcare Provider (PHCP) if signs of infection occur.
Respiratory Distress
- In case of air embolism, clamp the tubing and position the client on their left side with the head down.
- Notify the PHCP immediately to prevent serious complications.
Infiltration Signs
- Infiltration occurs when IV fluids seep into surrounding tissues, leading to edema, discomfort, or coolness at the site.
- Monitor IV rate for any decrease or cessation of flow.
- Avoid using veins in areas of flexion and secure the IV cannula with tape.
Phlebitis and Thrombophlebitis
- Phlebitis is characterized by inspection signs like redness, tenderness but not swelling; can lead to thrombophlebitis.
- Symptoms of thrombophlebitis include hardness and cord-like tenderness at the site.
- Remove IV immediately if phlebitis or thrombophlebitis is suspected and notify the PHCP.
- Apply warm compresses as prescribed for symptoms management.
Extravasation
- Extravasation is serious; identify if vesicant or irritant solutions are involved.
- Immediate PHCP notification is required for potential tissue necrosis.
- Monitor for skin color changes, discomfort, and document findings.
Infection Control
- Ensure strict aseptic technique while caring for the IV site to prevent both local and systemic infections.
- Assess patients for risk factors for infection, including pre-existing conditions.
Additional Considerations for PN
- Validate PN solution components with the PHCP, sometimes requiring two registered nurses' confirmation.
- IV medications and blood should not be administered through the PN line to prevent complications and incompatibilities.
- Blood draws from central venous access sites should utilize different ports than those used for PN after a delay to ensure accurate laboratory results.
- Monitor laboratory studies such as liver function, renal function, electrolytes, and albumin levels to guide therapy adjustments.
- Take precaution against refeeding syndrome in malnourished patients, which can lead to electrolyte imbalances and serious complications.
- Store PN solutions under refrigeration and ensure use within 24 hours post-preparation; do not use cloudy or discolored solutions.
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