Anatomy & Physiology - IV Therapy (PDF)

ANATOMY & PHYSIOLOGY INTEGUMENTARY SYSTEM Components  Skin  Nails  Hair  Glands of specific receptors Facts  Considered the largest organ  Essential for survival  Performs specific activities INTEGUMENTARY, CONT.  Functions ◦First line of defense ◦Body temperature  Structure ◦Ep...

ANATOMY & PHYSIOLOGY INTEGUMENTARY SYSTEM Components  Skin  Nails  Hair  Glands of specific receptors Facts  Considered the largest organ  Essential for survival  Performs specific activities INTEGUMENTARY, CONT.  Functions ◦First line of defense ◦Body temperature  Structure ◦Epidermis  Outermost layer  Varying degrees of thickness  Several layers ◦Dermis  Thicker  Highly sensitive and vascular  Reacts quickly to pain, temp, pressure INTEGUMENTARY, CONT.  Structure ◦Superficial fascia  Lies below dermal layer  Superficial (peripheral) veins are located here  Varies in thickness  Careful with venipuncture—infection spreads rapidly due to loose tissue and adipose tissue that may be present. ◦Hair  Never shave  Has root—hurts to pull out  Main problem with hair is tape may not stick well and hurts when tape is removed  INTEGUMENTARY, CONT. Structure  Sebaceous glands  Most where hair grows  Secretes oily substance to keep skin and hair moist  Problem—may not allow tape to stick well  Sweat glands  Produces sweat to cool the body  Excessive sweating may not allow tape to stick to skin  RESPIRATORY SYSTEM Function To supply oxygen to be carried by the blood to all parts of the body To eliminate waste (CO2 & H2O) Maintain acid base balance through production of carbonic acid RESPIRATORY, CONT. Gas exchange Deoxygenated blood enters capillaries of lungs from pulmonary artery Oxygen in the alveoli and CO2 in the capillary bed cross over through diffusion CO2 is exhaled Oxygenated blood returns to the left atria by way of the pulmonary vein RESPIRATORY, CONT. Precautions in IV therapy Certain patients more prone to fluid overload—this will impair gas exchange Monitor lung sounds and any respiratory difficulty/effort Daily weights I & O URINARY SYSTEM  Functions ◦Regulate fluid and electrolytes ◦Waste removal ◦Regulate blood pressure  Structure ◦Kidneys  Nephron—functional unit  Glomerulus—filtering unit  Afferent arteriole—supplies blood  Efferent arteriole—drains blood—helps maintain high pressure in glomerular capillaries; smaller than afferent URINARY, CONT. Structure  Bladder  Hollow muscular sac—mucous membrane  Located behind symphysis pubis  Capacity of 700-800 mL—urge to void occurs between 250 and 400 mL (stretch receptors)  Urethra URINARY, CONT. Hormonal control of urine production  ADH  Posterior pituitary  Tells kidneys to conserve water  Aldosterone  Adrenal gland  Tells kidneys to conserve sodium, thereby conserving water URINARY, CONT. Urine  No bacteria, glucose, protein, or RBC  Protein in urine may signify damage to the glomerulus  Composed primarily of water  Electrolytes—esp. sodium and potassium  Contains waste products  Clear yellow to amber color  Contains nitrogenous wastes  Urea—main one URINARY Nursing actions with IV therapy Monitor for fluid overload I & O Edema Daily weight Characteristics of urine CIRCULATORY SYSTEM Main parts of circulatory system Pulmonary Blood flow through heart and lungs— Right heart system Systemic Blood flow throughout body excluding heart/lungs—Left heart system CIRCULATORY, CONT. Central Circulation Systemic Circulation  RA  Aorta  Tricuspid valve  Arteries  RV  Arterioles  Pulmonary artery  Capillaries  Lungs  Venules  Pulmonary vein  Veins  LA  Superior and inferior  Mitral valve vena cavas  LV  Aortic valve CIRCULATORY, CONT. Systemic veins  Superficial—usually lie in superficial fascia; in lower extremities may unite with deeper veins— this is why LE are not good sites for IVs—any embolism may extend to deeper veins— pulmonary embolism or amputation of limb  Deep—usually located within same sheath as arteries CIRCULATORY, CONT.  Anatomical differences between veins and arteries ◦Arteries need more protection so are deeper ◦Veins have valves—which can interfere with either drawing blood or cannulating a vein ◦Veins are thinner—sometimes hear/feel a “pop” as you enter the vein ◦Thinner middle layer of vein makes it more sensitive to heat or cold—cold may cause vasospasm and pain (cold IV fluids)—heat will dilate veins making larger and easier to cannulate ◦Inner layer of veins must be smooth to allow free flow of blood—careful about causing trauma—can precipitate thrombosis CIRCULATORY, CONT. Signs of arterial puncture  Pulsating backflash of blood  Rapid filling of blood into the IV tubing  IV won’t run by gravity and blood continues to back up in tubing  Pump will continue to “beep” and indicate “increased pressure”  Arterial blood is bright red  Arterial sticks produce a great deal of pain due to vasospasm and puncture of the muscle tissue CIRCULATORY, CONT. Prevention of arterial sticks Never stick a pulsating site Know location of common veins CIRCULATORY, CONT.  Peripheral vein location ◦Digital lateral/dorsal aspect of fingers ◦Metacarpal dorsal hand ◦Cephalic radial portion of FA (thumb side) ◦Basilic Ulnar aspect of FA (pinkie side) ◦Upper cephalic above the elbow ◦Median FA, just above palm ◦Antecubital bend of elbow ◦Jugular neck—never by an LPN ◦LE feet/legs—used only in pediatric—DO NOT USE ON ADULTS CIRCULATORY, CONT. Factors affecting size and condition of veins  Age  Disease and underlying medical conditions  Blood pressure  Past trauma and repeated sticks  State of hydration