NCM 112 RB .pdf

Signals of infiltration and irritation Infiltration - happens when IV fluid or medication leaks into the surrounding tissue instead of the vein. Swelling: The area around the IV site may become swollen and puffy. Discoloration: The skin around the IV site may...

Signals of infiltration and irritation Infiltration - happens when IV fluid or medication leaks into the surrounding tissue instead of the vein. Swelling: The area around the IV site may become swollen and puffy. Discoloration: The skin around the IV site may change color, becoming red, blue, or pale. Pain or discomfort: The patient may experience pain, tenderness, or discomfort around the IV site. Coolness or warmth: The skin around the IV site may feel cooler or warmer than the surrounding area. Lack of blood return: When attempting to flush the line, there may be little or no blood return. Slowed or stopped infusion: The flow of fluid or medication may slow down or stop completely. Blistering or skin breakdown: In severe cases, the skin around the IV site may blister, peel, or break down Irritation (Phlebitis) - vein inflammation, often due to IV catheter insertion. Pain or tenderness: The area around the IV site may be painful or tender. Swelling: The area may become swollen. Increased skin warmth: The skin around the IV site may feel warmer than the surrounding area. Itching: The patient may experience itching around the IV site. Skin discoloration: The skin may change color, becoming red or darker. Changes in skin texture: The skin around the IV site may thicken or harden Fluid volume overload - also known as hypervolemia, occurs when there is too much fluid in the body. This condition can lead to symptoms such as swelling (especially in the arms and legs), high blood pressure, shortness of breath, and rapid weight gain. Causes of hypervolemia: Heart or kidney conditions: can impair the body’s ability to regulate fluid balance. Excessive sodium intake: Too much salt in the diet can cause the body to retain fluid. Hormonal changes: Certain hormonal imbalances can lead to fluid retention. Pregnancy: Fluid retention is common during pregnancy Treatment typically involves: Reducing fluid and sodium intake: This helps to decrease the amount of fluid in the body. Medications: Diuretics can help the body expel excess fluid. Dialysis: In severe cases, dialysis may be necessary to remove excess fluid from the body IVT - delivers fluids, medications, or nutrients directly into a person’s vein. It’s commonly used in hospitals for hydration, administering drugs, and other treatments. Blood Transfusion - involves transferring blood or blood components directly into a patient’s bloodstream. This procedure is used to replace lost blood during surgery, injury, or illness, and to treat various medical conditions such as anemia, clotting disorders, and certain cancers. Blood Transfusion (BT) in IV Therapy: Purpose: To restore blood volume, improve oxygen-carrying capacity, and correct clotting deficiencies. Components: Can involve whole blood or specific components like red blood cells, platelets, plasma, or cryoprecipitate. Procedure: Requires compatibility testing to match donor and recipient blood types to prevent adverse reactions. Indications: Used in cases of severe blood loss, anemia, surgical procedures, and certain medical conditions. Medication via bolus Bolus - involves delivering a concentrated dose of medication directly into the bloodstream over a short period, typically within seconds to a few minutes. This method is often used in emergencies where immediate drug effects are needed. Key points about bolus administration: Rapid Delivery: Medication is quickly administered, providing immediate therapeutic effects. Common Uses: Often used for painkillers, antibiotics, electrolyte replacements, and emergency medications like epinephrine. Routes: While intravenous (IV) is the most common, bolus injections can also be administered intramuscularly, subcutaneously, or intradermally. When to change IV catheter - IV catheters are typically replaced every 72 to 96 hours to minimize the risk of complications such as infection, occlusion, and phlebitis. However, they should be replaced sooner if there are signs of infection or malfunction, or if they are no longer needed. Sample of isotonic, hypertonic, and hypotonic Isotonic Solutions Normal Saline (0.9% NaCl): This solution has the same concentration of solutes as blood plasma, making it ideal for maintaining fluid balance without causing cells to shrink or swell. Lactated Ringer’s Solution: Often used for fluid resuscitation, it contains electrolytes in concentrations similar to those found in blood. Hypertonic Solutions 3% Saline: This solution has a higher concentration of solutes compared to blood plasma, causing water to move out of cells, which can be useful in treating hyponatremia (low sodium levels). Dextrose 10% in Water (D10W): Used in situations where a higher concentration of glucose is needed, it draws water out of cells into the extracellular space. Hypotonic Solutions 0.45% Saline (Half Normal Saline): This solution has a lower concentration of solutes than blood plasma, causing water to move into cells, which can help in rehydrating cells. Dextrose 5% in Water (D5W): Initially isotonic, but becomes hypotonic once the dextrose is metabolized, allowing water to enter cells. Blood type and Rh-positive ABO System Type A: Has A antigens on the surface of red blood cells and B antibodies in the plasma. Type B: Has B antigens on the surface of red blood cells and A antibodies in the plasma. Type AB: Has both A and B antigens on the surface of red blood cells and no A or B antibodies in the plasma. This type is known as the universal recipient. Type O: Has no A or B antigens on the surface of red blood cells but has both A and B antibodies in the plasma. This type is known as the universal donor. Rh System Rh-positive (Rh+): Has the Rh antigen on the surface of red blood cells. Rh-negative (Rh-): Does not have the Rh antigen on the surface of red blood cells. Combining these two systems, there are eight possible blood types: A+, A-, B+, B-, AB+, AB-, O+, and O-. Signs and symptoms of drug transfusion; Common Symptoms Fever and Chills: A sudden rise in body temperature and shivering. Itching and Hives: Skin reactions such as itching, rash, or hives. Shortness of Breath: Difficulty breathing or respiratory distress. Back Pain: Pain in the lower back or flank area. Dark Urine: Urine that appears darker than usual, indicating hemolysis (breakdown of red blood cells). Severe Symptoms Anaphylactic Reaction: Severe allergic reaction causing difficulty breathing, swelling, and low blood pressure. Hemolytic Reaction: Destruction of red blood cells leading to symptoms like fever, chills, back pain, and dark urine. Hypotension: A significant drop in blood pressure.  Respiratory Distress: Severe difficulty in breathing, which may require immediate medical attention. Signs and symptoms of phlebitis; Phlebitis is the inflammation of a vein, often in the legs, but it can occur in other parts of the body as well. Here are the common signs and symptoms: Superficial Phlebitis Redness: The skin over the affected vein may appear red. Swelling: The area around the vein may be swollen. Warmth: The skin over the inflamed vein often feels warm to the touch. Tenderness: The affected area can be tender or painful. Visible Vein: The vein may appear as a red, hard cord under the skin. Itching: The skin around the inflamed vein may be itchy. Deep Vein Phlebitis (Deep Vein Thrombophlebitis) Pain: There may be pain in the affected limb, often in the calf or thigh. Swelling: The entire limb may swell. Warmth: The limb may feel warm. Skin Discoloration: The skin over the affected area may change color. Fever: A low-grade fever may be present. Complications Pulmonary Embolism: A blood clot can break off and travel to the lungs, causing a potentially life-threatening condition. Infection: The inflamed area can become infected, leading to more severe symptoms like high fever and increased pain. Antibiotics - medications used to treat bacterial infections by either killing the bacteria or inhibiting their growth. They are crucial in modern medicine for treating a wide range of infections. Types of Antibiotics 1. Penicillins: Used for infections like strep throat, skin infections, and ear infections. 2. Cephalosporins: Treat more serious infections such as meningitis. 3. Aminoglycosides: Typically used in hospitals for severe infections. 4. Tetracyclines: Commonly prescribed for acne and respiratory infections. 5. Macrolides: Often used as an alternative to penicillin for lung and chest infections. 6. Fluoroquinolones: Broad-spectrum antibiotics used for various infections. Common Examples Amoxicillin Azithromycin Ciprofloxacin Doxycycline Penicillin How They Work - by targeting specific features of bacterial cells, such as cell walls or protein synthesis mechanisms, which are not present in human cells. This allows them to kill bacteria or stop their growth without harming human cells. When to Use Antibiotics Bacterial Infections: Such as strep throat, urinary tract infections, and bacterial pneumonia. Not for Viral Infections: Antibiotics are ineffective against viruses like the common cold, flu, or COVID-19. Side Effects Common: Nausea, diarrhea, and allergic reactions. Serious: Antibiotic resistance, which occurs when bacteria evolve to resist the effects of antibiotics, making infections harder to treat. Important Considerations Complete the Course: Always finish the prescribed course of antibiotics, even if you feel better, to ensure all bacteria are eliminated. Avoid Overuse: Using antibiotics when not needed can contribute to antibiotic resistance.