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IV Therapy Quiz 1

Hondros 4th Lpn Term
nursing process related to infusion therapy
ADPIE, assessment, diagnosis, planning, implemenatation, evaluation
sources of law related to infusion therapy
constitutional, statutory, administrative, common law
threatening a pt
actually smacking the dude
failing to do something a reasonable person would do
form of negligence in which a professional fails to do adhere to a practice within their profession
4 components of malpractice
-must be established that the nurse had a duty to the pt
-breach of standard of care or failure to carry out duty must be proven
-pt must suffer actual harm or injury
-must be a casual relationship between the breach of care and the injury
standards of care
focuses on the recipient of care
standards of nursing practice
focuses on the provider
6 rights
-right pt
-right dose
-right time
-right route
-right documentation
code of ethics based on
quality pt management
systematic process to ensure desired pt outcome
sentinel event
unanticipated event that causes the death, serious physical or psychological injury to a person; not related to a pts actual course of illness
average daily I&O of water (adult)
average output of water (adult)
output fluids
urine, diarrhea, vomit, nasogastric suction, chest tube drainage, surgical wound drainage. If it leaks something, measure it!
125mL hour or 180L per day
movement of particles in all directions thru solution or gas.
-movement higher to lower concentration
movement of WATER from an area of lwer concentration to high concentration
hypertonic solutions
pulls fluids from cells, makes them shrink. Think cold water to a penis
isotonic solutions
same osmotic pressure. Doesn't cause any kind of fluid shift
hypotonic solutions
low osmotic pressure. Fluids move in cells causing them to enlarge and swell
transfer of water and solutions from high to low pressure
positive charge ions
negative charged ions
positive should equal negative
anion electrolytes
cation electrolytes
-most abundant electrolyte
-norm 135-145mEq/L
functions of sodium
regs water balance, controls extracellular fluid volume, stimulates nerve impulses, control contractility of muscles
factors that cause sodium imbalance
-deficit caused by excessive vomiting
-change in chloride content (remember, chloride ALWAYS goes with sodium)
-change in quantity of water in extracellular fluid (ECF)
-can occur with water excess
-body attempts to compensate by decreasing water excretion
-pt likely to have potassium imbalance because of fluid moving in cells, pushing potassium out of cells
hyponatremia S/S
-muscle weakness
-muscle twitching
-decreased skin turgor
-headache, tremor, seizures, coma
hyponatremia tx
-replace sodium/fluid loss
-restore norm ECF volumes
-correct other electrolyte imbalances (potassium and bicarb)
-occurs with water loss
-body attempts to correct by conserving water thru renal absorption
-causes fluid to shift from cells into interstitial spaces causing cellular dehydration (uh oh)
hypernatremia S/S
-elevated body temp
-swollen tongue, flushed skinpo
-red, dry and sticky mucous membranes
-disorientation, irritability, hyperactivity
hypernatremia tx
-infuse hypotonic solution (0.9 NS)
-use of diurectics, inducing excretion of water and sodium
-norm 3.5-5.0 mEq/L
-kidneys control excretion of potassium
-main function is to regulate water and electrolyte content within cells
-no effective stroage for K+, must be ingested daily
functions of K+
-effects skeletal and cardiac muscles
-can cause myocardial irritability and rhythm
-respnsible for nerve pulse transmission
-major cause is loss thru renal secretion
-can be depleted thru GI losses, vomiting and use of diuretics
-can effect cardiac and skeletal function
hypokalemia tx
-increase of K+ supplements
-IV K+ treatment
-NEVER give K+ IV push (that is what lethal injection is)
hypokalemia S/S
-decreased GI, skeletal muscle, cardiac function
-decreased reflexes
-rapid, weak, irregular pulse
-low bp
-decreased BM
-muscle weakness or irritability
-major cause is renal disease
-can cause cardiac arrest
hyperkalemia S/S
-EKG changes
-muscle weakness
-flaccid paralysis
-anxiety, nausea, cramping, diarrhea
hyperkalemia tx
-restrict diet, d/c K+ supplements
-admin calcium gluconate
-IV sodium bicarb (causes shift of K+ into cells)
-admin regular insulin and hypertonic solution
-peritoneal dialysis or hemodialysis
-norm 9-11 mEq/L
-99% is in bones and teeth
-best sources are thru milk and cheese, and calcium cheeseburgers with lots of mayo and onions, Maybe a little bar b q sauce too
-caused by excessive loss thru diarrhea, inadeqate dietary intake, surgical removal of parathyroid function, pancreatic or small bowel disease
hypocalcemia tx
-must treat underlying cause
-calcium gluconate and calcium supplements
hypocalcemia S/S
-muscle cramps
-numbness or tingling of fingers
-tonic-clonic seizures
-Chvosteks sign
-Trousseaus sign
Chvostek's Sign
contraction of facial muscles in response to light tap over facial nerve in front of ear. Or you can just punch them in the face and if they look mad then they're normal. If they looked shocked then they're hypocalcemic
Trousseau's Sign
carpal spasm induced by inflating a bp cuff above systolic pressure for a few minutes
-occurs when calcium in bones begins to circulate with blood; occur with immobilization
hypercalcemia causes
-Paget's disease
-multiple fractures
-over use of calcium containing antacids
hypercalcemia tx
-treat underlying cause
-organic phosphate salts
-hemodialysis or peritoneal dialysis
-Lasix to prevent fluid overload
-Calcitonin to lower serum levels
-Plicamycin to stop bone reabsorption
Hypercalcemia S/S
-muscle flaccidity
-constipation hypertension
isotonic solutions examples
normal saline (NS), D5W, WD40, lactaded ringers (wish I knew what a lactated ringer was)
longitudinal burrows
lines on the tongue
hypovolemia S/S
low bp, high HR, high HNH
hypervolemia S/S
-HTN, bounding pulse, tachycardia, edema, crackels