Unit 2: IV Therapy

The nurse is going give a 4mg of Zofran IV. The method of giving this medication is called?

(Quiz Question)
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Which test result would the nurse anticipate when reviewing the laboratory reports of a client with end-stage renal disease? (Quiz Question)Potassium of 6.3 mEq/L.The licensed practical nurse (LPN) has been trained to initiate intravenous therapy and has received an order to start an IV on a client. The LPN recognizes that the only part of the procedure that can be safely delegated to certified nursing assistant (CNA) is: (Quiz Question)Protecting the infusion while assisting the client with basic care.After giving IV medications, how soon would the nurse go re-evaluate the effectiveness?10-15 minutes.The pharmacist brings a bag of TPN to the licensed practical nurse to be administered to a patient. What would the licensed practical nurse do first?Review PICC line policy and procedure of the facility.Before starting IV therapy on a patient, the LPN should perform which of the following? (Quiz Question)1. Review the facilities procedures for IV initiation and therapy. 2. Verify doctor's orders. 3. Verify the correct patient.The nurse has an order for a one time dose of IV steroids in choosing a PIV cannula for an older adult patient which is the appropriate cannula to use? (Quiz Question)22 gauge.What is the difference between peripheral IV and a central line?The difference is in where the tip ends up - a peripheral IV starts and stops in the same position it was inserted, to get medication or fluids directly into the bloodstream. A central line, no matter its location, goes directly to the heart. Nurses cannot insert central lines, and it wasn't until recently that LPN's can even access them (always check with the facility's policies to see if we can access them).What three pieces of assessment data do we always gather, no matter the IV?1. The type of IV present. 2. The site of the IV (including what the site looks like). 3. What is running through it.What is the major advantage and disadvantage of IV therapy?The advantage is that medications or fluids are instantly available for circulation to all the tissues. The disadvantage is that if an error is made, adverse effects will occur more rapidly.How are IV sizes measured?They are measured in gauges - the smaller the gauge number, the bigger the catheter, and the bigger the gauge number, the smaller the catheter. For example, a 16 gauge catheter is very thick and large, and a 24 gauge catheter will be very thin and small.How long do we use peripheral IV's?These can stay for roughly 3 days or 72 hours (they are usually used in short-term IV therapy for this reason - if we were to need to access a peripheral IV longer than 3 days, we'd have to change the site after this 72 hour period).How long do we use central lines?Central lines are used more permanently - they can stay up to about 9 months.What are tunneled catheters?These are thin catheters placed underneath the skin in a vein allowing long-term access (these are usually able to be kept for years). The catheter is "tunneled" under the skin, allowing tissue to grow around it, making it more stable.What is a port catheter?A port catheter is a device placed centrally and is generally located on the upper chest - they are used to give medications such as chemotherapy, antibiotics, and blood products. They avoid the need to have frequent needle sticks or temporary IV's.What is the purpose of priming tubing?To prevent air from entering the circulatory system - an air embolism (or air obstructing anything in the body), can be a very dangerous complication. It usually takes 10 mL's or more of air to cause injury to the body.Where do we never perform venipuncture, or start an IV?In an extremity where there is a hemodialysis access, a shunt, or on the side of a mastectomy or paralysis.What is the purpose of a tourniquet?It is a constricting or compressing device that is used to cause a temporary occlusion - it distends the veins, making them more prominent, and thus, easier to stick.What is phlebitis?Inflammation of a vein, usually causing irritation or redness at the vein site.What is infiltration?It occurs when fluid or medication leaks out of the vein and into the tissue, usually causing skin coolness, sometimes edema, and feelings of tightness.What do we do if infiltration occurs?We need to discontinue the infusion, remove the catheter, and re-establish another IV line at a different site.What is extravasation?Infiltration, or leakage of a fluid from a vessel into the tissue, that causes severe tissue damage, infection, disfigurement, or even loss of function due to what is being infused (these particular medications are caused vesicants, when they have the ability to extravate).What are some examples of vesicants?Zosyn and various chemotherapy drugs.What are the three "fluids" in the body?1. Intracellular fluid is the fluid inside the cell. 2. Extracellular fluid is the fluid outside of the cell. 3. Intravascular fluid is the fluid inside the blood vessels.What are isotonic solutions?They have an equal osmolality or concentration as blood. They are used to expand the body's fluid volume without causing a fluid shift or changing the electrolytes in the system. They will typically leave the cells the same size.What are hypotonic solutions?They contain less solute than other fluid (so essentially more water). They will cause fluid to shift into the cell and out of the vascular space, "swelling" the cell.What are hypertonic solutions?They contain more solute than other fluids (so essentially less water). They will cause fluid to shift out of the cell and into the vascular space, "shrinking" the cell.What are some examples of isotonic solution?Lactated ringers, 0.9% normal saline (NaCl).What are some examples of hypotonic solutions?0.45% normal saline (NaCl), water.What are some examples of hypertonic solutions?3% normal saline (NaCl), total parental nutrition (TPN), D5WWhat do we need to know about antidysrythmics in IV therapy?These medications correct irregular heartbeats, and are considered a high-risk medication that used to not be allowed to be given by LPNs through IVs. This will be a medication we refer to the facility's policy to know if we can give it or not.What is a common antidysrythmIc given via IV?Amiodarone (Pacerone)What do we need to know about labor induction medications in IV therapy?These medications are given to induce the birthing process, and are considered a high-risk mediation that used to not be allowed to be given by LPNs through IVs. This will be a medication we refer to the facility's policy to know if we can give it or not.What is a common labor induction medication we use?Oxytocin (Petocin)What do we need to know about chemotherapy medications in IV therapy?Chemotherapy medications are very dangerous due to their toxicity, and used to be a medication that wasn't allowed to be given by LPNs via IVs. This will be a medication we refer to the facility's policy to know if we can give it or not (in chemotherapy medications specifically, we usually have to be "chemotherapy certified" on top of being allowed to give it due to how dangerous these medications can be).What is an example of a chemotherapy medication we give via IV?Cyclophosphamide (Cytoxan)What do we need to know about TPN in IV therapy?TPN is otherwise known as total parenteral nutrition, and it is usually given over a 24 hour period, through a central line only. It used to be a medication LPNs couldn't give, so we need to refer to the facility's policies to know if this is a medication we are allowed to give or not.What do we need to be careful to monitor when someone is on TPN?Their electrolytes - we need to be highly alert to their labs, specifically potassium, sodium, and glucose.What are some examples of isotonic solutions?Lactated ringers, 0.9% normal saline (NaCl).