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IV Therapy (Definitions (autologous transfusion - occurs when a patient…

- - - - 0.9% NaCl (normal saline)
        
        not for routein maintenance - temporarily expand extracellular compartment if circulatory insufficiency -- treats hypovolemia, metabolic alkalosis, mild hyponatremia, hypercalcemia -- w/ administration of blood transfusions
      - LR (lactated Ringers
        
        multiple electolyes in same concentration as plasma -- used for hypovolemia, burns, and fluid lost from GI sources
    - - 0.45% NSS (1/2 strength)
        
        provides Na, Cl, and free water as basic fluid for maintenance - - often treats hypernatremia - dilutes plasma sodium w/o dropping
      - 0.33% NaCl (1/3 strength normal saline)
        
        used to treat hypernatremia and aid kidneys in elimination of solutes
    - - 5% Dextroxe in 0.9%NaCl
        
        treats SIADH -- temporarily used for hypovolemia if plasma expander not available
      - 5% Dextrose in LR
        
        supplies fluid and calories to body -- replaces electrolytes; shifts fluid from intracellular compartments to intravascular space, expanding vascular volume
  - - - PVC (Peripheral venous catheter) - used when therapy dwells <3" in peripheral vein - not for chemo, irritants, or TPN, smallest gauge
      - Central Venous (CVAD) - long term therapy and IV, blood products, TPN
        
        catheter terminates in central venous circulation, superior vena cava above right atrium -- requires xray confirmation before use
        
        Types of CVAD
        
        Tunneled
        
        goes through body and into veins
        
        Non Tunneled Percutaneous CVC
        
        directly into jugular or subclavian vein -- more acute -- HIGH RISK FOR INFECTION/COMPLICATIONS
        
        PICC
        
        peripherally insterted central catheter -- multiple lumens for multiple meds -- STERILE
        
        6 weeks to 6 months
        
        Port (implanted ports)
        
        (in chest) - huber (curved hook) needly to insert into indented rubber postion (can't see, must feel) -- places SURGICALLY -- for chemo
  - - - INITIATE
        
        prepare client, select site, prepare site, perform venipuncture, secure device
      - MAINTAIN
        
        monitor and document, calculate and regulate flow rate, dressing changes, changing bottles and tubing, intermittent flushing of IV capped, assess for complications, discontinue IV infusion
  - - - local acute tenderness
      - warmth, redness, edema above insertion site
      - mechanical trauma from needle or chemical trauma from solution
    - - IV infusion sluggish r cease
      - heat redness, tenderness at site
    - - edema, pain, and coolness at site
      - significant decrease in flow rate
      - usually d/t dislodged needle
    - - red, tender insertion site
      - fever, malaise, other VS changes
    - - increased BP
      - distended jugular veins
      - rapid breathing, dyspnea
    - - respiratory distress
      - increased HR
      - cyanosis
      - decreased BP
      - change in LOC
    - - seen with central line