Foundations of Nursing – IV Therapy, Transfusions, Nutrition & Electrolytes

Vocabulary flashcards covering IV therapy best practices, transfusion reactions, infiltration management, nutrition calculations, macronutrient values, DRI guidelines, major vitamins and minerals, electrolyte imbalances, ABG interpretation, and related nursing interventions.

Dialysis Shunt Arm Precaution

Never attempt venipuncture or start an IV in the arm that contains a dialysis (AV) shunt or fistula.

Palpating a Vein

Use gentle pressure to feel for a soft, bouncy resistance, indicating a suitable vein for cannulation.

Tourniquet Time Limit

Remove the tourniquet within 1 minute (30–60 s) of application to prevent venous congestion and vein injury.

Distal Site Selection

Begin IV insertion in the most distal portion of the nondominant arm to preserve proximal sites for future use.

Infiltration (IV)

Leakage of IV fluid into surrounding tissue characterized by pale, cool, edematous skin and a sluggish flow rate; requires discontinuing the IV.

Phlebitis

Inflammation of the vein, typically presenting with warmth, redness, pain, and a palpable cord along the vein.

First Action for Blood Transfusion Reaction

Stop the transfusion immediately and keep the vein open with normal saline to maintain IV access.

Transfusion Reaction Signs

Fever, chills, nausea, itching, wheezing, flank pain, or a feeling of "not feeling right" during transfusion.

Intermittent Saline Lock – Flush Resistance

Assess for kinks or a clamped line first; do not force flush if resistance is met.

Heparin Lock Flush Solution

Low-dose (10–100 units/mL) heparinized saline used to maintain patency of certain central lines when ordered.

Enteral Feeding Order Example

30 mL/hr for 3 hr delivers 90 mL of formula before the next residual check.

Kilocalories per Gram – Carbohydrate

4 kcal per gram of carbohydrate.

Kilocalories per Gram – Protein

4 kcal per gram of protein.

Kilocalories per Gram – Fat

9 kcal per gram of fat.

Dietary Reference Intake (DRI) – Protein

0.8 g of protein per kilogram of body weight per day for healthy adults.

Body Mass Index (BMI) Formula

BMI = weight (kg) ÷ height (m²); assesses underweight, normal, overweight, and obesity categories.

Fluid Restriction Formula (Renal)

Daily allowance = 750 mL plus the previous 24-hour urine output.

Scheduled NG Water Flushes

100 mL every 6 hours equals 400 mL of water over 24 hours.

Six Classes of Nutrients

Carbohydrates, proteins, fats (lipids), vitamins, minerals, and water.

Vitamin A Source

Carrots, sweet potatoes, spinach, fortified dairy products.

Vitamin A Function

Maintains vision, healthy skin, and epithelial tissues; supports immune function.

Vitamin A Deficiency

Night blindness, dry eyes (xerophthalmia), impaired immunity.

Vitamin A Toxicity

Liver damage, headache, bone pain, teratogenic effects in pregnancy.

Vitamin D Source

Fortified milk, fatty fish, egg yolks, synthesis via sunlight on skin.

Vitamin D Function

Promotes calcium and phosphorus absorption; supports bone mineralization.

Vitamin D Deficiency

Rickets in children, osteomalacia in adults, bone pain, muscle weakness.

Vitamin D Toxicity

Hypercalcemia, kidney stones, vascular calcification.

Vitamin K Source

Green leafy vegetables (e.g., kale, spinach), synthesis by gut bacteria.

Vitamin K Function

Essential for synthesis of clotting factors II, VII, IX, and X.

Vitamin K Deficiency

Prolonged bleeding, increased prothrombin time (PT/INR).

Calcium – Major Functions

Bone and teeth formation, muscle contraction, nerve transmission, blood clotting.

Hypocalcemia Signs

Tetany, positive Chvostek/Trousseau signs, numbness, seizures.

Potassium – Major Functions

Maintains intracellular osmolarity, nerve impulse conduction, cardiac rhythm, muscle contraction.

Hypokalemia Clinical Significance

Serum K⁺ < 3.5 mEq/L; can cause muscle weakness, dysrhythmias, ileus, and requires replacement.

Hyperkalemia Clinical Significance

Serum K⁺ > 5.0 mEq/L; risk for life-threatening cardiac arrhythmias, especially in CKD.

Sodium – Major Functions

Extracellular fluid balance, acid-base regulation, nerve impulses, muscle contraction.

Hyponatremia Level & Risk

Serum Na⁺ < 135 mEq/L; can lead to cerebral edema, confusion, seizures.

Intake Measured in I&O

Oral fluids, IV fluids, tube feedings, and medications in solution.

Output Measured in I&O

Urine, vomitus, diarrhea, wound/NG drainages, and ileostomy effluent.

Respiratory Acidosis (ABG)

pH < 7.35 with PaCO₂ > 45 mm Hg; indicates hypoventilation such as in pneumonia.

Hypoxemia

PaO₂ < 80 mm Hg or O₂ saturation < 95 %; causes dyspnea, restlessness, cyanosis.

Treatment for Respiratory Acidosis with Hypoxemia

Administer oxygen, promote airway clearance, possibly bronchodilators or antibiotics, and support ventilation.

Kayexalate (Sodium Polystyrene Sulfonate)

Cation-exchange resin given orally or rectally to remove excess potassium from the body.

Insulin–Glucose Protocol (Hyperkalemia)

IV regular insulin with dextrose drives potassium into cells, temporarily lowering serum K⁺.