Pharm kaplan

pharm + blood transfusions

rights of med admin

right client two identifiers - right med - right time - right dosage - right route - right documentation

Peripheral IVs

• short term therapy cant be on infected site

• graft/fistula - area of flexion - hands on older adults

CVADs

in superior vena cava, subclavian vein, or jugular vein

CVCs, PICCs, Implanted ports

• long term therapy - 3 types - invasive risk of systemic infection - can admin blood, blood products, vesicants, parenteral nutrition

Centrally inserted catheters

• SVC - multi-lumen - tunneled - not tunneled - not tunneled is best for short term - tunneled is long term and no dressing needed when healed so perfect for home maintenance

Peripherally inserted catheters

• insert in arm basillic vein, - multi lumen - 1 wk - 6 months - No BPs - blood draws from the sight - done at the bedside - increased risk DVT and pheblitis

Implanted infusion port

• surgically implanted in upper arm/chest low infection risk - for long term therapy - special needle used to access - catheter occlusion, PE, infection, pneumothorax - catheter migration are complications

NC implanted infusion port

• flush caths - change caps frequently - confirm placement with x-ray - sterile dressing changes - chlorihexidine based - push - pause technique with >= 10 mL

Infiltration

non-vesicant/irritating med unintentionally in surrounding tissues

• s/s swelling burning tightness - leaking of fluid in sit - treat: remove device elevate extremity, apply warm moist heat, check circulation distal to site

Extravasation

• Vesicant in surrounding spaces - can lead to tissue necrosis + severe pain

Phlebitis

• inflammation of the vein - pain - tenderness - warmth - erythema - swelling