Fluid & Electrolytes and IV Therapy Fall 2022

What is the purpose of intravenous infusion therapy?

To prevent or treat fluid or electrolyte imbalance or to deliver medications, nutrition, or blood products.

What are the two major types of solutions administered intravenously?

Crystalloid solutions and colloid solutions.

What is the nurse's role in intravenous therapy?

Initiating, monitoring, maintaining, and discontinuing intravenous therapy.

What guidelines should be followed for site selection in peripherally inserted venipuncture?

Select sites that are not over joints and to ensure they are over long bones.

What is the nursing care associated with peripheral catheters?

Care and maintenance to prevent complications like infiltration and phlebitis.

What is the purpose of parenteral nutrition?

To provide nutrition when a patient's gastrointestinal tract is not functioning.

What are potential complications of intravenous therapy?

Infiltration, phlebitis, infection, fluid overload, and air embolism.

What principles of education should be applied for patients and families regarding intravenous therapy?

Educate about the purpose, procedure, and potential complications of IV therapy.

Define osmolality.

The proportion of dissolved particles in a given weight of fluid (mOsm/kg).

What is the normal serum osmolality range?

280 to 300 mOsm/kg.

What does diffusion refer to in fluid movement?

Movement of molecules from an area of higher concentration to an area of lower concentration.

What is osmosis?

Movement of a fluid through a semipermeable membrane.

What is active transport?

Process requiring energy to move molecules across membranes from lesser to greater concentration.

What causes hydrostatic pressure?

It's the force that causes filtration of fluid from an area of higher pressure to an area of lower pressure.

What factors affect fluid and electrolyte balance?

Fluid intake, output, vomiting, diarrhea, diuretics, chronic illness, and stress.

What happens to the body's fluid balance as a person ages?

Decreases in kidney mass and glomerular filtration rate may alter fluid and electrolyte status.

What is hypovolemia?

Extracellular fluid volume deficit due to inadequate intake or abnormal losses.

What type of solutions are considered crystalloid solutions?

Isotonic, hypotonic, and hypertonic fluids.

What characterizes Total Parenteral Nutrition (TPN)?

It is hypertonic, can provide over 2000 calories/day, and is administered through a central vein.

What defines Peripheral Parenteral Nutrition (PPN)?

It is isotonic, provides less than 2000 calories/day, and is administered into a peripheral vein.

What are the nursing implications when providing parenteral nutrition?

Assess access sites for infection, maintain asepsis, and monitor for metabolic complications.

What complications are associated with intravenous therapy?

Infiltration, phlebitis, infection, fluid overload, and air embolism.

What does infiltration refer to in IV therapy?

When IV fluid leaks into the surrounding tissue.

What should you monitor for signs of fluid overload?

Dyspnea, anxiety, jugular vein distension, and weight gain.

What is the indication for using electronic infusion devices (EIDs)?

To regulate the infusion rates of fluids and medications.

What factors can affect the flow rate of IV infusions?

Height of the solution container, position of the extremity, and tubing obstruction.

What causes phlebitis in IV therapy?

Inflammation of the vein, often due to irritation from the IV solution or catheter.

What should be done if an IV catheter is found to be malfunctioning?

Discontinue IV and restart in another location.

How often should IV sites be changed?

Every 72 hours unless the site becomes compromised or as per agency policy.

What does the nurse need to monitor when managing TPN therapy?

Fluid overload and signs of infection at the catheter site.

What should the nurse assess during venipuncture?

For signs of infiltration, phlebitis, and infection at the IV site.

What is an air embolism?

An air bubble that enters the bloodstream, potentially causing serious complications.

What should be included in documentation after IV therapy discontinuation?

The condition of the site and the integrity of the catheter.

What technique reduces the risk of air embolism during catheter care?

Having the patient perform the Valsalva maneuver when changing tubing.

What is the significance of osmotic pressure in fluid balance?

It attracts water and keeps fluid within blood vessels.

What are colocater solutions?

Solutions such as blood products that increase oncotic pressure.

Explain the importance of careful site selection in IV therapy.

To decrease risk of infection and ensure better flow rates.

What types of IV catheters are available for short-term access?

Peripheral catheters and midline catheters.

What are the advantages of using a PICC line?

Lower infection rates and suitability for long-term use.

How does fluid overload manifest in patients?

By signs such as dyspnea, orthopnea, and jugular vein distension.

What is TPN used for?

When a patient cannot consume sufficient nutrients orally.

What are signs of phlebitis at an IV site?

Pain, warmth, and redness with a cord-like feeling of the vein.

What role do electrolytes play in the body?

They help maintain fluid balance and are essential for various physiological processes.

What fluid movement occurs during filtration?

Transfer of water and dissolved substances through a permeable membrane due to pressure differences.

What are indicators of effective IV therapy?

Ordered fluids infused, stable vital signs, and absence of complications.

What is the function of an EID?

To precisely control infusion rates of fluids and medications.

How should IV administration sets and tubing be managed?

Changed according to protocol (every 96 hours as appropriate) to prevent infection.

What should a nurse do first if infection is suspected at an IV site?

Discontinue the IV and assess the site for further signs.

What is the process for discontinuing an IV infusion?

Discontinue fluids, remove the IV catheter, and document findings.

How can one prevent infiltration during IV therapy?

Select an appropriate site and monitor the infusion site regularly.

What information should be included in patient education about IV therapy?

Explain monitoring requirements, potential complications, and purpose of the therapy.

What is the appropriate action if fluid overload is suspected?

Slow the IV infusion rate and notify the healthcare provider.

What should a nurse check before starting parenteral nutrition?

The integrity of the access device and the TPN solution ordered.

How does chronic illness affect fluid and electrolyte balance in older adults?

It increases the risk of fluid imbalances due to diseases like heart and renal failure.

What needs to be monitored closely in patients receiving dialysis during IV therapy?

The infusion site for signs of infiltration or phlebitis.

What is ACLS, and how does it relate to IV therapy?

Advanced Cardiac Life Support; appropriate IV access is crucial during cardiac emergencies.

What factors should be considered for patient positioning during IV therapies?

Positioning can affect flow rate and patient comfort.

Why is fluid balance crucial in patient care?

It affects overall health, hydration status, and recovery outcomes.

How is the normal saline (0.9% NaCl) classified?

As an isotonic crystalloid solution.

What is the difference between PPN and TPN in terms of calorie content?

TPN provides more than 2000 calories/day while PPN provides less than 2000 calories/day.

Explain the significance of conducting a thorough assessment before IV therapy.

To identify appropriate sites and prevent complications.

What are the common IV catheter types used for central venous access?

PICC lines, tunneled catheters, and implanted ports.

Why is it critical to monitor vital signs closely during IV therapy?

To quickly detect any adverse reactions or complications.

What complication might indicate a central catheter-related blood stream infection?

Fever, chills, malaise, and purulent drainage at the IV site.

What considerations should be taken for patients with renal failure concerning IV therapy?

Avoid excess fluid administration and monitor electrolytes closely.

What is 'third spacing' in the context of IV therapy?

Fluid shifts from the intravascular space to the interstitial space, leading to edema.

How does patient education positively impact IV therapy outcomes?

Increases patient cooperation, reduces anxiety, and improves monitoring.

What documentation is critical to maintain when performing IV therapy?

The type of infusion, rates, patient responses, and any complications.

What would indicate a successful IV placement?

Immediate blood return and no pain or discomfort at the site.

Why is a strict aseptic technique essential during IV therapy?

To reduce the risk of infection and complications related to the access device.