Nursing Care of Patients Receiving IV Therapy

Vocabulary flashcards covering IV therapy indications, solution osmolarity, device types, flow rate calculations, local and systemic complications, and parenteral nutrition care.

IV Therapy

Administration of fluids or medication via a needle or catheter (cannula) directly into the bloodstream.

Indications for IV Therapy

Hydration, electrolyte replacement, parenteral nutrition (PN) including peripheral PN (PPN), medication administration, and blood product transfusions.

Types of IV Infusions

Continuous, intermittent (such as piggyback), direct injection/IV push, and patient-controlled analgesia (PCA).

Piggyback Infusion System

An intermittent IV infusion delivery system featuring a primary infusion container and a secondary piggyback container connected above a check valve.

Electronic Infusion Devices (EIDs)

Powered infusion pumps used to precisely regulate the delivery rate and volume of intravenous solutions and medications.

Gravity Drip

A method of IV fluid administration where flow rate is driven by gravity and adjusted manually with a clamp.

Factors Affecting IV Flow

Change in cannula position, height of solution, patency of cannula, vein condition, and kinks in the cannula or tubing.

Types of IV Fluids

Dextrose solutions, sodium chloride solutions, combined dextrose and sodium chloride solutions, Ringer's and lactated Ringer's solutions, and balanced electrolyte solutions.

IV Flow Rate Formula

$$\text{Drip Rate (gtt/min)} = \frac{\text{Volume (mL)}}{\text{Time (hours)}} \times \frac{1\,\text{hour}}{60\,\text{minutes}} \times \text{Drop Factor (gtt/mL)}$$

Isotonic IV Solution

An IV fluid with an osmolarity of $250$ to $375\,\text{milliosmoles per liter}$, such as $0.9\%$ sodium chloride.

Hypotonic IV Solution

An IV fluid with an osmolarity lower than $250\,\text{milliosmoles per liter}$, such as $0.45\%$ sodium chloride.

Hypertonic IV Solution

An IV fluid with an osmolarity of $375\,\text{milliosmoles per liter}$ or higher, such as dextrose $5\%$ in $0.9\%$ sodium chloride.

Peripheral Venous Access Sites (Hand)

Veins on the back of the hand suitable for peripheral IV insertion, including digital veins, metacarpal veins, dorsal venous arch, basilic vein, and cephalic vein.

Peripheral Venous Access Sites (Arm)

Veins of the forearm and arm used for peripheral IV access, including the cephalic vein, accessory cephalic vein, median cubital vein, basilic vein, and median antebrachial vein.

Peripheral IV with Needleless Connector

A short peripheral venous catheter secured to the patient's arm and connected to a extension tubing with a needleless connector port.

Nursing Diagnoses for IV Therapy

Risk for Fluid Volume Excess, Impaired Physical Mobility, Risk for Infection, and Fear.

Signs of Fluid Overload in Older Adults

Elevated blood pressure, increasing weight, bounding pulse, shallow rapid respirations, jugular venous distention, increased urine output, and crackles.

Local IV Complications

Hematoma, thrombosis, phlebitis/thrombophlebitis, infiltration/extravasation, local infection, venous spasm, and nerve injury.

Systemic IV Complications

Septicemia, circulatory overload, venous air embolism, and speed shock.

Central Venous Access Devices (CVADs)

Catheters placed into central veins; types include non-tunneled central catheter, tunneled catheter, peripherally inserted central catheter (PICC), and implanted vascular port (e.g., Mediport).

CVAD Anatomical Placements

Catheter insertion routes and placements for central lines, including subclavian non-tunneled catheters, arm-inserted PICC lines, and tunneled catheters with Dacron cuffs terminating in the superior vena cava.

Indications for CVAD Use

Administration of parenteral nutrition, chemotherapy, and long-term intravenous treatment.

Parenteral Nutrition Contents

Carbohydrates (dextrose is most common in PN), proteins/amino acids, electrolytes, trace elements, vitamins, and lipids (which may be administered as a separate solution).

Rationale for Parenteral Nutrition

Indicated for patients unable to eat or tolerate tube feedings to promote wound healing, achieve optimal weight before surgery, avoid malnutrition from chronic disease, and treat cancer cachexia (wasting syndrome).

Nursing Care for Parenteral Nutrition

Initial and ongoing assessments including monitoring blood glucose, tracking daily weights, monitoring signs and symptoms of infection, and initiating the infusion slowly.