Care II Exam I

Failure to save

When a hospitalized patient’s condition deteriorates

Rapid response team

Respond when a patient shows signs of deterioration in an effort to recognize and reverse the problem before a cardiac arrest occurs; Physician, ER and/or ICU nurse, and respiratory therapist

Code blue

Respond to cardiac and/or respiratory arrest; Physician, ER and/or ICU nurse, respiratory therapist, nursing supervisor, IV nurse, lab technician, anesthesiologist, etc

Osmosis

Water moves back and forth across the semipermeable cell membrane to keep the total solute concentration equal on both sides

Hydrostatic pressure

Pushing force; Pushes fluid out of capillaries

Oncotic pressure

Pulling force; Pulls fluid back into capillaries

Tonicity

Describes how an IV fluid affects the movement of water between the intracellular and extracellular spaces; Water moves toward the area with the higher concentration of dissolved particles

Fluid balance

Maintained through the interaction of the kidneys, hormones, and cardiovascular system

Isotonic fluid

No fluid shift; Expands intravascular volume i.e. 0.9% normal saline

Hypotonic fluid

Fluid moves out of intravascular into intracellular space i.e. 0.45% normal saline

Hypertonic fluid

Fluid moves out of intracellular into intravascular space i.e. 3% normal saline

Peripheral IV access

Tip terminates outside of the central vasculature in a peripheral vein; Lasts 1-4 days

Peripheral IV access: Midline

Longer length than PIV catheter that’s inserted in the upper arm; Lasts 1-4 weeks

Central IV access

Inserted into the internal jugular, external jugular, subclavian, or femoral vein; Used short, intermediate, or long term depending on tunneling

PICC IV access

Inserted into the basilic, cephalic, or brachial vein; Lasts weeks to months

Interosseous IV access

Rapid vascular access through the medullary cavity of a bone (tibia and humerus); Used in emergencies or if no peripheral vascular access

Implanted port

Totally implanted central venous access device used for patients who require long-term or intermittent IV therapy; Lasts months to years

Implanted port: Reservoir

A small chamber implanted beneath the skin, commonly in the upper chest

Implanted port: Catheter

Extends from the port into a central vein, with the catheter tip typically positioned in the lower superior vena cava/cavoatrial region

Primary tubing

Connects directly to the pt’s IV access; Used for continuous IV fluids and may have one or more needleless access ports

Secondary tubing

Connects to primary tubing’s secondary port; Used for intermittent medications and placed higher than the primary bag

Extension tubing

Short tubing added between catheter and primary; Reduces manipulating catheter

Blood administration tubing

Specialized with inline filter; Only tubing approved for blood administration

Multi-lumen tubing

Multiple channels or ports; Allows multiple infusions without compatibility issues

Volumetric pump

IV fluids and medications; Delivers a programmed mL/hr

Syringe pump

Small-volume/high-alert medications; Uses a syringe for precise delivery

PCA pump

Patient-controlled analgesia; Allows prescribed patient doses

Ambulatory pump

Home/long-term therapy; Portable and battery-operated

0.9% Saline flushes

Maintain IV catheter patency and assess catheter function

Alcohol swabs

Disinfect the injection port/needleless connector and/or skin as indicated

Dressing

Transparent semipermeable dressing that allows visualization of the insertion site

Securement device

Helps stabilize the catheter and reduce movement

IV patency

Allows fluids, blood products, and medications to flow smoothly directly into the patient's bloodstream without leaking, swelling, or meeting resistance

IVP

Rapid medication delivery when immediate or relatively rapid effect is desired; Medication is injected into the IV access device using a syringe

IV Bolus

Rapid fluid replacement or administration of certain

medications; May be given through existing IV access or an IV infusion system, depending on the order

Continuous IV Infusion

Fluid/electrolyte replacement, maintenance fluids, continuous medications, or other therapies requiring controlled delivery; Fluid/medication remains connected to the IV access and infuses over an extended period

IVPB

Administration of intermittent IV medications such as

antibiotics; Secondary bag/tubing is connected to the primary IV tubing and medication is infused over the prescribed time

Saline Lock/Intermittent IV Access

Intermittent medications, IV access, or situations where continuous fluids are unnecessary; IV catheter remains in place; access is flushed according to institutional policy and medication administration requirements