IV Therapy, Blood Transfusions, and Fluid Management

Comprehensive vocabulary flashcards covering IV therapy principles, blood transfusion components and reactions, fluid compartments, and vascular access devices based on lecture notes.

Intravenous (IV) therapy

A treatment used to provide parenteral nutrition, transfuse blood products, provide a route for hemodynamic monitoring, diagnostic testing, and administer fluids and medications.

Vascular access device (VAD)

Medical devices including peripheral, midline, and central catheters used for providing access to the venous system.

Isotonic solutions

IV solutions that have the same osmolality as body fluids and expand only the extracellular fluid (ECF) with no net loss or gain from the intracellular fluid (ICF).

Infiltration

An IV-related complication where the infusion must be stopped and the catheter removed; treatment includes elevating the affected extremity and avoiding pressure to the area.

Phlebitis

Inflammation of the vein that can be chemical, mechanical, or bacterial; it is documented using a standardized scale and often requires VAD removal.

MARSI

Medical Adhesive-Related Skin Injury that develops under the adhesive covering the IV site dressing.

Electronic infusion devices (EIDs)

Devices that maintain correct flow rates and catheter patency while preventing an unexpected bolus of IV infusion for patient safety.

Packed RBC (PRBC)

A blood product used for replacing red blood cells; one unit (typically $250$-$350\,ml$) is expected to raise Hgb by $1\,g/dL$ and Hct by $3\%$.

Fresh Frozen Plasma (FFP)

A blood component used for bleeding caused by a deficiency in clotting factors; it must be infused within $2$ hours of thawing and over $30$-$60$ minutes.

Albumin

A colloid volume expander that does not require ABO or Rh factor matching; it is used to treat hypovolemic shock, hypoalbuminemia, and hyponatremia.

Cryoprecipitate

Blood component therapy used for Factor $8$, $13$, and fibrinogen replacement, infused at a rate of $1\,unit/min$.

Rhogam

An IM injection used to prevent Rh immunization in an Rh-negative mother when Rh+ fetal red cells enter her circulation.

Febrile non-hemolytic reaction

The most common transfusion reaction, involving a WBC antigen-antibody reaction that causes an increase in temperature by $1\,^{\circ}C$ ($2\,^{\circ}F$).

Acute hemolytic reaction

A reaction occurring within minutes of transfusion due to ABO or Rh incompatibility, characterized by fever, tachycardia, hypotension, and lumbar or flank pain.

TRALI (Transfusion Related Acute Lung Injury)

A transfusion complication presenting with fever, hypotension, acute dyspnea, and a "white-out" appearance on chest x-ray, with minimal response to diuretics.

TACO (Circulatory overload)

A transfusion-associated complication characterized by hypertension, acute dyspnea, rales, and significant improvement when treated with diuretics.

Intracellular fluid (ICF)

Fluid located inside the cells, which constitutes $2/3$ of total body fluids.

Extracellular fluid (ECF)

Body fluid located outside the cells, subdivided into interstitial (outside of cells), intravascular (plasma), and transcellular (lymph).

Osmosis

The movement of water across a semipermeable membrane from a region of low solute concentration to high solute concentration.

Second spacing

The abnormal accumulation of interstitial fluid, more commonly known as edema.

Third spacing

A condition where fluid is trapped where it is difficult or impossible for it to move back into cells or blood vessels.

Hypotonic solutions

Fluids with lower osmolality than plasma that dilute the ECF and cause water to move into the ICF; they carry a risk of causing cerebral edema.

Hypertonic solutions

Fluids with higher osmolality than plasma that draw water out of the cells and into the ECF, requiring frequent monitoring of blood pressure and lung sounds.

Central Venous Access Devices (CVADs)

Catheters placed in large veins such as the subclavian, jugular, or femoral for the administration of vesicants, parenteral nutrition, or long-term therapy.

PICC (Peripherally Inserted Central Catheter)

A central venous catheter inserted into an arm vein for long-term access ($1$ week to $6$ months); the affected arm cannot be used for blood pressure or blood draws.

Implanted Infusion Port

A long-term central venous catheter connected to a subcutaneous titanium or plastic injection port with a self-sealing silicone septum.

Push-pause technique

A flushing technique used for CVAD management using a $10\,mL$ syringe or larger to ensure catheter patency.

Interosseous (IO) Access

Emergency access into non-collapsible bone used for blood sampling, medication administration, and fluid resuscitation.