IV Fluids and Venous Access Devices

Flashcards summarizing fluid tonicities, dextrose administration, peripheral and central venous access devices, central line lumens, and dressing care instructions.

What effect does a hypotonic solution have on fluid movement and cells?

It moves water into cells and may cause swelling.

What is the osmolarity range for isotonic fluids, and where does the fluid move?

Isotonic fluids have an osmolarity of $240\text{--}340$ and move fluid into the extracellular space, which may cause circulatory overload.

Where does hypertonic fluid move, and what complication can it cause?

It moves fluid into the vascular space and may cause circulatory overload.

How many calories does $1_pct$ dextrose provide according to the lecture notes?

$1_pct = 34\text{ calories}$.

How does Dextrose 5% behave in the bag versus inside the body?

It is isotonic in the bag and hypotonic in the body.

Which dextrose concentrations are administered via regular IV versus central line?

Concentrations of 2.5, 5, and 10 are given via regular IV, while 20, 50, and 70 require a central line.

How does dextrose assist in managing dehydration and hypernatremia?

For dehydration, it gives water; for hypernatremia, it dilutes sodium.

How does aldosterone respond to hyperkalemia?

Hyperkalemia activates aldosterone, which saves $Na^+$ and excretes $K^+$.

What are the characteristics and uses of an over the needle catheter (ONC)?

It is a peripheral IV with short-term use that contains no needle (just a cannula) and is used for pain medication, antibiotics, and hydration.

What distinguishes a winged infusion from an ONC regarding device type and maximum duration?

A winged infusion uses an actual needle rather than a cannula and is intended for short-term use only ($1\text{ hr}$ at most).

What peripheral sites are listed for IV insertion, and what factors should be considered when selecting a site?

Sites include hands, forearms, and AC (short term). Factors to consider are patient condition, type of use needed, and vein condition.

What flush size is required for a PICC line, and who is qualified to insert it?

A $10\text{ cc}$ flush is used, and insertion requires a specially trained RN.

What are the primary characteristics and specific sites associated with a Tunneled Cath?

It provides long-term access (such as chemo) with a distant exit site, is inserted surgically by a physician only, and uses Hickman or Grashong sites.

What are the primary features of a Port a cath?

It allows years of use, has a lower infection risk, requires special access, and is available in single or double lumen.

What is the location and function of the proximal lumen on a central line?

It is closest to insertion and is used for medication administration and blood return.

Which central line configuration includes a medial lumen, and what are its uses?

It is present only on a triple lumen central line and is used for blood draws and medication administration.

Where does the distal lumen stop, and what is it used for?

It is furthest from insertion, stops in the Superior vena cava, and is used for TPN and continuous infusions.

What are the dressing protocol and patient positioning guidelines for central line dressing changes?

Dressings must be sterile, masked, and changed weekly; the patient must be flat, masked, and turned away.

What does the acronym CLABSI stand for?

Central line bloodstream infections.