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Side A ------ Side B
Microdrip tubing ------ 60 tiny drops=1mL
Final Filter ------ Removes foreign particles, blood set has specific filter, some remove air only
Macrodrip tubing ------ 10-20 big drops= 1mL
 
Backcheck valve ------ Keeps piggyback solution from getting into primary, allows primary to restart when piggyback is finished
Hub ------ connects the administration set to the IV catheter, needleless system also called the male luer-lock
Injection ports ------ access for admin of meds, membrane covered, use 25 gauge needle for good reseal
Spike ------ tops drip chamber, sharp tip, do not touch (must stay sterile)
Flange ------ plastic guard next to spike, hold behind flange to spike
Drop orifice ------ hole opening that determines drop size, determines the drop factor (10,20, or 60 gtt/min) or micro or macro drip
Drip chamber ------ connected to tubing (clear- can see to count drops)
tubing ------ primary/standard sets 66-100" long, vented or nonvented-- Secondary 32-42" long.  Each contains clamps, ports, connectors, filters, available macro or micro
Clamps ------ compress tubing to reduce/stop flow  (roller, slide, or screw)
List two advantages of the plastic system ------ Closed system, flexible, light weight, composed of one substance, easy storage
List two disadvantages of the plastic system ------ easily punctured, fluid level difficult to determine
How do you check the plastic system and what would you be looking for? ------ Inspect outer bag with inner bag (obvious condensation, inner wet?)  Squeeze for pin holes.  Hold to light look for clarity, no color, no floaters, expiration date, label (right solution)
Does the plastic system need vented tubing or nonvented? ------ doesn't need it but can use either
 
List two advantages of the glass system ------ 1. clear  2. good visualization of fluids/contents  
3. easy to read level    4. inert, no plastics to react
List two disadvantages of glass system ------ 1. Breakage  2. bulky to store   3. hard to spike
4. disposal   5. rigid
How do you check the glass system and what are you looking for? ------ 1. Hold up to light, check for rainbows, must be clear, no floaters, no cracks, no flashes of light, expiration date
What are three contributing factors that could cause leakage in the plastic system? ------ 1. Length of storage  2. heat   3. agitation   4. blood products   5. fat emulsions   6. certain drugs
What are  "Standards of Practice" ------ that of which the average qualified healthcare provider of the same training and background would provide under the same circumstances
What are "Standards of Care" ------ describe outcomes of care, focus on patient
Risk Management ------ Process that centers on identification analysis, treatment, and evaluation of real and potential hazards
Name strategies to deal with potential hazards and reduce risk of liability ------ 1. informed consent   2. documentation  
3. unusual occurance reports  4. Professional liabilty   5. sentinel events
Informed consent ------ Without this, IV is assault and battery.  Patient must be capable of giving consent, must receive necessary information to make informed decision, must not be coerced
Coring and how do you prevent it? ------ Spiking through rubber stopper can cause rubber shreds to get into solution, (microscopic) could = emboli
Five examples of what should be reported on an Unusual Occurrence Report ------ 1.  Patient admitting diagnosis  2. Date/time incident  3. room #  4. name & age  5. type of incident
What type of tubing is needed with the glass system? ------ vented tubing or long straw
What are the two kinds of delivery systems? ------ 1. Glass system
2. Plastic system
Postcannulation ------ 11. Label
12. Dispose of equipment
13. Educate
14. Calculate rate
15. Documentation
Cannulation ------ 6. Needle selection
7. Glove up
8. Site prep
9. Vein entry
10. Stabilize cath and dress
What are the 15 steps in Phillips 15 step method?
Precannulation ------ 1.Check order
2. Wash hands
3. Prep equiptment
4. Assess patient
5. Site selection/vein dialation
What is the number one way to prevent infection? ------ wash hands
What are the recommended documenting guidelines of IV complaints/discomfort? ------ Date/time, vein specific insertion location, brand model/style of device, gauge & length, infusion solution, gravity or pump, rate of flow, patient comments & teaching
List 4 of the stategies to prevent/treat infections ------ 1. use recommended precautions
2. wash hands
3. no artificial or long nails
4. use skin antisepsis
What are 3 factors that cause infusion phlebitis? ------ 1. Irritation
2. Injury
3. Invasion of organisms
What is infusion phlebitis, include signs and symptoms ------ protective response of vein to irritation, injury, or invasion by disease producing organisms
Emporiatirics ------ study of disease in travelers
Pharmacoepidemiology ------ benefit and adverse effects to drugs
What are the three stages of antibiotic use? ------ 1. infection suspected
2. adjusted to microbial agent (ID'd)
3. Patient shows improvement
Indirect transmission ------ indirect object carries the germ
3 types:
1. Vehicle borne: water, food, tourniquet
2. Vector borne:  animal, insect
3. Airborne:  attach to dust
Portal of Entry ------ way it enters the body of host
Susceptible Host ------ person at risk for infection
Method of transmission:
Direct transmission ------ Touching it.. (Droplet within 3 feet)
What is the most common microorganism that causes IV related infections? ------ Coagulase Negative Straphylococci
Chain of Infection:
Causative agent ------ Causes infection
Reservoir ------ Place where it grows
Portal of Exit ------ Place where it passes from source to host
Colonization ------ Microorganisms replicate without signs and symptoms
Carrier ------ a colonized person--- No signs and symptoms
Dissemination ------ sheding microorganisms
Nosocomial Infection ------ Hospital aquired  (after 72 hours)
Active Immunity ------ vaccine or have the disease
Passive Immunity ------ use someone elses antibodies (maternal)
Signs/symptoms of immunosuppression ------ Frequent infections, more severe, rare infection agents, incomplete response to treatment
Nonspecific Immune Response ------ present at birth (function without antigen)
Specific Immune Response ------ acquired functions (prior to exposure)
What are the primary organs of the immune system? ------ Thymus & Bone marrow
What are the secondary organs of the immune system? ------ Lymph nodes, spleen, liver, peyer's patches, appendix, tonsils, adenoids
Epidemiology ------ Study of diseases injury and causes
 
 
Antigens ------ Invaders that trigger the immune system
 
 
List 5 procedures a qualified LPN MAY NOT PERFORM ------ 1. Initiating blood components
2. Initiating or maintaining central venous line
3. Initiating on person under 18
4. Discontinuting any other than peripheral IV
5. Administering meds via IV line
According to 4723.17 Ohio Revised Code:
List 5 procedures a qualified LPN MAY PERFORM ------ 1. Prepare an adult for IV therapy
2. Assemble and maintain equiptment for gravity drip infusion
3. Initiate infusion of IV solution as directed by authorized person
4. Maintain those solutions
5. Regulate peripheral IV
Quality Assurance ------ Policys and procedures that promote better outcomes
Quality management ------ Systemic process to ensure positive patient outcomes
List  5 physical occupational hazards and how they can be prevented ------ 1.  Needlesticks (guards)  2. Abrasion (watch sharp objects)  3. Contusion (watch sharp objects)
4. Chemical exposure (double glove)  5. latex allergy  (avoid exposure)
Communication ------ Complete data through documentation
Collaboration ------ JCAHO demands (consult with other staff)
Autonomy ------ Independant decision making
What is some common device problems related to IV's? ------ contaminated infusate, skin organisms, device contaminated prior to insertion, cath hub contaminated, hematogeous, thrombus
Elements of IV competency:
Accountability ------ Nurse must be knowledgable enough to adjust interventions for long term & short term goals
*** The 6 rights of administering medication ------ 1. Right patient   2. right medication   3. right dose
4. right route     5. right time    6. right documentatin
When should a medical device be reported to the FDA? ------ when it's faulty
Breach of Duty ------ Failure to comply with standards of care
Malpractice ------ Negligent conduct of a professional person
Liabiltiy ------ Legal responsibility
Intentional Tort ------ Assault & battery, false imprisonment, defamation, breach of confidentiality
Unintentional Tort/Negligence ------ person does not act in a resonable matter and causes harm or damage to a person or their property
Tort ------ private wrong against a person or their property by act or omission
Criminal Law ------ Offense that causes harm to society in general  (jail, fine, or both)
Civil Law ------ Affects legal rights of individuals or corporations  (more likely than not that the incident happened)
What is the INS Standard for changing administrative sets? ------ Change continuous sets every 72 hrs and when suspected of contamination.  Primary intermittent sets change every 24 hours and immediately with suspected  contamination
Common Law ------ court made law based on interpretaion of statutory law  (Roe VS Wade)
Administrative Law ------ set by appointed agencies of government basic rules applied to specific groups  (Ohio Board of Nursing)
Constitutional Law ------ Rules and principles that describe the powers of government and peoples' rights.  Addresses relationship between people and their government
Statutory/Legislative Law ------ Governs society- basic rules which are written by legislature or congress

Side A ------ Side B
Microdrip tubing ------ 60 tiny drops=1mL
Final Filter ------ Removes foreign particles, blood set has specific filter, some remove air only
Macrodrip tubing ------ 10-20 big drops= 1mL
 
Backcheck valve ------ Keeps piggyback solution from getting into primary, allows primary to restart when piggyback is finished
Hub ------ connects the administration set to the IV catheter, needleless system also called the male luer-lock
Injection ports ------ access for admin of meds, membrane covered, use 25 gauge needle for good reseal
Spike ------ tops drip chamber, sharp tip, do not touch (must stay sterile)
Flange ------ plastic guard next to spike, hold behind flange to spike
Drop orifice ------ hole opening that determines drop size, determines the drop factor (10,20, or 60 gtt/min) or micro or macro drip
Drip chamber ------ connected to tubing (clear- can see to count drops)
tubing ------ primary/standard sets 66-100" long, vented or nonvented-- Secondary 32-42" long.  Each contains clamps, ports, connectors, filters, available macro or micro
Clamps ------ compress tubing to reduce/stop flow  (roller, slide, or screw)
List two advantages of the plastic system ------ Closed system, flexible, light weight, composed of one substance, easy storage
List two disadvantages of the plastic system ------ easily punctured, fluid level difficult to determine
How do you check the plastic system and what would you be looking for? ------ Inspect outer bag with inner bag (obvious condensation, inner wet?)  Squeeze for pin holes.  Hold to light look for clarity, no color, no floaters, expiration date, label (right solution)
Does the plastic system need vented tubing or nonvented? ------ doesn't need it but can use either
 
List two advantages of the glass system ------ 1. clear  2. good visualization of fluids/contents  
3. easy to read level    4. inert, no plastics to react
List two disadvantages of glass system ------ 1. Breakage  2. bulky to store   3. hard to spike
4. disposal   5. rigid
How do you check the glass system and what are you looking for? ------ 1. Hold up to light, check for rainbows, must be clear, no floaters, no cracks, no flashes of light, expiration date
What are three contributing factors that could cause leakage in the plastic system? ------ 1. Length of storage  2. heat   3. agitation   4. blood products   5. fat emulsions   6. certain drugs
What are  "Standards of Practice" ------ that of which the average qualified healthcare provider of the same training and background would provide under the same circumstances
What are "Standards of Care" ------ describe outcomes of care, focus on patient
Risk Management ------ Process that centers on identification analysis, treatment, and evaluation of real and potential hazards
Name strategies to deal with potential hazards and reduce risk of liability ------ 1. informed consent   2. documentation  
3. unusual occurance reports  4. Professional liabilty   5. sentinel events
Informed consent ------ Without this, IV is assault and battery.  Patient must be capable of giving consent, must receive necessary information to make informed decision, must not be coerced
Coring and how do you prevent it? ------ Spiking through rubber stopper can cause rubber shreds to get into solution, (microscopic) could = emboli
Five examples of what should be reported on an Unusual Occurrence Report ------ 1.  Patient admitting diagnosis  2. Date/time incident  3. room #  4. name & age  5. type of incident
What type of tubing is needed with the glass system? ------ vented tubing or long straw
What are the two kinds of delivery systems? ------ 1. Glass system
2. Plastic system
Postcannulation ------ 11. Label
12. Dispose of equipment
13. Educate
14. Calculate rate
15. Documentation
Cannulation ------ 6. Needle selection
7. Glove up
8. Site prep
9. Vein entry
10. Stabilize cath and dress
What are the 15 steps in Phillips 15 step method?
Precannulation ------ 1.Check order
2. Wash hands
3. Prep equiptment
4. Assess patient
5. Site selection/vein dialation
What is the number one way to prevent infection? ------ wash hands
What are the recommended documenting guidelines of IV complaints/discomfort? ------ Date/time, vein specific insertion location, brand model/style of device, gauge & length, infusion solution, gravity or pump, rate of flow, patient comments & teaching
List 4 of the stategies to prevent/treat infections ------ 1. use recommended precautions
2. wash hands
3. no artificial or long nails
4. use skin antisepsis
What are 3 factors that cause infusion phlebitis? ------ 1. Irritation
2. Injury
3. Invasion of organisms
What is infusion phlebitis, include signs and symptoms ------ protective response of vein to irritation, injury, or invasion by disease producing organisms
Emporiatirics ------ study of disease in travelers
Pharmacoepidemiology ------ benefit and adverse effects to drugs
What are the three stages of antibiotic use? ------ 1. infection suspected
2. adjusted to microbial agent (ID'd)
3. Patient shows improvement
Indirect transmission ------ indirect object carries the germ
3 types:
1. Vehicle borne: water, food, tourniquet
2. Vector borne:  animal, insect
3. Airborne:  attach to dust
Portal of Entry ------ way it enters the body of host
Susceptible Host ------ person at risk for infection
Method of transmission:
Direct transmission ------ Touching it.. (Droplet within 3 feet)
What is the most common microorganism that causes IV related infections? ------ Coagulase Negative Straphylococci
Chain of Infection:
Causative agent ------ Causes infection
Reservoir ------ Place where it grows
Portal of Exit ------ Place where it passes from source to host
Colonization ------ Microorganisms replicate without signs and symptoms
Carrier ------ a colonized person--- No signs and symptoms
Dissemination ------ sheding microorganisms
Nosocomial Infection ------ Hospital aquired  (after 72 hours)
Active Immunity ------ vaccine or have the disease
Passive Immunity ------ use someone elses antibodies (maternal)
Signs/symptoms of immunosuppression ------ Frequent infections, more severe, rare infection agents, incomplete response to treatment
Nonspecific Immune Response ------ present at birth (function without antigen)
Specific Immune Response ------ acquired functions (prior to exposure)
What are the primary organs of the immune system? ------ Thymus & Bone marrow
What are the secondary organs of the immune system? ------ Lymph nodes, spleen, liver, peyer's patches, appendix, tonsils, adenoids
Epidemiology ------ Study of diseases injury and causes
 
 
Antigens ------ Invaders that trigger the immune system
 
 
List 5 procedures a qualified LPN MAY NOT PERFORM ------ 1. Initiating blood components
2. Initiating or maintaining central venous line
3. Initiating on person under 18
4. Discontinuting any other than peripheral IV
5. Administering meds via IV line
According to 4723.17 Ohio Revised Code:
List 5 procedures a qualified LPN MAY PERFORM ------ 1. Prepare an adult for IV therapy
2. Assemble and maintain equiptment for gravity drip infusion
3. Initiate infusion of IV solution as directed by authorized person
4. Maintain those solutions
5. Regulate peripheral IV
Quality Assurance ------ Policys and procedures that promote better outcomes
Quality management ------ Systemic process to ensure positive patient outcomes
List  5 physical occupational hazards and how they can be prevented ------ 1.  Needlesticks (guards)  2. Abrasion (watch sharp objects)  3. Contusion (watch sharp objects)
4. Chemical exposure (double glove)  5. latex allergy  (avoid exposure)
Communication ------ Complete data through documentation
Collaboration ------ JCAHO demands (consult with other staff)
Autonomy ------ Independant decision making
What is some common device problems related to IV's? ------ contaminated infusate, skin organisms, device contaminated prior to insertion, cath hub contaminated, hematogeous, thrombus
Elements of IV competency:
Accountability ------ Nurse must be knowledgable enough to adjust interventions for long term & short term goals
*** The 6 rights of administering medication ------ 1. Right patient   2. right medication   3. right dose
4. right route     5. right time    6. right documentatin
When should a medical device be reported to the FDA? ------ when it's faulty
Breach of Duty ------ Failure to comply with standards of care
Malpractice ------ Negligent conduct of a professional person
Liabiltiy ------ Legal responsibility
Intentional Tort ------ Assault & battery, false imprisonment, defamation, breach of confidentiality
Unintentional Tort/Negligence ------ person does not act in a resonable matter and causes harm or damage to a person or their property
Tort ------ private wrong against a person or their property by act or omission
Criminal Law ------ Offense that causes harm to society in general  (jail, fine, or both)
Civil Law ------ Affects legal rights of individuals or corporations  (more likely than not that the incident happened)
What is the INS Standard for changing administrative sets? ------ Change continuous sets every 72 hrs and when suspected of contamination.  Primary intermittent sets change every 24 hours and immediately with suspected  contamination
Common Law ------ court made law based on interpretaion of statutory law  (Roe VS Wade)
Administrative Law ------ set by appointed agencies of government basic rules applied to specific groups  (Ohio Board of Nursing)
Constitutional Law ------ Rules and principles that describe the powers of government and peoples' rights.  Addresses relationship between people and their government
Statutory/Legislative Law ------ Governs society- basic rules which are written by legislature or congress