IV Therapy Midterm Study Guide


IV Therapy Mi Dterm St
  
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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
Administrative Law
 
set by appointed agencies of government basic rules applied to specific groups (Ohio Board of Nursing)
Common Law
 
court made law based on interpretaion of statutory law (Roe VS Wade)
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)
Tort
 
private wrong against a person or their property by act or omission
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
Malpractice
 
Negligent conduct of a professional person
Liabiltiy
 
Legal responsibility
Breach of Duty
 
Failure to comply with standards of care
*** The 6 rights of administering medication
 
1. Right patient 2. right medication 3. right dose 4. right route 5. right time 6. right documentatin
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
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 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
When should a medical device be reported to the FDA?
 
when it's faulty
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
Communication
 
Complete data through documentation
Collaboration
 
JCAHO demands (consult with other staff)
Autonomy
 
Independant decision making
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)
Quality Assurance
 
Policys and procedures that promote better outcomes
Quality management
 
Systemic process to ensure positive patient outcomes
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
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
Epidemiology
 
Study of diseases injury and causes
Antigens
 
Invaders that trigger the immune system
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
Nonspecific Immune Response
 
present at birth (function without antigen)
Specific Immune Response
 
acquired functions (prior to exposure)
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
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)
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
Method of transmission: Direct transmission
 
Touching it.. (Droplet within 3 feet)
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
What are the three stages of antibiotic use?
 
1. infection suspected 2. adjusted to microbial agent (ID'd) 3. Patient shows improvement
Pharmacoepidemiology
 
benefit and adverse effects to drugs
Emporiatirics
 
study of disease in travelers
What is infusion phlebitis, include signs and symptoms
 
protective response of vein to irritation, injury, or invasion by disease producing organisms
What are 3 factors that cause infusion phlebitis?
 
1. Irritation 2. Injury 3. Invasion of organisms
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 is the number one way to prevent infection?
 
wash hands
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
Cannulation
 
6. Needle selection 7. Glove up 8. Site prep 9. Vein entry 10. Stabilize cath and dress
Postcannulation
 
11. Label 12. Dispose of equipment 13. Educate 14. Calculate rate 15. Documentation
What are the two kinds of delivery systems?
 
1. Glass system 2. Plastic system
What type of tubing is needed with the glass system?
 
vented tubing or long straw
Coring and how do you prevent it?
 
Spiking through rubber stopper can cause rubber shreds to get into solution, (microscopic) could = emboli
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
Does the plastic system need vented tubing or nonvented?
 
doesn't need it but can use either
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)
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)
Injection ports
 
access for admin of meds, membrane covered, use 25 gauge needle for good reseal
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
Final Filter
 
Removes foreign particles, blood set has specific filter, some remove air only
Macrodrip tubing
 
10-20 big drops= 1mL
Microdrip tubing
 
60 tiny drops=1mL
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

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