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)
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
Negligent conduct of a professional person
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:
Nurse must be knowledgable enough to adjust interventions for long term & short term goals
Complete data through documentation
JCAHO demands (consult with other staff)
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

Study of diseases injury and causes

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

Microorganisms replicate without signs and symptoms
a colonized person--- No signs and symptoms
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
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
benefit and adverse effects to drugs
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?

1.Check order
2. Wash hands
3. Prep equiptment
4. Assess patient
5. Site selection/vein dialation

6. Needle selection
7. Glove up
8. Site prep
9. Vein entry
10. Stabilize cath and dress

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)
tops drip chamber, sharp tip, do not touch (must stay sterile)
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)
primary/standard sets 66-100" long, vented or nonvented-- Secondary 32-42" long. Each contains clamps, ports, connectors, filters, available macro or micro
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
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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