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IV Therapy & IV Med Administration questions and answers graded A+ 2024/2025
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IV Therapy & IV Med Administration questions and answers graded A+ 2024/2025
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IV Therapy & IV Med AdministrationOBJECTIVES - ANSAfter reviewing this, you should be able to:
1. Identify common IV (intravenous) solutions and abbreviations.
2. Calculate the amount of specific components in IV solutions.
3. Define the following terms associated with IV therapy: peripheral line, central line, primary
line, secondary line, saline/heparin locks, IV piggyback (IVPB), and IV push.
4. Differentiate among various devices used to administer IV solutions such as PCA
(patient-controlled anesthesia) pumps, syringe pumps, and volumetric pumps.
5. Identify best practices that prevent IV administration errors and ensure client safety
6. Identify how technology related to IV therapy can enhance client safety
Intravenous Therapy - ANS--IV therapy—fluids, blood, and blood products, nutrients, as well
as medications administered via a vein
--RAPID acting
Replacement fluids:
--Vomiting, diarrhea, nutritional imbalances, or hemorrhage
Maintenance fluids:
--Sustain normal levels of fluids and electrolytes
Provide IV medication therapy
Intravenous Therapy (NOTES) - ANSThe goal of IV fluid administration is to correct or
prevent fluid and electrolyte disturbances. IVs allow direct access to the vascular system,
permitting continuous infusion of fluids over a period of time.
To provide safe and appropriate therapy to patients who require IV fluids, you need
knowledge of the correct ordered solution, the reason the solution was ordered, the
equipment needed, the procedures required to initiate an infusion, how to regulate the
infusion rate and maintain the system, how to identify and correct problems, and how to
discontinue the infusion.
[Table 41-11 on text p. 905 presents types of IV solutions.]
An IV solution may be isotonic, hypotonic, or hypertonic.
Isotonic solutions have the same effective osmolality as body fluids. Sodium-containing
isotonic solutions such as normal saline are indicated for ECV replacement to prevent or
treat ECV deficit.
Hypotonic solutions have an effective osmolality less than body fluids, thus decreasing
osmolality by diluting body fluids and moving water into cells.
Hypertonic solutions have an effective osmolality greater than body fluids. If they are
hypertonic sodium-containing solutions, they increase osmolality rapidly and pull water out of
cells, causing them to shrivel. The decision to use a hypotonic or hypertonic solution is
based on the patient's specific fluid and electrolyte imbalance.
Additives such as potassium chloride (KCl) are common in IV solutions. A health care
provider's order is necessary if an IV is to have additives added.
,Administer KCl carefully because hyperkalemia can cause fatal cardiac dysrhythmias. Under
no circumstances should it be administered by IV push (directly through a port in IV tubing).
Verify that a patient has adequate kidney function and urine output before administering an
IV solution containing potassium. P
Intravenous Fluids (SAFETY ALERT) - ANSNurse is responsible for administering IVF to the
correct client at the right rate and monitoring response. Too rapid an infusion or inappropriate
infusions can result in reactions that range from mild to fatal!
IV Delivery Methods - ANSContinuous IV Infusions
--Replace/maintain fluids and electrolytes
--Flows continuously until changed
Intermittent IV Infusions
--Use IV piggy back (IVPB) or IV push (IVP)
--Administer medications and supplemental fluids
--Intermittent peripheral infusion devices (saline/heparin locks) maintain venous access
without the need for continuous infusion
Types of Solutions - ANS-Solutions are classified according to how they compare to the
osmolality of blood serum
---Remember that blood serum normal osmolality is 280 - 295 mOsm/kg
Classified as:
--Isotonic
--Hypotonic
--Hypertonic
(look at abbreviations sheet)
IV Orders - ANSPrescriber orders must specify:
1. Name of the IV solution
2. Name of the medication to be added (if any)
3. Amount (volume) to be administered
4. Time period during which the IV is to infuse
Isotonic Solution - ANS--Osmolality of 250 - 375mOsm/L
--Remain inside the intravascular compartments
--No fluid shifting occurs
------No net loss or gain from the ICF
--Expands only ECF
------Ideal for pts with Hypovolemia or hypotension.
--Examples:
-------0.9% saline
, --------Lactated Ringer's solution
Hypotonic Solution - ANSOsmolality lower than of 250mOsm/L
Water moves out of blood vessel into the cells and interstitial tissue
Used for:
--Patients with hypertonic dehydration
--Patients needing water replacement
Examples:
--5% dextrose (D5W)
--0.45% Saline (1/2NS)
--0.33% Saline
--0.25% Saline
Hypertonic Solutions - ANSOsmolality of 375 mOsm/L or greater
Initially raises the osmolality of ECF
Water moves from ICF & interstitial compartments into vascular space
Useful in treatment of
--Hypotonic Dehydration
--Temporary treatment of hypovolemia, hyponatremia and shock
Hypertonic Solutions require - ANSRequire frequent monitoring of BP, lung sounds, & serum
Na+ levels
Examples:
Volume expanders (Dextran, Albumin)
D10% W
D5% 1/2NS
D5%NS
D5% LR
5% Dextrose in Water (D5W) - ANS--Isotonic but physiologically hypotonic
--Provides 50 g/L of glucose or 170 cal/L
----5 grams of Dextrose per 100mL of fluid
Indications and Considerations
--Provides free water only, no electrolytes
--Moves into ICF
--Increases renal solute excretion
--Used to replace water losses, glucose, and treat hypernatremia
Normal Saline (NS, 0.9% NS) - ANS--Isotonic
--No calories, free water, or other electrolytes
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