Lab quiz #1

• Goals of IV therapy include:

  1. Maintain fluid and electrolyte balance
  2. administer medication
  3. replace fluid and blood losses
  4. pain management
  5. parenteral nutrition
  6. hemodynamic monitoring
• Peripheral IV: goes to peripheral(arms, legs)
• Scalp in neonates: best place as veins are biggest(can be traumatic for parents so warn them)
• PICC Line: long term, but can’t stay in forever
• Implanted infusion port: indefinitely
• Central venous catheter: ICU, cancer patients
• Running blood cells: 20 gage or bigger, running it fast can cause damage to the cells
• Peripheral IV sites: usually at least every hour monitor

  1. phlebitis
  2. inflateation
  3. discharge
  4. moisture
• Ensure patent by completing IV site flush prior to each use or at least once a shift
• Pull back on flush to check for blood return: if no blood return put a little more in and assess for infaltration
• Lock saline lock while moving fluid(last 0.5mL)
• watch for signs of complications- swelling, pain, redness, warmth/cold
• Hypotonic: A solution with a lower solute concentration than the cell. fluid shifts from bloodstream into surrounding tissue
• Isotonic: fluid should not shift. Equivalent osmolarity to blood
• Hypertonic: higher osmolarity than blood. Fluid shifts from surrounding tissue into bloodstream
• fluid overload: edema

  • usually on feet
  • always check bilaterally

  wet/crackle lungs

  increases ruin output
• Bolus: large volume, short amount of time
• Continuous: small volume, long amount of time, mL/hr
• IV label closets to patient
• Change I’ve bag after 24 hours even if you don’t go through a whole bag
• Change lines ever 72 hours
• Change IV after 3 days
• syringe pump- acting as a secondary bag- mix in syringe rather than mini bag

  • connect tubing closest to patient
• BUBBLEHE-

  B(breast)

  U(uterus)

  B(bladder)

  B(Bowels)

  L(lochia)

  E(episiotomy)
• Breast- colour/symmetry, are they intact?, blister, bleeding
• Nipples should not be inverted
• Breast should be soft 24-48 hours after birth—> milk hasn’t come in yet
• Colostrum: Yellowish fluid that is secreted by the mammary glands of the mother
• Baby’s stomach is very small, does not need much/the colostrum has a lot of nutrients just not the volume
• colostrum- the orange juice concentrate

  breast milk- the diluent
• More bottom aveola should be on babies mouth
• Sucking reflex is on the roof of their mouth at the back
• 4 A’s of breast feeding

  • audible swallow
  • areolar grasp
  • areolar compression
  • alignmeny
• Alignment( ears, shoulders, hips in straight line)
• Cross cradle: what we want to see. hold baby in arm of breast feeding, support behind the head, by ears, used other hand to hold breast up
• Cradle hold: out in natural environment

  • hold baby in the same arm you are breastfeeding from, moms confidently breastfeeding, no control of baby’s head
• Milk comes in quicker in vaginal births than c-section
• If mom has sore:

  lanolin cream—> not to moms with wool allergy

  colostrum onto nippled—> lots of WBC and healing properties
• Fund us= top of uterus
• Fund us- should feel firm