Exam 2

• Best catheter for rapid administration of high volumes of fluids

  Large bore, short catheter, 1 1/4" 14 g
• Best catheter for med admin (without fluids)

  18-20 gauge, 22 in pedis
• Complications of iv therapy

  infiltration, extravasation, phlebitis, thrombosis, air embolism, circulatory overload, site infection, hematoma, pulmonary edema
• Indication of iv


  Med admin, fluid /blood resuscitation
• Contraindications of iv


  Fresh cuts/burns/bruises/tattoos/etc.
• Complications of io

  Fracture, infiltration, growth plate damage, complete insertion, pulmonary embolism, infection, air embolism, thrombophlebitis, circulation overload, allergic reaction
• Indications of io


  Can't gain iv access, cardiac arrest, respiratory compromise, hemodynamic instability, bridge to central line, altered LOC
• Contraindications of io


  1. Fracture
  2. Prev ortho procedure
  3. Infection
  4. Cellulitis
  5. Prosthetic
• Iv flow troubleshooting


  Use a large vein, use short large bore catheter, use short tubing with large drip set
• Infiltration

  Non-vesicant fluid, i.e. norm saline, leaks into surrounding tissues
• Extravasation


  When vesicant fluid, ie k+ chloride, leaks into surrounding tissues
• Air embolism


  Air gets into a blood vessel
• Catheter shear embolism


  When part of the catheter travels through bloodstream and gets into lungs
• Thrombophlebitis


  inflammation of a vein associated with a clot formation
• Isotonic fluids


  Serum sodium concentration is the same as the cell
• Hypotonic fluids

  Serum sodium concentration is lower than the inside of the cell, pulls fluid in
• Hypertonic fluids


  Serum sodium concentration is higher than inside the cell, pulls fluid out
• Macrodrip admin sets


  10-15 gtts/min
• Microdrip admin sets

  60 gtts
• Prior to admin of fluids, what do you assess the bag for

  Leakage, contaminants, med and dose, expiration
• Procedure for inserting an io

  Prepare equipment, identify landmark, clean sites , insert until between black lines and when you hit bone, then drill
• Procedure for removing an io

  Attach syringe, rotate clockwise and pull
• Bariatric io needle


  45mm (3 Black lines), 15g
• Adult io needle


  25mm ( 2 Black lines), 15g
• Pediatric io needle


  15 mm (1 Black line), 15g
• EZ-IO driver has how many uses

  1000
• Ez -io battery type

  Lithium
• What can be given io?

  Anything that can be given iv
• Water % of average 70 kg male

  60%
• Water % of average female

  50%
• Water % of average infant

  80%
• intracellular fluid

  the fluid contained within cells, 2/3 of body fluid
• Extra cellular fluid


  fluid outside the cell, 1/3 of body fluid
• Intravascular fluid


  fluid within blood vessels , 1/4 of ECF, (blood plasma)
• Interstitial fluid


  fluid in the spaces between cells, 3/4 of ECF, (CSF, synovial fluid )
• Homeostasis


  Regulation of flow of solutes that maintains a cells balance
• Osmosis


  Movement of H2O, fluid moving from a lower solute to a higher one
• Diffusion


  Movement of molecules, fluid moving from a higher solute concentration to a lower one
• Active transport


  Requires ATP, moves substances against a concentration gradient, low to high
• facilitated diffusion


  requires a carrier protein, moves substances in /out of cells from high concentration to low concentration