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Iv certification class review for test
Steps after transfusion reaction step 1 - Turn off blood Steps after transfusion reaction step 2 - Hang normal saline Steps after transfusion reaction step 3 - Take vitals Steps after transfusion reaction step 4 - Call attending Steps after transfusion reaction step 5 - Position patient Steps after transfusion reaction step 6 - Call blood bank Steps after transfusion reaction step 7 - Send blood and tubing to lab Steps after transfusion reaction step 8 - Urine test Steps after transfusion reaction step 9 - Input and Output Steps after transfusion reaction step 10 - Meds as ordered Steps after transfusion reaction step 11 - Documentation ABO blood groups - Every unit crossmatched is remove from the general inventory and reserve for the patient for 72 hrs. A full crossmatched procedure takes hoe long to complete and cannot be shortened - 45 min
What are frigerated until use? - Units A how much blood must be properly labeled and must be checked before use - 1 unit of blood Blood compatibility Anitbodies: B Antigens: A - Group A Blood compatibility Anitbodies: A Antigens: B - GROUP B Blood compatibility Anitbodies: none Antigens: AB - Group AB Blood compatibility Anitbodies: AB Antigens: none - Group O Antigen - A substance that can initiate an immune response and induce the formation of corresponding antibody. The established major antigens found in blood are inherited such as those in the ABO system in exogenous sources IE blood transfusions Antibody - Immunoglobulin molecule produced in response to a specific antigen Euythocytes - RBC Leukocytes - WBC Platelets - Cell fragments for clotting Blood physiology - Supplies O2, transports cellular waste, defense against infections, regulates body temperature, acid base balence
What can the lvn do when directed by a physical and surgeon? - Administer medication by hypodermic injection, approved by board school and in structed by the doctor after demonstrating competency withdraw blood from a patient,( board pass or competency.) Lvn may start or superimpose iv fluid only if all of the following occured: - 1. completed a course approved by the board/state,
- The procedure is performed in an organized health care system and according to said systems procedure guidelines Unable to see vien through skin - Blind stick % of water ADULT MALE - 60-70% % of water ADULT FEMALE - 54-60% % of water NEWBORN - 70-80% %of water Elderly - 50% What % of water loss is considered moderate - 5% What % of fluid loss is considered serious? - 10% What % of fluid loss is considered fatal? - 20% What are our 2 body regulation systems - Kidneys: main monitor of fluid balance Heart: amount of blood it pumps Fluid balance - Concept of human homeostasis in that the amount of fluid lost from the body is equal to the amount of fluid taken in Euvolemia - Is the state of normal body fluid volume
What is the difference between water loss insensible and sensible - Insensible: water loss that we are unaware of Sensible: person is aware ( wound draining, voiding) What are the three types of fluid loss - Hypotonic or hyponatrimic: loss of electrolytes Hypertonic: loss of water ( abundance of electrolytes) Isotonic (equal loss of water and electrolyte When pH levels are out of range what happens? - Proteins are denatured, enzymes don't function, death my occur Normal range (7.35-7.45) What are electrolytes? - Are substances that become ions in solution and acquire the capacity to conduct electricity. Positive ions: cations Neg ions: anions. NA+ - Sodium ion CL- - Chloride ion Mg2+ - Magnesium ion CA2+ - Calcium ion K+ - Potassium Ion Where is the positive ions (cation) found in for potassium? - Inside the cells What is the primary function of potassium? - Regulate heart beat and the function of muscles (Normal: 3.5-5meq/l) Increased level of potassium - Hyperkalemia What causes hyperkalemia - Caused by kidney failure or decreased in kidney function may need dialysis
Periatic and geriatric population often use fluid control delivery systems such as buretrol. True or false - True During blood withdrawal, it is permitted to move the Vacutainer and needle while changing blood collection tubes to her false? - False when performing venipuncture the bevel should be pointed down. true or false? - False piggyback or secondary bags should be hung lower than the primary bags. true or false - False IV pumps are generally silent when they detect air bubbles in the tubing. true or false? - False drip factor (gtt/min) of IV tubing is found on the manufacturers' package. true or false? - True one of the reason for central line placement is surgery for simple appendectomy. true or false? - False currently what is the percentage Is estimated to have IV therapy during their hospital stay? - 80% it is becoming more common to find patients with central in out of the hospital setting. true or false - true the RN Can't merely "sign off" on data collected by the LVN. true or False - True the LVN may withdraw blood from a patient if previously been instructed by a physican or surgeon. True or false? - true LVNs who are IV Certified may start peripheral IV's, superimpose IV solutions, withdraw blood and perform arterial blood gas withdrawal. true or false? - False an RN may delegate or assign simple heparin flushes to clear out cental line to an LVN team member. True or False? - False
Group A blood type may donate to Group AB type. true or false? - True Group O blood type may donate to Group AB type. True or False - True Group A blood type can donate to type B blood type. True or false? - False Total patenteral Nutrition external tubing need to be changed every 48 Hours. true or False - False: its 24hrs Chloride (Cl-) - major anion, formed outside of the cells. Hyperchloremia - elevated chloride seen in diarrhea, kidney disease and over activity of parathyroid. what are signs and symptoms of hyperchloremia - no symptoms, usually CNS activity decrease, stupor, weakness what is the treatment for hyperchloremia - PO chloride or IV(along with potassium) Calcium - major calcium reserve is in the bones, Immobility (paralysis) hypercalcemia on lab works what causes deficiency of magnesium - alcoholism, malnutrition, prolonged GI suction, Healthy range(1.5-2.5 mEq/L) who usually gets magnesium deficiency? - Alcoholics, anorexics, and pregnant women what acts as a buffer for hydrogen ions (H+) - bicarbonate ion(HCO3-) the disruption of what levels may be caused by diseases that intefer with respiratory function, kidney disease and metabolic conditions - Bicarbonate Ion three reasons why there is a need for IV - 1. replave volume losses.
- maintain fluid balance
- repair imbalances(electrolytes)
- time drops for GTT/min
- take requisition form to blood bank
- ask another license professional to verify into is correct and exp. date.
- rotate blood bag to mix contents
- assess bag for integrity
- recheck V/S
- prime port that connects to blood
- spike blood bag
- unclamp NS
- hang blood bag and open clamp
- prime blood until it reaches IV Bag
- set up rate of infusion
- stay in room and observe patient for adverse reaction for 15min
- document assessment, procedure and observations.
- after 15min of transfusion recheck VS
- after a couple of hours of no reaction. may increase rate
- after transfusion, flush IV again the RBC cells that were given to the patient are destroyed by the patients own immune system is called what? - hemolytic transfusion reaction what is isotonic when goes into the body. then it becomes metabolized by liver and becomes isotonic. - D5W what is only given with blood transfusion. is Isotonic with blood - NaCl 0.9% what are the most commonly fluids in IV? - 1. NaCl 0.9%
- lactated ringer's solution
- D5W (acts as hypotonic solution in the body) what is partial parenteral - nutrition supplies only part of the daily nutritional requirements, supplemented by oral intake. what is total parenteral - supplies all of daily nutritional requirements parenteral should be used for patients with intact GI tract. true or false? - False. it should not be used for patients with intact GI tracts
