Medical-Surgical Nursing, 10th Ed., Ignatavicius & Workman, 2020 | Registered Nurse (RN) School Study Aid
IV Solutions
- Hypotonic (< 280 mOsm/L)
- 1/4 Normal Saline (0.225% NaCl)
- 1/2 Normal Saline (0.45% NaCl)
- Isotonic (280-300 mOsm)
- Normal Saline (0.9% NaCl)
- Lactated Ringer's (LR)
- Dextrose 5% in Water (D5W)
- Hypertonic (> 300 mOsm)
- 3% or 5% NaCl
- Dextrose 5% in 0.45% NaCl
- Dextrose 10% in Water (D10W)
Total Parenteral Nutrition (TPN)
- Nutrition Given Outside GI
- Hyperglycemia
- Hyperlipidemia
- Refeeding Syndrome
- Nausea and Vomiting
- Slow IV Infusion
- Use Large Central Vein
- No Added Meds to TPN Line
Vancomycin
- Inhibits Bacterial Cell Wall Synthesis
- Serious Gram-Positive Infections
- Nephrotoxicity
- Ototoxicity
- Red Man Syndrome
- Thrombophlebitis
- Culture Samples First
- Infuse IV Over 60 Minutes
- Take Around the Clock
Vancomycin Side Effects & Toxicity
- Thrombophlebitis
- Nephrotoxicity
- Ototoxicity
- Diffuse Flushing Called Red Man Syndrome
- Prevent with Antihistamine
- Prevent with Slow Infusion
Whole Blood Composition
- Plasma
- Electrolytes And Other Solutes
- Proteins
- Albumin
- Fibrinogen
- Globulins
- Water
- Formed Elements
- Buffy Coat
- White Blood Cells (WBC)
- Platelets
- Red Blood Cells (RBC)
Needle Sizes and Uses
- Adjust Size Based on Height/Weight
- Subcutaneous Injections
- 3/8 or 5/8 inch
- Intramuscular (IM)
- 1-1.5 inches
Heparin (Unfractionated)
- Suppresses Coagulation
- Deep Vein Thrombosis (DVT)
- Pulmonary Embolism
- Hemorrhage
- Heparin-Induced Thrombocytopenia (HIT)
- Monitor aPTT
- Preferred (Safe) During Pregnancy
- Protamine Sulfate
Interventions for Impaired Skin Integrity
- Signs of Skin Breakdown
- Pain
- Redness
- Decreased Skin Turgor
- Bleeding
- Bony Prominences
- Reposition Q2H
- Pressure Relief
- Maintain Clean and Dry Skin
- Adequate Nutrition and Hydration
Superficial Thrombophlebitis
- IV Catheter Irritation
- Erythema
- Cord-like Vein
- Edema
- Remove IV Catheter
- Elevate
- Warm Compress
- Rotate Sites Q3 Days
- Aseptic Technique
Compartment Syndrome Assessment
- Trauma
- Increased Pressure
- Compressed Nerves and Blood Vessels
- 1 or more of 6 P's
- Ankle-Brachial Index (ABI)
- May take Days to develop
- Early Detection
- Ischemia
- Damage often Irreversible