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Med Surg I - Unit 4 Notes


Med Surg I - Unit 4 Notes NU111

Marketplace > Kaplan University > NURSING > NU111 > Med Surg I Unit 4 Notes
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About this Document

Notes include IVs, Central Lines, Fluids & Electrolytes
Medical-Surgical I
Class Notes




Popular in Medical-Surgical I

Popular in NURSING

This 3 page Class Notes was uploaded by BALNL on Thursday October 13, 2016. The Class Notes belongs to NU111 at Kaplan University taught by in Spring 2015. Since its upload, it has received 3 views. For similar materials see Medical-Surgical I in NURSING at Kaplan University.


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Date Created: 10/13/16
Unit 4 [Notes] IVs  Orders ⟶ must include: what fluid & what rate o WILL NOT include: location, kind of line to start o TKVO or KVO not acceptable orders  TKVO = to keep vein open  KVO = keep vein open  DO NOT check BP in arm with IV  NO IV in extremity with past lymph node resection  Complications: o Can cause:  phlebitis  s/s = red swollen & hard  infiltration MUST  s/s = cold, pale, swollen discontin  leaking of IV fluid into surrounding ue if any of these tissue occur!  nerve injury  s/s= numbness, tingling  Do not tourniquets geriatrics – use BP cuff instead  IV drug infusion: o meds must be compatible if putting through same line o triple lumen can allow multiple drug admins  drugs do not mix until bloodstream  Dressing Changes: o central lines and midlines must be done by sterile technique!  IO = short term | must be changed asap  Central Lines = o placed in veins in arm, neck, or chest o complications: pneumothorax  check for SOB, ↓ pulse ox stats!  x-ray to determine proper placement  ↑ risk of infection if not kept sterile o tubing change:  know facility protocol  NCLEX = q96h change tubing | hypertonic solution change q24h  ↑ risk for air embolus o always check for blood return prior to med admin!  PICC Line o peripherally inserted central catheter o long term – up to 1 yr o complications = infiltration  extremity swells ⟶ check for blood return! Fluids & Electrolytes  Aldosterone o ↑ Na & water retention o ↑ K loss o hyperaldosterone – hyperkalemic & hpyernatremic o hypoaldosterone – hypokalemic & hyponatremic  Dehydration o @ risk = cognitively impaired o s/s = tachy, hypotension, weight loss, loss of consciousness o interventions = ↑ fluid intake, encourage fluids, check daily weight  Fluid overload o @ risk = pt getting IV fluids | HF | renal failure o s/s = ↑ BP, tachy, rales/crackles in lungs – DO ABC assessment! o interventions – restrict fluids, diuretics  Na [Sodium] o {Neuro} o hyponatremia =  @ risk – pt on IV fluids (hypotonic)  affects – brain, ↓ nerve impulses, can induce seizures o Na follows water! o Diet low in Na  read labels  avoid: cheese, frozen foods, lunch meat, ham, canned soup  Lasix o K levels ↓  hypokalemia = cardiac arrhythmias, weakness, muscle cramps, fatigue  equal I&O ⟶ nursing goal!  Orthostatic hypotension = dizziness upon going from sitting to standing = BP! = geriatrics @ risk due to dehydration  Ca [Calcium] = hypocalcemia = @ risk = hypo-parathyroidism & hypothyroidism = s/s= tingling, numbness, muscle twitch, tetany, Chvosteks sign  tap check


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