Observe for blood return through flashback cannula

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24. observe for blood return through flashback cannula, advance catheter into arm 25. apply pressure above insertion site with middle finger of nondominant hand, retract stylet by pressing safety tip 26. continuous infusion: connect end of IV tubing to catheter tubing, secure connector 27. Intermittent infusin: connect adapter of heparin lock to hub of ONC cannula (clean hub, insert prefilled syringe, flush 28. continuous infusion: begin infusion by slowly opening clamp of IV tubing 29. secure cannula 30. apply sterile dressing over site 31. loop tubing alongside arm, place 2nd piece of tape over 32. for IV fluid administration, recheck flow rate to correct drops per minute or connect electronic infusion device 33. write date and time of IV placement, cannula, gauge size and length, nurse’s initials 34. dispose of stylet or other sharps, discard supplies, remove gloves, perform hand hygiene 35. instruct client how to move without pulling cannula 36. change IV access every 72 hours or per orders 37. when solution less than 100 ml have next solution at bedside 38. observe client every 1 to 2 hours 39. evaluate response to therapy Review Methods used to regulate infusion rates: gravity (gtts/min) and IV pumps
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Skills Test 3 (ml/hr) (pg. 1007) a gtts/min= ml per hour x gtt/min(iv set) / hours to administer x 60 ( minutes per hour) b ml/hr= amounts of solution x 60/ minutes to administer Demonstrate phlebotomy procedures Normal Potassium Range (3.5-5.0 mEql) Review Equipment and demonstrate steps to administer blood and blood components Demonstrate Central Line dressing change Review the principles/procedures regarding PICC/central line care and flushing (saline/heparin) to ensure patency Review factors that place individuals at risk for fluid and electrolyte imbalances: sweating, blood loss, feces, drainage, urine Identify methods for fluid replacement: a Enteral: think of the shakes that we give through any type of feeding tubes (nose, stomach, or small intestine) b Parenteral: IV fluids and electrolyte therapy Review guidelines for fluid restriction Identify types of parenteral replacement (TPN/IV fluid and electrolytes/blood and blood components) Note common IV solutions : D5W, D10W, NS (normal saline/0.9%) ½ NS (0.45%), D5NS, D5 ½NS, RL, LR (Ringer’s Lactate or Lactated Ringer’s), D5LR Recognize unexpected outcomes/complications of IV therapy and how to handle them when they occur (pg 1004) Review policies/procedures to maintain IV systems (cannula, site, dressings, tubing, injection caps, saline locks, etc) Review blood groups/types a most important grouping for transfusion purposes is the ABO system, which inclused A, B, O, and AB blood types b Individuals with A antigens, B antigens or no antigens belong to groups A, B, and O c Individual with A and B antigens has AB blood d O: universal donor because has neither A or B antigen e AB: universal recipient because produces neither antigen when received f Another consideration when matching is the Rh factor, an antigenic substance in the erythrocytes of most people. A person with the factor is Rh positive, with out it is Rh Negative
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