Question

ABG's

Name: 14. Jill, an 84-year-old woman, was admitted to the hospital for treatment for dehydration. The physician immediately ordered intravenous therapy, 1,000mL of DSW, q8h. The nurse understands that, when administering intravenous (IV) fluids to this patient, monitoring for complications is included in the plan of care. What systemic complications should the nurse monitor for in the patient? a. b. After several attempts to obtain a peripheral IV site, the nurse requests that a central vein be accessed by the physician. Which vein does the nurse anticipate the physician will cannulate? The nurse is determining the flow rate of the IV fluids. What would be the correct way for her to calculate the flow rate? c.

Answer 1

14.

a. The nurse should monitor for the systemic complications of

i) Infiltration:

Infiltration is the leaking of IV fluids into the surrounding tissues. It occurs due to improper placement of the needle. Signs and symptoms include pale and cool skin, swelling, and decreased flow of IV fluids. It can be managed by stop the infusion.

ii) Hematoma:

It occurs due to leakage of blood from the vessel into the surrounding tissue. It can be managed by giving direct pressure on the site.

iii) Phlebitis:

It is the inflammation of the vein occurs due to the continuous flow of IV fluids and the needle is irritating the endothelium. Signs and symptoms include redness, tenderness, puffiness. It is treated by stopping the infusion and apply warm compression.

iv) Air embolism:

An air embolism occurs when a large volume of air enters into the vein during IV administration. It can be prevented by ensuring no air bubbles in the IV tube before administering.

b. The nurse anticipated the physician will cannulate central vein on

• internal jugular vein or
• femoral vein

c. Calculation of flow rate:

Flow rate = Total volume of fluids X Drop factor / time in mins.

Total volume of fluids = 1000

Drop factor = 15 gtt/min

Time in mins = 8 X 60 = 480mins

No of drops per min = 1000 X 15 / 480

= 31.25

= 31 drops per min.

The nurse should adjust the flow rate of 31 drops per min.