ch 14 medication administration part 1

Choosing an IV solution: IV solution bags are wrapped in a sterile bag and guaranteed sterile until the expiration date. a. Solution must be used within ____ hours once opened. Each bag has two ports: i. _____________ port for medication ii. __________ port for connecting the administration set c. IV bags come in different fluid volumes. (1,000 mL, 500 mL, 250 mL, 100 mL, and 50 mL)

24 Injection Access

bolus dose

A single dose of a drug or other substance given over a short period of time

Overhydration - Causes: a. ________________ IVs (pediatrics) b. ___________ failure c. Water intoxication in _______________ sports d. Prolonged ________ventilation

Unmonitored Kidney endurance hypo

Medical Direction: ~The principles of ________ resource management suggest you should use any resources available to help reduce cognitive load. ~If you are not confident with a drug dose, indication, contraindication, or any other aspect of medication administration: a. Use your protocols, a drug formulary, a flip guide, a smartphone or tablet application, or any other available resource. ~_____________ medical control is not just for approval of medications that are outside of your protocols. ~You can also use medical control for general __________________ of treatment modalities with which you are not confident. If you have any doubt regarding the correct action, then consult medical control!

crew Online consultation

For a sterile field to exist: a. Wear sterile sleeves or a ___________ that covers you from the wrist to 5 cm proximal of the elbow. b. Wear sterile gloves using ______________ sizes. c. Place sterile __________ around procedural area. d. Only sterile items and personnel may enter the sterile field.

gown numerical drapes

A hypertonic solution has a ____________ concentration of sodium than does the cell. Water is drawn _____ of the cell, and the cell may ____________ from the increased extracellular osmotic pressure.

greater out; collapse

Overhydration: Fluid fills the vascular compartment, filters into the interstitial compartment, and is forced from the engorged interstitial compartment into the _______cellular compartment. This fluid backup can lead to death

intra

Inserting the IV catheter: Apply ___________ traction on the vein, while holding the catheter bevel side up in your dominant hand. 5. Insert at a ___° angle. 6. Push the catheter through the skin until the vein is pierced. a. You should see a flash of blood in catheter flash chamber. 7. Drop angle to ___° and advance catheter a few centimeters. 8. Slide sheath off needle into vein. 9. Apply pressure to the vein ______________ to the end of the indwelling catheter. 10. Remove needle. 11. Dispose of needle in a sharps container.

lateral 45 15 proximal

A hypotonic solution has a ___________ concentration of sodium than does the cell. Water flows _______ the cell, causing it to ______ and possibly burst from the increased intracellular osmotic pressure.

lower into; swell

You must always make a conscious effort to prevent contamination—whether handling equipment, supplies, or the patient. This is the cornerstone of maintaining a ....

medically clean environment.

Ensuring Correct and Safe Medication Administration: ~Paramedics administer medications based on ____________ orders or online medical direction. ~Use a ________ to verify the drug dose, name, route, rate of administration, indication for administration, contraindications, drug concentration, and volume to be administered.

standing tool

IV Techniques and Administration: The most important point to remember about IV therapy is to keep the IV equipment __________. One way to ensure proper technique is to develop a routine to follow as you assemble the appropriate equipmen

sterile

Each bag of IV solution must be sterile and safe; therefore, each bag of IV solution is individually ________________

sterilized

osmotic pressure

stops the flow of water through a semipermeable membrane. This pressure, in turn, prevents osmosis

Dehydration is defined as inadequate total _____________ fluid volume.

systemic

tonicity

the ability of a surrounding solution to cause a cell to gain or lose water

Body fluid composition: 1. The human body is composed mostly of _________. a. Provides environment necessary for life b. Body maintains balance between intake and output of fluids and electrolytes, ensuring the internal environment remains fairly constant i. Injured or ill body may be unable to maintain _______________.

water homeostasis

Contaminated stick

when a paramedic punctures his or her skin with the same catheter that was used to cannulate the vein of a patient.

A butterfly catheter is a hollow, stainless steel needle with two plastic ________ to facilitate its handling. These catheters are most common in phlebotomy, but are sometimes used for IV placement in _______ veins for pediatric patients.

wings scalp

Dehydration: ~It is usually a chronic condition of __________ and __________ patients and may take _______ to manifest. ~As fluid loss occurs from the vascular compartment, the body reacts by shifting ________________ fluid into the vascular area ~Fluid also shifts from the _______cellular to the ________cellular compartments. As a consequence, a total systemic fluid deficit occurs.

young; older; days interstitial intra; extra

Isotonic: ___.___% sodium chloride (normal saline), ____ Hypotonic: __% dextrose in water (D5W) Hypertonic: __% saline, blood products, a_________

0.9; LR 5 3; albumin

Choosing an IV Site: __________ veins can roll from side to side. ~ Apply manual ____________ to lock it in place. ~Hold hand veins in place by pulling the skin over the vein taut with the ________ of your free hand as you flex the patient's hand ~Stabilize wrist veins by _________ the wrist and pulling the skin taut over the vein. ~Applying lateral traction to the vein with your free hand can stabilize veins in the forearm and antecubital areas.

Bulging traction thumb flexing

Causes of dehydration include: a. Diarrhea b. Vomiting c. Gastrointestinal drainage d. Infections e. Metabolic disorders f. h__________________ g. Environmental emergencies h. High-___________ diet i. Insufficient fluid intake

Hemorrhage caffeine

IV Fluid Composition: ____________ is used as the benchmark to calculate a solution's tonicity (movement of water). The concentration of sodium in the cells of the body is approximately __.__%. Altering the concentration of sodium in the IV solution, therefore, can move the __________ into or out of any fluid compartment in the body.

Sodium 0.9 water

Medication Administration C________-Check (MACC): This tool uses principles of crew resource management by requiring a process for v________________ for every medication, every time. The tool employs job aids to help reduce ___________ load and ensure the process is completed each time a medication is administered. ~designed to work with ____ provider levels. ~the second provider, regardless of certification level, acts as a _____________ board for the first provider. This forces the first provider to validate the medication administration. The tool will not eliminate all medication errors. However, with proper use of this tool, medication errors can be significantly reduced

Cross verification cognitive all sounding

_______ helps to make veins more visible by changing ambient light reflection. This technique is particularly beneficial in _______-skinned people

Iodine; dark

Saline locks (buff caps)

Special types of intravenous devices filled with a small amount of normal saline to keep blood from clotting at the end of the catheter, allowing an IV site to be maintained without running fluids through the vein

Securing the I.V. line: 1. ________ the area to secure the catheter and tubing. a. Double back the tubing to create a __________. i. Will act as a shock absorber if the line is accidently pulled 2. Cover the insertion site with sterile gauze, and secure with tape. a. Avoid _____________________ taping around any extremity. 3. Establish vascular access.

Tape loop circumferential

Oxygen-carrying solutions: a. _________ blood is the best replacement for lost blood. i. Contains hemoglobin (carries oxygen to the body's cells) ii. Impractical in the prehospital setting (a) Requires refrigeration and unique storage (b) On occasion (eg, aeromedical transports, multiple-casualty incidents), ___-________________ blood—a universally compatible blood type—may be used outside a hospital setting. b. Synthetic blood substitutes are being researched and field-tested.

Whole O-negative

Choosing an IV catheter: While 10- and 12-gauge catheters do exist, they are not typically used by EMS providers for vascular access. Their presence in the prehospital realm is reserved for needle _____________________.

decompression

Hypotonic solutions have a lower concentration of sodium than the cell's serum. a. Begins to _________ serum once in the vascular compartment b. Soon the serum osmolarity is _____ than that of the interstitial fluid; water is pulled from the vascular compartment into the interstitial fluid compartment c. Eventually the same process is repeated, pulling water from the interstitial compartment into the _____ d. Hydrate the cells while depleting the vascular compartment i. May treat hypoglycemic conditions e. Can cause a sudden fluid shift from intravascular space to the cells i. May lead to ___________________ collapse and increased intra________ pressure ii. Dangerous for patients with stroke, head trauma, burns, malnutrition, or liver disease, can cause: Third spacing: Abnormal fluid shift into the _________ linings

dilute less cells cardiovascular; cranial serous

Choosing an IV Site: Limit IV access to _______ areas of extremities. a. Start _________. b. Work ________________.

distal distally proximally

It is your responsibility to administer the appropriate medications and the appropriate ___________ when needed, and to determine the most effective __________ by which to administer them.

dosage; route

Changing an IV bag: 1. Never allow an IV fluid bag to become completely __________. a. Change when ____ mL of fluid is left.

empty 25

Medical asepsis may be accomplished through the use of: ~sterilization of __________________ ~anti__________ ~____________________.

equipment septics disinfectants

Preparing an administration set: a. Verify the ______________ date, and check the solution for _________.

expiration; clarity

Choosing an IV catheter: ~Select the largest-diameter catheter that will ____ the vein you have chosen or that will be the most appropriate and comfortable for the patient. ~An ___- or ___-gauge catheter is usually a good size for adults. ~_________________ veins of the hand can usually accommodate 18- or 20-gauge catheters. ~An ___-gauge catheter should be used when the patient requires fluid replacement (eg, for hypovolemic shock)

fit 18; 20 Metacarpal 18

Choosing an IV catheter: Over-the-needle catheters are sized by their diameter, which is referred to as the ________. The smaller the gauge of the catheter, the larger the diameter. Thus, a 14-gauge catheter is of ___________ diameter than a 22-gauge catheter ~___-gauge is the largest, ____-gauge is the smallest. The larger the diameter, the more _______ that can be delivered through it.

gauge larger 14; 27 fluid

A patient's electrolytes can become altered from...

i. Excessive vomiting ii. Diarrhea iii. Dietary issues iv. Medications (taken regularly or administered by the EMS crew) v. Blood loss, or a variety of other injuries

The first rule of standard precautions is to treat any body fluid as being potentially __________________

infectious

Isotonic solutions have almost the same osmolarity as serum and other body fluids. a. Example: Normal saline (0.9% sodium chloride) b. Expand the contents of the _______vascular compartment c. Does not _______ fluid to or from other compartments d. Use care to avoid fluid overloading (Patients with _________tension and _______________ heart failure are at greatest risk of this problem.)

intra shift hyper; congestive

A hypertonic solution has an osmolarity higher than serum. ~Pulls fluid and electrolytes from the intracellular and intestinal compartments to __________________ compartment c. Cells may ____________ from increased extracellular osmotic pressure. d. Helps stabilize blood pressure, increase _______ output, and reduce _________

intravascular collapse urine; edema

Over-the-needle catheter

is a Teflon catheter inserted over a hollow needle (eg, Angiocath, Terumo, Jelco).

Cannulation

is the insertion of a catheter, such as into a vein to allow for fluid flow.

External jugular (EJ) vein cannulation: a. EJ vein runs down and obliquely backward behind the ____ b. Exhaust all other means of cannulating a peripheral vein before attempting EJ vein cannulation. i. Risks include: (a) Inadvertent puncture of _____________ artery (b) Rapidly expanding _______________ (c) ______ embolism

jaw carotid hematoma Air

Vascular access: ~Is often needed in emergency medicine for patients who are hemodynamically unstable and in need of intravenous (IV) fluids, various medications, or both. A number of techniques are used to gain vascular access in the prehospital setting, including: ~cannulation of a peripheral extremity vein ~external _____________ (EJ) vein cannulation ~intraosseous (IO) access ~long- term vascular access devices (________).

jugular VADs

Overhydration: May occur in patients: a. With impaired ___________ function b. Who have been administered more fluid than their body can ___________ c. N___________ (Younger than __ month) kidneys are not fully developed

kidney excrete Neonates; 1

Colloid Solutions: ~Contain molecules (usually proteins) that are too ________ to pass through the capillary membranes and, therefore, remain in the ____________ system.

large; vascular

Isotonic Solutions - D5W D5W, 5% dextrose in water, is a unique type of isotonic solution. As long as it remains in the bag, it is considered an isotonic solution. Once it is administered, however, the dextrose is quickly __________________, and the solution becomes ________tonic. It is usually administered when you are preparing medication infusions such as _______________ (Intropin) or ___________________ (Cordarone).

metabolized hypo dopamine; amiodarone

Choosing an IV catheter: ~larger catheters do not help enough to make a difference, the ______ rate is higher and the pain factor significant. ~You should be able to insert an ___-gauge catheter into an antecubital vein or EJ vein in the average adult.

miss 18

Over-the-needle catheters are preferred in the prehospital setting. i. Readily secured ii. Less cumbersome than a butterfly catheter iii. Allow for greater patient ______________ iv. Do not need to ______________ the entire limb v. Sized by diameter (gauge) (a) The smaller the gauge, the _________ the diameter.

movement immobilize larger

Disposal of Contaminated Equipment: Accidental __________________ are the most common route for disease transmission in the health care setting. You must always handle contaminated equipment carefully and dispose of it immediately and properly.

needlesticks

Consider the patient's ___________ when selecting an IV site. a. Avoid extremity if it shows signs of: i. Trauma ii. Injury iii. Infection b. Look for ______ marks. i. Signs of ____________ (abnormal hardening) ~Some protocols allow IV cannulation of leg veins. a. Can increase risk of venous thrombosis and pulmonary ___________

opinion track sclerosis embolism

Colloid Solutions: ~These large protein molecules give colloid solutions a high _______________. ~As a result, they _______ fluid from the interstitial and intracellular compartments into the ____________ compartments. ~Reduce ________ (eg, in pulmonary or cerebral) while expanding the vascular compartment.

osmolarity draw; vascular edema

Choosing an IV catheter: The most common types used in the prehospital setting are _______-the-needle catheters and ____________ catheters.

over; butterfly

When the body's total systemic fluid volume increases, ____________________ occurs

overhydration

When you replace volume loss in a patient, remember crystalloid solutions cannot carry ____________. Fluid boluses should be administered to maintain ______________ (ie, radial pulses, adequate mental status) but not to restore blood pressure to the patient's _____________ level. Increasing blood pressure may increase internal ________________. (1) Interferes with ________________ (body's blood-clotting mechanism) ii. Blood pressure should be titrated to ___ mm Hg unless otherwise noted.

oxygen perfusion; normal bleeding hemostasis 90

Disposal of Contaminated Equipment: Sharps include IV/intramuscular (IM) and subcutaneous needles and catheters, scalpels, broken ampules or vials, and anything else that can p______________ or l_______________ the skin. Immediately dispose of all sharps in a p_____________-proof sharps container that bears a ________________ logo

penetrate; lacerate puncture; biohazard

hypertonic solution: "Hypertonic" often used to refer to solutions with high concentrations of __________ which have same effect on fluid as sodium. f. Careful monitoring to avoid fluid overloading i. Should not be given to: (a) Diabetic ___________________ patients (b) Patients at risk of cellular dehydration i. Used as a temporizing measure to draw out fluid in an effort to __________ intra__________ pressure until the patient can be taken into neurosurgery

proteins ketoacidosis reduce; cranial

Choosing an IV catheter: ~Catheter should be based on the ____________ of the IV line, the ______ of the patient, and ____________ for the line.

purpose; age; location

Choosing an IV solution: IV solution is usually limited to two isotonic crystalloids. ~ Normal __________ ~ ____ solution

saline LR

Types of IV Solutions - Crystalloid Solutions: a. Dissolved crystals (eg, _____ or sugars) in water b. Able to ______ membranes and alter fluid levels c. _______ choice for prehospital care of injured patients needing body fluid ___________________

salts cross Best; replacement

An isotonic solution has the _________ concentration of sodium as does the cell. ~water does not ________ and no change in cell _________ occurs.

same shift; shape

Colloid Solutions: Could cause dramatic fluid _________ i. Danger to patient if not given in a controlled setting f. _______ duration of action g. Low cost-to-benefit ratio

shifts Short

Pediatric IV Therapy Highlights: ■ Use __________ gauge catheters or butterfly needles for peripheral IV access due to smaller vasculature. ■ IV catheters and tubing may need additional gauze to secure them from being pulled out. ■ Arm boards or ________ may be needed to assist in securing the lines ■ Access may be obtained in other locations such as _______ veins or _____________ veins

smaller splints scalp; umbilical

Geriatric IV Therapy Highlights: ■ Use __________ gauge catheters to increase comfort and prevent extravasation. ■Distal ____________ is needed due to increased skin elasticity, but caution should be taken. Aggressive traction can cause skin tears. ■__________ flow rates should be considered to reduce the possibility of rupturing a vein or causing complications from fluid overload. ■Avoid smaller, __________, veins which are not likely to tolerate a catheter.

smaller traction Slower spider

Verify the _____________ of the drug name; this is where medication errors commonly occur.

spelling

Choosing an IV Site - Use the following criteria to select a vein: ■ Locate the vein section with the ________________ appearance ■ Choose a vein that has a _______, round appearance or is __________ when palpated. ■ Avoid areas where the vein crosses over _________. ■ Avoid extremities w/ _________ and any extremity with a dialysis ________ or on the side a ________ectomy was done.

straightest firm; springy joints edema; fistula; mast

Steps to cannulate EJ vein: ~Place patient in _________, head-_________ position. (a) Turn patient's head to ___________ side of intended venipuncture. (b) Feel carefully for a __________; do not pierce the carotid artery. ~Puncture midway between the _______ and _________________ line.

supine; down opposite pulse jaw; midclavicular

The effects of osmotic pressure on a cell are referred to as the _______ of the solution. Tonicity is the concentration of _____________ in a solution and the movement of _________ in relation to the sodium levels _________ and __________ the cell

tonicity sodium; water; inside; outside

Disinfectants: ~Are ________ to living tissues; therefore, you should never use them on a _____________. Use disinfectants only on _____living objects such as the inside of the ambulance, laryngoscope blades, and other nondisposable equipment.

toxic; patient non-

Inserting the IV catheter: Considerations for any technique: a. Keep the beveled side of the catheter ____. b. Maintain adequate ______________ on the vein.

up traction

Choosing an IV Site: ~Avoid areas of the vein that contain _______ and _______________ because a catheter will not pass through these areas easily and the needle may cause damage.

valves; bifurcations

Choosing an administration set: An administration set moves fluid from the IV bag to the patient's ____________ system Each set has a _________ spike protected by a plastic cover. Once this spike is exposed and the seal surrounding the cap is broken, the set must be used immediately or discarded.

vascular piercing

You are also responsible for the documentation and security of all controlled substances carried on your ambulance, including accounting for all controlled substances that were ____________ (ie, residual medication that was not administered to the patient). Follow the specific policies and procedures of your local drug distribution, security, and accountability system. If you administer a controlled substance to your patient (eg, morphine), then document the amount of medication that you ________ to the patient and the amount of medication that you ___________ (did not give to the patient). Have your _____________, ________ or physician from the receiving facility, or supervisor witness (actually see) you wasting the medication. Both of you should sign the ________—you as the paramedic who administered and wasted the medication—and the witness who observed you waste the medication.

wasted gave; wasted partner; nurse form

The compounds and ions dissolved in IV solutions are identical to the ones found in the body, although the ____________________ may vary.

concentrations

Ensuring Correct and Safe Medication Administration Document the following: 1. Dose ___________________ a. Total ____________ administered during that administration b. ________ of measure for that drug c. ____________ administered to the patient 2. _________ of medication a. Verify spelling of the drug name 3. _________ 4. ________ a. Bolus, infusion, or other administration method 5. ________ of administration 6. _______ administered the drug 7. Who helped perform the medication c______ 8. Patient's r___________

1. administered quantity Units Volume 2. Name 3. Route 4. Rate 5. Time 6. Who 7. check 8. response

Cannulation of the EJ vein: Do not let air enter the catheter once it is in the vein. Patients can draw in as much as ____% of their tidal volume through an open EJ vein, causing a large air embolism.

10

A healthy person loses approximately __ to __.__ L of fluid daily through urine output, through the lungs (______________), and through the ______.

2; 2.5; exhalation; skin

When you use an isotonic crystalloid solution for fluid replacement to support blood pressure after blood loss, remember the 3-to-1 replacement rule: ~___ mL of isotonic crystalloid solution is needed to replace __ mL of patient blood. ~________ thirds of the infused isotonic crystalloid solution will leave the vascular spaces in about __ hour. ~The two-thirds of infused crystalloids is either absorbed into the interstitial space or excreted. ~You should closely monitor _______ output when heavy fluid resuscitation occurs.

3; 1 Two; 1 urine

Apply the constricting band above the intended IV site. It should be placed approximately ___ to __ inches (10 to 20 cm) above the intended site.

4; 8

Choosing an administration set: The number on the package indicates the number of drops it takes for a milliliter of fluid to pass through the orifice and into the drip chamber. a. Two sizes: i. Microdrip set: Allows ____ gtt (drops) per milliliter (mL) (a) Ideal for _______________ administration or ___________ fluid delivery (b) Easy to control fluid flow ii. Macrodrip set: Allows ___ or 15 gtt/mL (a) Ideal for ________ fluid replacement

60 medication; pediatric 10 rapid

To change an IV fluid bag

a. Stop the flow of fluid by closing the roller clamp. b. Prepare the new IV bag. i. Inspect the new bag of IV fluid for clarity and discoloration; ensure it has not expired. c. Remove the piercing spike and insert it into the port on the new bag. i. Do not touch the piercing spike port. d. Ensure the drip chamber is filled and open the roller clamp, adjusting the fluid rate accordingly.

Use a constricting band __________ the site. The most common constricting band is a latex-free IV tourniquet. i. Unlike tourniquets used for bleeding control, these constricting bands stop only ____________ flow.

above venous

Sterile technique: Deconstruction of ____ living organisms using ______, gas, or chemicals

all; heat

Ultrasonographically Guided Peripheral IV

allows providers to see deeper veins that are not visible to the naked eye and may not be palpable.

Because it may not be feasible to maintain a sterile environment in the field, you must practice medical ___________ to reduce the risk of contamination and infection. Examples of medical asepsis include ________ washing, wearing ________, and keeping equipment as clean as possible. For example, the site on a patient's hand that has been cleaned with iodine and alcohol before starting an IV line is said to be "_____________ _______."

asepsis hand; gloves medically clean

Assembling your equipment: 1. Gather and prepare your equipment ___________ starting an IV line. 2. The following equipment will be available: a. Elastic tourniquet b. Anti_______ wipe or solution c. Gauze d. Tape or adhesive bandage e. Appropriate-size IV catheter f. IV administration set g. A _______ flush h. IV administration set

before septic saline

Before responding to an EMS call, you must ensure all equipment on the ambulance is fully functional. This verification is made during your check of the ambulance at the ________________ of your shift. All medications must be checked to ensure they are not ____________ or ______________ and they are readily available in the right quantity

beginning expired; damaged

Choosing an IV Site: Because failed cannulation brings the possibility of leakage into the surrounding tissues, any fluid introduced immediately _________ an open wound has the potential to enter the tissue and cause damage.

below

Isotonic Solutions - Lactated Ringer (LR) solution: ~Generally used for patients who have lost large amounts of _________. i. Contains lactate which is metabolized in the ________ to form ________________—the key buffer that combats the intracellular acidosis associated with severe blood loss. ii. Should not be given to patients with _______ problems iv. Contraindicated during blood product ___________________ (a) Nitroglycerin (b) Nitroprusside (c) Norepinephrine (d) Propranolol (e) Methylprednisone infusions

blood liver; bicarbonate liver transfusions

Minimizing Your Risk of a Needlestick: ~Use _______-tip needles when drawing medication from vials or infusing medications directly into an IV solution. ~Use a ________________ delivery system which "recap" themselves, which greatly reduces the risk of a needlestick. ~Immediately dispose of all sharps in a puncture-proof sharps container. Do not drop the sharps on thefloor for later disposal, and do not attempt to ________ a needle and syringe before placing it in the sharps container. Even if you use a needle or IV line that automatically retracts, you still must discard it in a sharps container. ~When possible, perform all invasive procedures at the _________ ~Recap needles only as an absolute last resort. If you must recap a needle, then use the ______-handed technique: Place the needle cover on a stationary surface, then slide the needle—with one hand—into the needle cap.

blunt needleless recap scene one

Overhydration - Signs and symptoms: a. Shortness of __________ b. Puffy _________ c. Edema d. Polyuria e. Moist crackles (________) f. Acute weight gain

breath eyelids rales

Choosing an IV Site: ~Valves can be recognized as small _________ located in the vein. ~Bifurcations are points where one vein may split into _____

bumps two

Antiseptics: ~Are used to _____________ an area before performing an invasive procedure such as IV therapy or medication administration. ~Even though antiseptics are capable of destroying pathogens, they are not toxic to __________ tissues. Isopropyl alcohol (rubbing ____________), ____________, and 2% chlorhexidine gluconate (ChloraPrep) are the three most common antiseptics you will use in the field.

cleanse living alcohol; iodine

Signs and symptoms of dehydration: ~decreased level of ___________________ ~_______________ hypotension ~_______pnea ~dry mucous membranes ~decreased urine output ~________cardia ~poor skin _________ ~_________, dry skin.

consciousness orthostatic tachy tachy turgor flushed

Medical asepsis is the practice of preventing _________________ of the patient by using aseptic technique. This method of cleansing is intended to prevent contamination of a site when you are performing an _____________ procedure such as starting an IV line or administering a medication.

contamination invasive

Choosing an IV solution: Ask yourself: a. Is the patient's condition ___________? b. Is the patient's condition _________? c. Does the patient require ________ replacement? d. Will the patient need ________________?

critical stable fluid medications

Types of IV Solutions: Based on their dissolved components, or makeup, IV solutions are categorized as either __________loid or ______loid. Based on their tonicity, they are also categorized as ____tonic, _______tonic, or ________tonic. IV fluids use combinations of these solutions to create the desired effects inside the body.

crystal; col iso; hypo; hyper