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Acid-Base Balance
Acknowledgments
Age-Related Considerations - Fundamentals of Fluid and Electrolyte Balance
Antigens (Agglutinogens)
Blood Preservatives
Calculator - Body Surface Area (BSA) - Calculator
Consultants
Crystalloid Solutions
Endocrine System
Figure - 0.2 Micron Air-Eliminating Filter Set
Figure - Acid-Base Scale
Fundamentals of Fluid and Electrolyte Balance
Glossary - Transfusion Therapy
Implementation of Interventions/Nursing Actions
Major Acid-Base Imbalances
Midline Catheters
Needle Protection: Active and Passive Sharps Safety
Preface
Renal Regulation
Reviewers
Step 3: Pretransfusion
Table - ABO Blood Grouping Chart
Table - ABO Compatibilities for Red Blood Cell Components
1. Professional Practice Concepts for Infusion Therapy
1. Professional Practice Concepts for Infusion Therapy
Delivery of Quality Care
Glossary
Introduction
Learning Objectives
Legal and Ethical Issues in Infusion Therapy
Nursing Process Related to Infusion Therapy
Quality Management
Risk Management and Risk Assessment
Table(s)
Thinking Critically: Case Study
2. Infection Prevention and Occupational Risks
2. Infection Prevention and Occupational Risks
Age-Related Considerations
Basic Principles of Epidemiology
Figure(s)
2-1. Chain of Infection
2-2. Sources of I.V. Cannula-Related Infections
2-3. Curos[®] Alcohol Disinfection Cap
2-4. Centers for Disease Control and Prevention (CDC) Injection Safety Checklist
2-5. Biopatch[®]
2-6. Chlorhexidine (CHG) Transparent Semipermeable Dressing
2-7. Aquaguard
2-8. Transparent Dressing over a Peripherally Inserted Central Catheter with Stabilization DeviceâStatLock[®]
Glossary
Health-Care-Associated Infections
Central Line-Associated Bloodstream Infection Surveillance and Public Reporting
Diagnosing Infection: Culturing Techniques
Health-Care-Associated Infections
Intrinsic Versus Extrinsic Causes of Bloodstream Infection
Pathogenesis of Vascular Access Device-Related Infections
Vascular Access Device-Related Infections: Scope and Terminology
Immune System Function
Introduction
Learning Objectives
Occupational Hazards
Procedures Display(s)
Strategies for Preventing Infection
Table(s)
2-1. Organs of the Immune System
2-2. Types and Functions of White Blood Cells
2-3. Factors Associated with Increased Central Line-Associated Bloodstream Infection (CLABSI) Risk
2-4. Microorganisms Most Frequently Encountered
2-5. Common Tests for Evaluating the Presence or Risk of Infusion-Related Infections
2-6. Sharps Safety Devices and Recommendations
Thinking Critically: Case Study
3. Fundamentals of Fluid and Electrolyte Balance
3. Fundamentals of Fluid and Electrolyte Balance
Acid-Base Balance
Age-Related Considerations
Basic Principles of Electrolyte Balance
Body Fluid Composition
Disorders of Fluid Balance
Figure(s)
3-1. Percentages of Body Fluid
3-10. Positive Trousseauâs Sign
3-11. Positive Chvostekâs Sign, which Occurs after Tapping the Facial Nerve Approximately 2 cm Anterior to the Ear Lobe
3-12. Acid-Base Scale
3-2. Effects of Fluid Shifts in Hypotonic, Isotonic, and Hypertonic States
3-3. Tonicity Osmolarity Ranges of Solutions
3-4. Hand Vein Assessment
3-5. Jugular Venous Distention
3-6. Edema
3-7. Sodium and Cellular Fluid Relationship
3-8. Sample ECG Tracing Showing Hypokalemia
3-9. Sample ECG Tracing Showing Hyperkalemia
Fluid and Electrolyte Homeostatic Mechanisms
Fluid Distribution
Fluid Function
Glossary
Learning Objectives
Major Acid-Base Imbalances
Physical Assessment of Fluid and Electrolyte Needs
Table(s)
3-1. Percentages of Total Body Fluid in Relation to Age and Gender
3-10. Summary of Acute Acid-Base Imbalances
3-2. Regulators of Fluid Balance
3-3. Summary of Laboratory Evaluation for Fluid and Electrolyte Imbalances
3-4. Quick Assessment Guide for Fluid Imbalances
3-5. Comparison of Electrolyte Composition in Fluid Compartments
3-6. Critical Guidelines for Administration of Potassium
3-7. Critical Guidelines for Removal of Potassium
3-8. Critical Guidelines for Administration of Magnesium
3-9. Clinical Problems Associated with Electrolyte Imbalances
Thinking Critically: Case Study
4. Parenteral Solutions
5. Infusion Equipment
5. Infusion Equipment
Add-On Devices
Administration Sets
Central Vascular Access Devices
Developing and Participating in Product Evaluation
Figure(s)
5-1. Comparison of Glass and Plastic Infusion Delivery Systems
5-10. Volume Chamber Control Set for Intermittent Infusion
5-11. Diagram of Y Administration Set Used for Blood Administration
5-12. Extension Tubing Connected to Access Device and Hub of Catheter, with Slide Clamp
5-13. Power Injectable Extension Set
5-14. Split Septum Needleless Connectors
5-15. Example of a Complex Needleless Connector (NC)
5-16. Curos[®] Alcohol Disinfection Cap, which is Changed after Each Catheter Access
5-17. Posidyne[®] ELD 0.2-Micron Filter with 96-Hour Bacterial and Endotoxin Retention
5-18. Lipopor⢠TNA Filter Set for Total Nutrient Admixture Administration with 1.2-Micron Air- and Particle-Eliminating Filter
5-19. Neonatal Filter
5-2. Plastic Infusion System
5-20. StatLock[®] PICC Plus Catheter Stabilization Device
5-21. Catheter Stabilization Device, Securacath[®]
5-22. I.V. House Ultradressing[®], which Consists of Flexible Fabric with Thumb Holes and a Polyethylene Dome that Wraps around the Patientâs Hand after an I.V. is Started
5-23. Butterfly-Winged Scalp Vein Needle
5-24. Over-the-Needle Catheters
5-25. Transillumination Device Veinlite[®]
5-26. Near-Infrared Imaging to Visualize Vein Using Vuetekvein-Siteâ¢
5-27. View of Upper-Extremity Veins Seen with the Vuetek Veinsite
5-28. Bioflo PICC Made of a Thromboresistant Material
5-29. Power PICC Solo[®]2 Catheters, Single, Double, and Triple Lumen
5-3. I.V. Container Systems for Addition and Reconstitution of Drugs
5-30. Subcutaneously Tunneled Catheter
5-31. Example of an Implanted Venous Access Port
5-32. View of an Implanted Port Model Showing Noncoring Needle Access
5-33. A, Safestep[®] Huber Needle Set
5-34. Mechanical Controller: Rate Flow Regulator
5-35. Elastomeric Infusion Pump
5-36. Ambulatory Pump: 6000CMS Ambulatory Electronic Infusion Device
5-37. Perfusor[®] Space Syringe Pump
5-38. Alaris[®] PCA Pump with Spo(2) Monitoring
5-39. Alaris[®] Multichannel Pump
5-4. Basic Administration Set Components
5-5. Spiking an I.V. Container
5-6. Primary Administration Set
5-7. Primary Administration Set Package
5-8. Secondary Administration Set
5-9. Dual Cap Systemâ¢
Flow-Control Devices
Glossary
Infusion Therapy Equipment
Learning Objectives
Peripheral Intravenous Catheters
Solution Containers
Table(s)
Thinking Critically: Case Study
6. Techniques for Initiation and Maintenance of Peripheral Infusion Therapy
6. Techniques for Initiation and Maintenance of Peripheral Infusion Therapy
Age-Related Considerations
Anatomy and Physiology Related to I.V. Practice
Approaches to Venipuncture: Phillips 16-Step Peripheral-Venipuncture Method
Chapter Highlights
Figure(s)
6-1. Anatomy of Skin
6-10. Skin Antisepsis Prior to Peripheral Intravenous Catheter Placement
6-11. Application of Traction to the Skin
6-12. A, Insertion of Needle at a 30-Degree Angle through Skin
6-13. Steps in Insertion of an over-the-Needle Catheter Once through the Skin into the Vein
6-14. A, BD Insyte Autoguard Bc Shielded I.V. Catheter Provides Blood Control during Insertion; Needle Safety System Button
6-15. StatLock Stabilizing a Peripheral I.V. Catheter
6-16. I.V. House Ultradressing, which Consists of Flexible Fabric with Thumb Holes and a Polyethylene Dome that Wraps around the Patientâs Hand after an I.V. is Started
6-17. A and B, Steps in Applying Transparent Semipermeable Dressing Directly over the I.V. Catheter Hub and Insertion Site
6-18. Applying a Tegaderm CHG Dressing over a Peripheral Intravenous Catheter
6-19. Tamper-Proof Biohazard Containers
6-2. Anatomy of a Vein
6-20. Intermittent Infusion Device
6-21. A, Superficial Veins of Scalp
6-22. 0.2 Micron Air-Eliminating Filter Set
6-23. IV House Ultradressing Pediatric
6-24. Fragile Veins
6-3. Superficial Veins of the Dorsum of the Hand
6-4. Superficial Veins of the Forearm
6-5. A, Spiking
6-6. Phillips Tourniquet Technique
6-7. Transillumination Techniques
6-8. Near-Infrared Imaging to Visualize Vein Using Veinsite
6-9. Intradermal Lidocaine Administered Before Venipuncture Using 0.1 to 0.2 Ml of 1% Lidocaine and a Tuberculin Syringe Entering the Skin at a 15- to 25-Degree Angle
Glossary
Learning Objectives
Peripheral Infusion Site Care and Maintenance (Peripheral-Short and Midline Catheters)
Procedures Display(s)
Table(s)
6-1. Comparison of Artery and Vein
6-10. Summary of Steps in Initiating Peripheral I.V. Therapy
6-11. Components of the Pediatric Physical Assessment
6-12. Pediatric Infusion Sites
6-13. Flushing Guidelines for Pediatric Patients
6-14. Tips for the Older Adult with Fragile Veins
6-2. Selecting an Insertion Site for Superficial Veins of Dorsum of Hand and Arm
6-3. Phillips 16-Step Peripheral-Venipuncture Method
6-4. Tips for Selecting Veins
6-5. Phillips Multiple Tourniquet Technique
6-6. Transillumination
6-7. Techniques to Assist with Difficult Venous Access
6-8. Recommended Gauges
6-9. Conversion Chart: Rate Calculation
Worksheet 6-2: Basic Calculation of Primary Infusions
7. Phlebotomy Techniques
7. Phlebotomy Techniques
Age-Related Considerations
Blood Collection Procedure
Assessment and Identification
Blood Collection Procedure
Disposal of Equipment
Drawing Station
Equipment Preparation and Venipuncture Technique
Fill and Mix of Tubes
Hand Hygiene/Gloving
Key Nursing/Phlebotomist Interventions
Order of Tube Collection
Postprocedure Patient Care
Preparation of the Venipuncture Site
Specimen Identification and Labeling
Test Requisition
Transport of the Specimen to the Laboratory
Venipuncture Site Selection
Complications
Equipment for Blood Collection
Figure(s)
7-1. Traditional Components of an Evacuated Tube System
7-10. Proper Insertion of Needle into Vacutainer Holder
7-11. Insertion of Winged Needle into ETS Holder
7-12. Vacutainer Push-Button Winged Needle Blood Collection Set Steps
7-13. Hematoma Resulting from Multiple Attempts at Blood Draw
7-14. Appropriate Site for Heel Puncture on Infant
7-2. BD Vacutainer Eclipse⢠Blood Collection Safety Needle
7-3. BD Vacutainer⢠Plastic Tubes
7-4. Blood Collection Tube Top Guide
7-5. BD Vacutainer Push Button Blood Collection Set
7-6. BD Quikheel⢠Microcollection Lancet
7-7. Blood Drawing Chair
7-8. Sample Barcode
7-9. Best Sites for Venipuncture
Glossary
Introduction to Phlebotomy
Learning Objectives
Procedures Display(s)
Table(s)
Thinking Critically: Case Study
8. Techniques for Initiation and Maintenance of Central Vascular Access
8. Techniques for Initiation and Maintenance of Central Vascular Access
Age-Related Considerations
Anatomy of the Vascular System
Assessment and Device Selection
Care and Maintenance
Chapter Highlights
Figure(s)
8-1. Veins of the Arm and Chest
8-10. Subclavian Insertion Site for a Tunneled Catheter
8-11. Diagram of Creation of Subcutaneous Tunnel
8-12. Example of Port Placement in Chest
8-13. Example of an Implanted Venous Access Port
8-14. Examples of Implanted Vascular Access Ports
8-15. Accessing the Port Wearing Gloves
8-16. A, Example of a Dressing Kit
8-17. Tegaderm CHG Dressing over PICC
8-18. Sorbaview Shield Contour TSM Dressing over Nontunneled CVAD Placed Via Internal Jugular Vein
8-19. Sorbaview TSM Dressing over Accessed Implanted Vascular Access Port
8-2. Venous Access Device Selection Algorithm
8-20. Biopatch[®]-Impregnated Foam Dressing around a CVAD
8-3. Bioflo PICC Made of a Thromboresistant Material that is Blended into the Polyurethane and Resistant to Accumulation of Blood
8-4. Power PICC Solo[*]2 Catheters, Single, Double, and Triple Lumen; Valve Located in Catheter Hub
8-5. A, Injection Ports of the Triple-Lumen Catheter Include the Proximal Lumen Port, Distal Lumen Port, and Medial Lumen Port
8-6. Siterite Ultrasound System
8-7. Algorithm for a 'Stuck' Peripherally Inserted Central Catheter
8-8. Diagram of Subcutaneously Tunneled Catheter Placement
8-9. Subcutaneously Tunneled Catheter
General Overview of Central Vascular Access Devices
Glossary
Learning Objectives
Long-Term Central Vascular Access Devices
Nontunneled Central Vascular Access Devices and Peripherally Inserted Central Catheters
Procedures Display(s)
8-1. Central Vascular Access Device Dressing Change
8-2. Flushing a Central Venous Catheter
8-3. Blood Sampling from a Central Vascular Access Device (CVAD)
8-4. Discontinuation of a Short-Term Vascular Access Device (Nontunneled Catheter or Peripherally Inserted Central Catheter)
8-5. Accessing an Implanted Port
8-6. Deaccessing an Implanted Port
Table(s)
Thinking Critically: Case Study
9. Complications of Infusion Therapy: Peripheral and Central Vascular Access Devices
9. Complications of Infusion Therapy: Peripheral and Central Vascular Access Devices
Age-Related Considerations
Central Vascular Access Device Complications
Figure(s)
9-1. Hematoma
9-2. Phlebitis
9-3. Infiltration of Vancomycin into Subcutaneous Tissue, Causing Blistering of Skin
9-4. Infiltration
9-5. Infiltration and Swelling below the I.V. Site Occurring after Hands Were Placed Underneath the Patient during Turning
9-6. Fibrin Sleeve
9-7. Intraluminal Occlusion
9-8. Portal Reservoir Occlusion
Glossary
Learning Objectives
Local Complications
Systemic Complications
Table(s)
9-1. Types of Phlebitis
9-2. Factors Increasing Risk for Phlebitis
9-3. Phlebitis Scale
9-4. Infiltration Scale
9-5. Factors That Increase Risk for Extravasation Injury
9-6. Local and Systemic Complications of Peripheral Intravenous Therapy
9-7. Central Venous Catheter Bloodstream Infection Prevention
9-8. Summary of Complications of Central Venous Access
Thinking Critically: Case Study
10. Infusion Medication Safety, Methods, and Routes
10. Infusion Medication Safety, Methods, and Routes
Age-Related Considerations
Drug Stability and Compatibility
Figure(s)
10-1. Methods of Delivery of Secondary Infusions
10-10. EZ-IO[®] Drill and Products
10-11. EZ-IO Steps
10-12. Ommaya Reservoir
10-13. A. Cross Sectional View of the Spinal Cord
10-14. Methods of Epidural Administration
10-15. Epidural Site Covered with Sorbaview[®] Shield Transparent Dressing
10-2. Administration of Medication Via a Volume-Controlled Chamber
10-3. Ambulatory PCA Pump: Painsmart Iod (Information on Demand)
10-4. Clearview⢠Ms: Multiple Site Subcutaneous Delivery Set
10-5. Aqua-C⢠Hydration Set for Hypodermoclysis and Clearview⢠Sub-Q
10-6. Aqua-C Subcutaneous Device with Two Needles; Used for Hypodermoclysis
10-7. Intraperitoneal Port Placement
10-8. Anatomy of a Long Bone
10-9. Sites for Intraosseous Infusions
Glossary
Infusion Medication Delivery
Intravenous Medication Administration
Learning Objectives
Other Infusion Medication Routes
Principles of Intravenous Medication Administration
Procedures Display(s)
Safe Delivery of Infusion Therapy
Table(s)
10-1. Advantages and Disadvantages of Intravenous Medication Administration
10-2. Patient Risk Factors for Oversedation and Respiratory Depression with Patient-Controlled Analgesia
10-3. Epidural and Intrathecal Medications
10-4. Monitoring Parameters for the Patient Receiving an Intraspinal Infusion
10-5. Eight Rights of Medication Administration
Thinking Critically: Case Study
11. Transfusion Therapy
11. Transfusion Therapy
Administration of Blood Components
Administration of Blood Components
Complications Associated with Blood Component Therapy
Step 1: Recipient Consent
Step 2: Verifying the Authorized Prescriber's Order
Step 3: Pretransfusion
Step 4: Vascular Access; Selecting and Preparing the Equipment
Step 5: Preparing the Patient
Step 6: Dispensing and Transportation of the Component
Step 7: Initiating the Transfusion
Step 8: Monitoring the Transfusion
Step 9: Completing the Transfusion
Age-Related Considerations
Alternatives to Blood Transfusions
Basic Immunohematology
Blood Component Therapy
Blood Donor Collection Methods
Blood Management
Figure(s)
Glossary
Learning Objectives
Procedures Display(s)
Table(s)
11-1. ABO Blood Grouping Chart
11-2. ABO Compatibilities for Red Blood Cell Components
11-3. ABO Compatibility for Fresh Frozen Plasma
11-4. Blood Types by Population
11-5. Blood Conservation Methods
11-6. Summary of Common Blood Components
11-7. Steps in the Administration of a Blood Component
11-8. Risks of Transfusion Therapy
11-9. Summary of Transfusion Reactions
Thinking Critically: Case Study
12. Parenteral Nutrition
12. Parenteral Nutrition
Age-Related Considerations
Complications Associated with Parenteral Nutrition
Concepts of Nutrition
Delivery of Nutritional Support
Figure(s)
12-1. Example of Fat Emulsion (Intralipid 30%)
12-2. Automated Method of Compounding Parenteral Nutrition
12-3. Body Protein Depletion
12-4. Routes to Deliver Nutritional Support to Adults
12-5. Multichamber PN Solution Container
12-6. Lipopor⢠TNA Filter Set for Total Nutrient Admixture Administration with 1.2 Micron Air- and Particle-Eliminating Filter
Glossary
Learning Objectives
Nutritional Requirements/Parenteral Formulations: Adults
Nutritional Screening
Nutritional Support
Parenteral Nutrition Administration
Table(s)
Thinking Critically: Case Study
Front Matter
