Infusion Therapy & Solutions Flashcards

Per ASPEN and INS guidance, what is the maximum osmolarity generally considered acceptable for parenteral nutrition infused through a peripheral catheter?

Answer: 900 mOsm/L

Peripheral parenteral nutrition is generally limited to 900 mOsm/L or less to reduce the risk of phlebitis and vein damage.

How is 0.45% sodium chloride classified by tonicity?

Answer: Hypotonic

0.45% NaCl (about 154 mOsm/L) has lower osmolarity than plasma, so it is hypotonic and moves fluid into cells.

A patient reports burning at a peripheral site during a vesicant infusion, and you suspect extravasation. What is the FIRST action?

Answer: Stop the infusion, disconnect the tubing, and aspirate residual drug from the catheter

Stop the infusion and aspirate residual vesicant through the catheter before removing it; never flush, because that pushes more drug into the tissue.

Which agent is indicated for extravasation of an anthracycline such as doxorubicin?

Answer: Dexrazoxane

IV dexrazoxane, started within 6 hours, is the approved treatment for anthracycline extravasation, along with cold compresses.

Norepinephrine has infiltrated the tissue around a peripheral IV and the site looks blanched. Which antidote is typically injected subcutaneously around the site?

Answer: Phentolamine

Phentolamine, an alpha-adrenergic blocker, reverses vasopressor-induced vasoconstriction and limits tissue ischemia.

What in-line filter size is used when infusing a total nutrient admixture (3-in-1) that contains lipids?

Answer: 1.2 micron

Lipid droplets cannot pass a 0.2-micron filter, so lipid-containing admixtures need a 1.2-micron filter.

When intravenous fat emulsion is infused separately (not in a TNA), what is the maximum hang time?

Answer: 12 hours

INS recommends finishing lipid emulsion infused alone within 12 hours because lipids support bacterial growth.