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IV Recert for the LPN Fall 2017

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by

Rebecca Cockrell

on 5 December 2017

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Transcript of IV Recert for the LPN Fall 2017

Who determines what you can and cannot do?


LEGAL Review
IV Recert for the LPN Fall 2017
NATIONAL PATIENT SAFETY GOALS
Joint Commission
Health Insurance Portability and Accountability Act

Federal law passed in 2003

Protects the privacy and confidentiality of patient information

Requires the patient’s permission to discuss health-care issues with a third party

HIPAA
Federal agency with the mission to prevent and control:

Infectious and chronic diseases, including infections related to IV therapy
Injuries
Workplace hazards
Disabilities
Environmental threats

Centers for Disease Control
Let's first review some basic MATH!!


Basic Pharmacology
Pharmacology Review

BODY SYSTEMS ASSESSMENT IS KEY
Neurologic
Cardiovascular
Respiratory
Integumentary
Special senses
Body weight

Fluids and Electrolyte Balance r/t IV Therapy
IV Fluids
Guidelines for care of patients with an IV

Close patient room doors when providing care or discussing health issues
Do not talk about patients in public places
Turn computer screens so passers-by cannot see patient information
Log off computer when you finish charting
Do not leave patient medical records open for unauthorized viewing
OSHA: Occupational Safety and Health Administration
Division of the Department of Labor

Mission – to assure the safety and health of workers by:
Setting and enforcing standards
Providing training, outreach, and education
Establishing partnerships
Encouraging continual improvement in workplace safety and health
Established universal and standard precautions and the blood-borne pathogen standard

Needle stick Safety and Prevention Act
Became law in 2001 through the combined efforts of NIOSH and OSHA

Mandates the use of safety devices shown to be effective in the reduction of needle stick injuries in the clinical setting

Authorizes OSHA to impose monetary fines on health-care facilities not using safe-needle devices


1) How many contact hours are required each renewal year by the IV certified LPN?
2) If the LPN graduates IV certified during a license renewal year, will they be required to complete the required amount of contact hours?
3) How does the LPN provide evidence of completion of contact hours?
4) What happens to the IV certified LPN if contact hours are not completed and submitted?
5)May a LPN be certified in hemodialysis?
6) May the LPN not certified in IV therapy perform phlebotomy for the purposes of initiating an IV?
7) May the IV certified LPN program a PCA pump?
8) What are the 2017 National Patient Safety Goals that relate to IV therapy?
9) Who determines the National Patient Safety Goals? How often is this updated?
10) List four “Do Not Use” abbreviations with rationale.

https://www.jointcommission.org/facts_about_do_not_use_list/
MALPRACTICE
It must be established that the nurse had a duty to the patient.
A breach of care or failure to carry out that duty must be proven.
Can include omission of care (failure to assess or provide an intervention) or commission or care (administering an IV med through a catheter despite pt c/o pain. The nurse violages the duty of care by not adhering to an appropriate standard of care.
The patient must suffer actual harm or injury.
There must be a causal relationship between the breach of duty and the injury suffered.
The injury is a result of negligence on the part of the nurse. It must be proved that if the nurse had not been negligent, it is more likely than not that the patient would not have suffered harm.
Tips to reduce risk for Malpractice
Maintain clinical competency
Assess and monitor
Prevent infections
Use equipment properly
Protect patient from harm
Neurologic
Advancing age
Changes in orientation — FVD
Fluid volume changes affect the CNS cells

Cardiovascular

Deficit: increased pulse rate, decreased blood pressure, narrow pulse pressure, slow hand filling, decreased pulse volume
Excess: bounding pulse, increased pulse rate, jugular vein distention, overdistended hand veins

Respiratory
Deficit: lungs clear
Excess: moist crackles, respiratory rate >20, dyspnea, pulmonary edema

Integumentary: skin
Deficit: decreased turgor, decreased skin temperature
Excess: warm, moist skin; fingerprinting over sternum

Special senses

Deficit: dry conjunctiva, sunken eyes, decreasing tearing, sticky mucous membranes, dry cracked lips, extra longitudinal furrows
Excess: periorbital edema

Body weight

Deficit: mild <5%, moderate: 5 – 10%,
severe: >15%
Excess: mild 5%, moderate: 5 – 10%,
severe: >15%

The following four cations are the most commonly administered via parenteral infusions
Sodium — Na+
Potassium — K+
Calcium — Ca+
Magnesium — Mg++
Sodium (Na+) 135 to 145 mEq/L

Regulation of fluid distribution in the body
Maintains body fluid osmolarity
Promotion of neuromuscular response
Regulation of acid-base balance

Potassium (K+) 3.5 - 5.0 mEq/L

Regulation of fluid volume within the cell
Promotion of nerve impulse transmission
Contraction of skeletal, smooth, and cardiac muscle
Control of H+ ion
Role of enzyme action for cellular energy


Calcium 8.5 - 10.5 mg/dL

Maintaining skeletal elements
Regulating neuromuscular activity
Influencing enzyme activity
Converting prothrombin to thrombin
Magnesium 1.5 - 2.5 mEq

Enzyme action
Regulation of neuromuscular activity
Regulation of electrolyte balance
Full transcript