IV Therapy

Description:	IV Therapy Indications, Complications
Category:	Nursing
Created by:	troutbaron on 2005-10-30

Term	Description
IV Therapy Indications	fluid volume maintenance, fluid volume replacement, med administration, blood administration, TPN, emergency line,
Advantages of IV Therapy	faster absorption, rapid distribution, emergency access, unconscious patient
Infection Control in IV	70% isopropyl alcohol inhibits bacterial growth, apply with friction; Iodine, inhibits bacterial growth, penetrates cell wall
IV and Dressing changes	PICC-every 6 weeks, IV inserted by paramedic w/in 24 hours, Peripheral site every 72 hours, Blood and TPN every 24 hours, CVC every 48-72 hours or 3xper week.
Nursing responsibilities for IV sites	assess site whenever in room, document at least every 8 hours, site CDI (clean, dry, intact), sterile technique, changine tubing and solution, awareness of complications, awareness of fluid types, 5 rights
Complications of IV therapy	Pain and irritation, infiltration and exravasion, occlusion, loss of patency, phlebitis, fluid overload
Pain and irritation of IV-intervention	increase amt of dilutent, arm board
Infliltration	seepage of IV fluids into tissue when IV cath penetrates vein
Extravasion	escape of irritating agent into tissue
Extravasion and Infiltration Assessment	swelling, pain, cool to touch, decreased flow, wet dressing, no back flow.
Causes of Infiltration and Extravasion	catheter permeates vein, poor taping of site, over manipulation
Intervention for Infiltration and Extravasion	Remove IV, cool compress
Occlusion causes	kinked tubing, patient lying on tubing, infusion too slow
Occlusion assessment	IV stops dripping
Occlusion intervention	milk IV, aspirate, irrigate (if no resistance OK, if resistance may be clot>
Occlusion Prevention	don't let IV run dry, flush periodically with 1-5 cc of NSS and before and after any intermittent IV therapy.
Phlebitis Causes	bacterial, chemical, mechanical
Phelebitis Intervention	remove IV, cool compress
Phlebitis Assessment	erythemia, pain or burning, warmth, edema, cordlike vein.
Bacterial Phlebitis possible cause	IV left in too long
Chemical Phlebitis Cause	irritating fluids
Mechanical Phlebitis	clot at tip of cannula, cath too large for vein.
Crystalloids	clear fluids, dextrose of saline, can be Iso, Hypo or Hyper tonic
Colloids	cloudy, yellowish, used to raise osmotic pressure, Dextran is clearish
Isotonic IV	same tonicity as body 0.9% NSS
Indications for Isotonic IV	Hypotension (increases BP), Hypovolemia
Complications of Isotonic IV	fluid overload
Examples of Isotonic Solutions	0,9% NSS, D5W(isotonic in bottle, hypotonic in body), Lactated Ringers
Indications for Hypotonic IV	Will cause fluid to shift from intravascular to intracellular space.
Indications for Hypotonic IV	dehydration
Hypotonic Solutions	.45% sodium chloride, 5%dextrose water (becomes hypotonic in body)
Complications of hypotonic solution	May cause edema
Indications for hypertonic IV	low bp, slight edema but not w/CHF, pulls fluid from intracellular space to intravascular space
Hypertonic IV Solution	Not as strong as Albumin, 10% Dextrose in Water D10W, 5% normal saline, D5 Ringers Lactate
Complications of Hypertonic IV	more fluid in bloodstream can cause circulatory overload.
PCA	Patient Controlled Analgesia
3 settings of PCA	drug dosage, lockout period, basal rate
Central Venous Therapy Indications	inadequate vascular access, complex treatment regimes, hyperosmolar infustions ie parenteral nutrition, irritating or vesicant druges, (ie. dopamine cancause necrosis) rapid absorption, long term therapy.
Contraindications for Central venous therapy	altered skin integrity, anomalies of central vasculature, cancer in area, coagulopathies, fractured clavicle, septicemia, radiation to insertion site
Common insertion pathways for Central Venous Therapy	subclavian, jugular, femoral vein, cephalic vein(is peripheral but the line runs to central area)
Risks and Complications of Central Venous Therapy	Air embolism, pneumothorax, sepsis,chest pain, confusion, hypotension, dyspnea, pallor, tachycardia, tachypnea, unresponsiveness
Components of Intravenous Nutritional Support	amino acids, carbohydrates, electrolytes, minerals, vitamins, lipids, other (ie insulin)
Lipids in Intravenous Nutritional Support	lipids are administered via Piggy back. (white, thin liquid)
Cautions for IV nutritional support	not refrigerated, observe for spoilage (fat on top, discoloration), expiration dateNo filter. , must be infused on IV pump, glucose monitored, gradual weaning. Daily weights,
Complications for IV nutritional support	hypoglycemia, hyperglycemia, dehydration, infection
Indications for IV Nutritional Support	bowel surgery, chronic weight loss, bowel rest, coma, excess nitrogen loss, hepatic or renal failure, malnutrition, low serum albumin, hypermetabolic states