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IV Therapy

IV Therapy Indications, Complications

IV Therapy is used for: 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
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
Infliltration seepage of IV fluids into tissue when IV cath penetrates vein
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.
Phlebitis possible causes: IV left in too long, irritating fluids, clot at tip of cannula, cath too large for vein
Crystalloids clear fluids, dextrose or 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
Reasons to give an 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
Reasons to give a 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
Reasons to give a 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 stands for: 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
Reasons to give IV Nutritional Support bowel surgery, chronic weight loss, bowel rest, coma, excess nitrogen loss, hepatic or renal failure, malnutrition, low serum albumin, hypermetabolic states
Created by: troutbaron
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