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Uses of IV therapy Restore or Maintain F&E Balance Administer Medication Administer Fluid to KVO Administer Blood Administer Intravenous Anesthetics Maintain or Correct Nutritional Status Administer Diagnostic Reagents Monitor Hemodynamic Functions
Body Fluid 60% of average adults weight is fluid. Proportion is lower in Women Older adults Obese ..Proportion higher in children
Extracellular outside cell Interstitial fluids Intravascular fluids Transcellular fluids
Solvent Solution which something (solute) is dissolved exp.-Water
Solute Number of grams of specific electolyte to be dissolved exp.- salt
Body Fluid Movement-4 Processes osmosis, diffusion, filtration, active transport
diffusion most solutes move this way, from higher to lower concerntration, NO energy required
filtration hydrostatic pressure
Active transport areas of lower to higher concentration REQUIRES energy
Osmosis Movement of pure solvent across semipermeable membrane from an area of lesser solute concentration to area of greater solute concentration
Osmosis is like...?? BOILING HOT DOGS!!!Concentration of molecules in hot dog is greater than in water. Water passes through hot dog skin Skin or (SM) ruptures when can hold no more water
osmolality Osmotic pressure of a solution ,Normal serum (blood) osmolality 275-295
Colloids fluids – thick suspensions such as blood and plasma
Crystalloids fluids nutrient and electrolyte solutions. Isotonic solution Hypertonic solution Hypotonic solution
Low osmolality fuild overload
Isotonic Fluids Has same osmolarity as blood plasma 310meq/L LR (Lactated Ringers) NS (Normal Saline) D5W (5% Dextrose in water)
Lactated ringers LR used in sugery. will stal in intravasclar compartments(AKA blood vessels) so BP will not drop
Hypertonic Fluids Higher osmotic pressure >375meq/L Pulls fluid from cell Cells shrink exp.-Blood products Albumin 9.0% normal saline
Hypotonic Fluids Lower osmotic pressure <250meq/L Moves fluid into cells Causes cells to enlarge D51/2NS
Primary fluid 1000ml or 1 L 500ml or 1/2L
Secondary fluid Or piggyback 50ml 100ml 125ml 150ml 200ml 250ml
Continuous Infusion Carefully regulated amount of fluid over a prolonged period of time
Intermittent Given for shorter periods at set intervals Antibiotics
Direct injection STRAIGHT into blood stream- IVP – single dose or bolus
Peripheral IV Catheter Most common Over the Needle Catheter Multiple gauges
Butterfly Catheters Small diameter Delivers small quantities of fluid Use in scalp veins in infants May lyse RBC’s
SMALL GAUGE Large vein = smaller gauge 20-16 gauge
LARGER GAUGE Small vein = larger gauge 24-22 gauge SMALLer diameter
Macrodrip tubing Use with fast infusion rates >100 ml/hr rates. Large drops 10, 12, 15, 20 gtts/ml
Microdrip tubing Used with slower infusion rates < 100 ml/hr. 60 gtts per ml
Digital Dorsal Vein fingers
Dorsal Metacarpal Vein top of hand
Dorsal Venous Network wrist
Cephalic Vein medial forearm
Basilic Vein lateral
forearm vein selection 1. Cephalic Vein 2. Median Cubital Vein 3. Accessory Cephalic Vein 4. Basilic Vein 5. Cephalic Vein 6. Median Antebrachial Vein
AVOID veins sites distal to previous puncture Hard, cord-like veins Infiltrated site Bruised area Areas of venous valves Bifurcation
WHAT needs a pump? Any solution through a central line TPN is always through central line Any medication that needs precise delivery Dopamine Blood Pitocin heparin Fluid infusing in small hourly volumes
WHAT clients need a pump? Renal patients Heart failure patients Pediatric patients Older adults Obstetrical patients
WHO comes first when pumps are limited? OB and ICU patients
IV Therapy Protocols Change IV bag every 24 hours Change IV dressing every 48 hours Change IV site every 72 hours Change IV tubing every 72 hours
INFILTRATION: Fluid infusing into subcutaneous tissue around venipuncture site Swelling Coolness Palor Pain
infiltration treatment? Stop infusion DC IV Notify Physician Elevate affected Extremity and cover with warm moist towel Resite IV in other arm
Phlebitis Inflammation of vein Risk factors Type of cannula material Chemical irritation of additives Drugs given intraveneously S/S Pain Edema Erythema Warmth Red streaks
PREVENT PHLEBITIS rotating sites per protocol.. At least every 72 hours exp for childeren
fluid volume overload Fluid Volume Overload Too rapid administration Signs and symptoms: Pulmonary crackles / edema Dyspnea Cough Frothy pink sputum Respiratory distress Elevated blood pressure Edema
Fluid volum over load TREATMENT Elevate HOB Slow IV fluid but do not remove IV Provide oxygen if needed Notify physician Restrict oral intake Sodium restriction Diuretics as ordered
Fluid Volume Deficit Fluid infusing too slowly Low BP Tachycardia Dry mucous membranes Decreased urinary output Cannula may cloe Increase rate of infusion
Air Embolism Air entering the venous system Immediate interventions: Turn to Left Side, Head Down Administer Oxygen Monitor Vital Signs Notify Physician
Allergic Reaction Stop Infusion S/S Notify Physician STAND BY WITH: Epinephrine Corticoisteroids Oxygen Mechanical ventilation
IVPB AKA piggyback Used for intermittent infusion when the medication must be given by IV, but requires a longer infusion time (typically 30-90 minutes) than IVP (1-5 minutes)
Hanging an IVPA Primary bag is always lower than secondary bag when hanging
tandem allows both fluids to infuse at the same time. Check drug compatibility
IVPB problems forgetting to open clamp, medication reaction, inflitration, phlebitis, imcompatibility(precipitation) pain, burning
When removing IV Ensure TIP is intact, and document
Created by: 1539360064