Question | Answer |
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 |