Intravenous Therapy and Care Flashcards
Common sites of IVC
Peripheral:
- Inner arm
- Dorsal surface of hand
- Dorsal surface of feet
How often should cannulas be replaced
Replace cannulas and rotate sites every 48-72 hours (all sites should be dated)
Phlebitis
Inflammation of vein resulting from
- Chemical reaction of additives
- Position of cannula
- The vein is hard, red skin, swollen, tender and warm
- Action- to remove cannula
- Phlebitis is dangerous as it can lead to thrombophlebitis
- Replacing cannulas and rotating sites every 48-72 hours
Infiltration
- When IV fluids enter the subcutaneous space around the venipuncture site
- Arm is swollen, tender and cool to touch, no blood return
- The flow rate slows or stops
- Action- discontinue and remove cannula, wrap the extremity in a warm towel and elevate
- This promotes venous return, and reduces pain and edema
Indications for IV therapy
- Provide water, electrolytes and daily requirements
- Replace water and correct electrolyte imbalances
- Administer medication and blood products
- For nutritional purposes
- Allow life life for emergencies (i.e. trauma)
Commencing IV therapy
- IV fluids are medications, and require a doctor’s order
- The 6 rights of safe medication administration apply
- A fluid balance chart will be required to monitor input and output of fluids
- Sterile technique
- The IV insertion site must be regularly monitored for signs of infection/inflammation
- 2 RNs are required
Complications in IV
- Intravenous site
- Respiratory or cardiac alterations
Identifiable by;
- Looking at the patient
- Fluid balance chart
- Urine analysis
- Blood results
Types of Fluids
Crystalloids
Solutions that contain small molecules
- Classes into 3 subgroups (isotonic, hypotonic, hypertonic solutions)
Colloid
- Blood and blood products/components (plasma, platelets, RBC)
TPN
- Supplies liquid form of carbohydrates, proteins, lipids and micronutrients
Crystalloids
- Isotonic (ISO) means same (equal both sides)
- Hypotonic- Hypo means less (less solutes outside of cell) puts fluid into cell
- Hypertonic - Hyper means more (more solutes outside the cell) pulls fluid out of the cell
Why choose a Isotonic Solution
- ECF volume deficient- helpful with patients who are hypotensive or hypovolemic
- The solution is similar to the concentration of Na and Cl in the intravascular space
- Caution; risk of fluid overloading exists, therefore be careful in patients with left ventricular dysfunction, history of CHF or hypertension
Hypertonic and Hypotonic Solutions
- Used to correct electrolyte disturbances
- Ability to transfer fluids to both intracellular and extracellular compartments
- Monitoring these patients closely is essential
Assessing and Maintaining Fluid and Electrolyte Balance
- Fluid balance→ difference between the amount of water taken into the body and the amount excreted or lost
- 60% of body weight is water; distributed to extracellular and intracellular
What may affect the balances of each department?
Diet, illness or environment Dehydration Vomiting Diarrhoea Excessive water consumption IV therapy Medication
Fluid, electrolyte and acid-base balance
- Essential to maintain health and function in all body systems
- Body fluids and electrolytes play an important role in homeostasis
Healthy environment relies on
- Intake/output of water
- Electrolytes
- Regulation of renal and pulmonary system
Functions of body water
- Body fluids are in constant motion transporting nutrients, electrolytes and oxygen to cells and carrying away waste products from cells
- Water is essential in the regulation of body temp
- Lubricates joints and is a medium for food
- Cells in the body live in an environment with an electrolyte and acid base balance concentration maintained in narrow ranges
- Changes affect electrical activity of nerve and muscle cells and cause the movement of fluid into or out of cells
- Cellular functions are disrupted
- Fluid fluctuations also affect blood volume and cellular function
