IV administation Flashcards
Goal of IV therapy?
= goal of IV fluid administration is to correct or prevent fluid and electrolyte disturbances
• It allows for direct access to the vascular system, permitting the infusion of continuous fluids over a period of time
two types of intravenous solutions
= crystalloids and colloids
Crystalloids:
- Are divided based on tonicity into hypotonic, isotonic and hypertonic
Colloids:
- Are solutions that contain protein or starch
- The particles remain intact in the solution and are unable to pass through the capillary membrane
- They are used to re-establish circulating volume and oncotic pressure
Types of IV solutions
Isotonic solution = solution of the same osmolarity as blood plasma
e.g. 0.9% sodium chloride (normal saline)
Hypotonic solution = a solution of lower osmotic pressure - moves fluid into the cells
e.g. 0.45% sodium chloride (half normal saline)
Hypertonic solution - solution higher than osmotic pressure - pulls fluid from cells
e.g. 10% dextrose in water
Macro drop factor?
= 10, 15, 20 drops per ml
Micro drop factor?
= 60 drops per ml
Safety of IV
- Legal prescription
- 5 rights checked 3 times
- right pt
- right fluid
- right volume
- right route
- right time/duration
- checked by two nurses
Advantages of using IV?
- Immediate therapeutic effect
- Pain and irritation caused by some substances when given intramuscularly or subcutaneously are avoided
- Patient who cannot tolerate fluids or drugs by the gastrointestinal route or NBM
- Some drugs cannot be absorbed by another route
- Control over the rate of administration of drugs
disadvantages of using IV?
- Inability to recall thee drug and reverse the action of it
- Insufficient control of administration may lead to speed shock or circulatory overload
- Additional complications may occur
o Microbial contamination (extrinsic or intrinsic)
o Vascular irritation (e.g. chemical phlebitis)
o Drug incompatibilities and interactions if multiple additives prescribed - Altered body image especially with central vascular access devices
- Time taken for administration
Nurses responsibility with IV fluid?
- identify pt and legal order
- check infusion fluid for any faults or contamination
- maintain asepsis
- 5 rights
- right reason
- inspect the side of insertion and report abnormalities
- control the rate of flow
- monitor and document
Aseptic non-touch technique IV
- technique used to prevent contamination of key parts and key sites by microorganisms that could cause infection
factors affecting flow rates?
- Position of cannular
- Tubing obstruction
- Position of extremity
- IV patency
- IV clamps left on
Maintaining the system?
- assess every hour according to pt condition
- assess for signs of over/ dehydration
- intake/outtake
- check drip rate
Checking IV site?
- Observe for any leaking or bleeding
- Dressing dry and intact
- Skin temp normal
- No swelling or pain
- Discontinue if infiltration or phlebitis and elevate affected extremity
Troubleshooting IV
- vascular access device will not flush
- kink in tubing or cathether tip against vein wall
- vascular access device (VAD leaking when flushed
- patient complains of pain
Discontinuing IV
• Check order to discontinue
• Maintain asepsis
• Small occlusive dressing
• Observe for bleeding
• Document
o Fluid balance
chart
o Progress notes
