MedicalSurgical Nursing An Integrated Approach 2 E Chapter

Medical-Surgical Nursing: An Integrated Approach, 2 E Chapter 11 IV Therapy

IV Therapy n Administration of fluids, electrolytes, nutrients or medications by the venous route.

Parenteral Fluids Hypotonic Fluids – lowers the osmotic pressure and causes fluid to move into cells n Isotonic Fluids – increases extracellular fluid volume n Hypertonic Fluids – increases osmotic pressure, drawing fluid from cells n

Equipment Needed n n IV Filters – remove particulate matter from solutions Needles & Catheters – provide access to venous system Peripheral IV & Heparin locks – establish a nenous route in those clients whose condition may change rapidly Vascular Access Devices – allow long-term IV therapy

Preparing a Solution Review agency policies n Verify the expiration dates n

Initiating IV Therapy Use the shortest needle and smallest gauge n Consider the client’s age, health and skin condition n In general, begin with the hand move up the arm n

Locating a Vein Place a tourniquet on patient’s arm n Palpate for vein with index and middle finger of non-dominate hand n

Placing the Needle Prepare selected site according to institution standards n Hold the needle at a 10 -30 degree angle n

Administering Flow-Rate Flow Rate must be calculated n Period of administration may vary n

Calculating Flow Rate Total Volume = m. L/hour infusion rate Hours of Infusion For example: 1000 m. L 8 Hours = 125 m. L/hour infusion rate

Managing IV Therapy requires constant monitoring n Concerns may be: n Hypervolemia (increased fluid volume) n Infiltration (seepage of foreign substances) n Phlebitis n

IV Drug Therapy The IV route is used when a rapid effect is desired n An immediate impact may be realized n

Methods of IV Drug Therapy Intravenous fluid container n Volume-control administration set n Intermittent infusion by piggyback or partial fill n IV push or bolus n

Blood Transfusions Designed to replace blood loss with whole blood or blood components n Used to restore blood volume after severe hemorage n

Whole Blood n Contains red blood cells (RBCs) and plasma

Administering Blood Follow institution guidelines n Verify consent form n Watch for reactions: n Allergic n Febrile n Hemolytic n