iv fluids 2006 website

8/9/2019 IV Fluids 2006 Website

http://slidepdf.com/reader/full/iv-fluids-2006-website 1/40

IV Fluids

Nur 105 Adult Health



Learning Objectives

Identify sources of law.

Define Legal Terms

Describe the difference betweenstandards of practice and standards of

care.



Sources of Law

Constitution Law

Statues Law

Administrative Law

Common Law



Legal Terms

Criminal

Civil ± Tort

Intentional/unintentional

Negligent and Malpractice



Factors to Reduce Risks

Risk Management Informed consent

Unusual Occurrence Report (IncidentReport)

Documentation



Nursing Competency in

IV Therapy Competency Standards

± Accountability

± Communication ± Collaboration

± Autonomy

Competency Model

± Cognitive, Psychomotor, Evaluation



Occupational Risks

Physical Hazards

± Needlestick injuries, abrasions and

contusions, chemical exposure, latex allergy

Biologic Hazards



Summary



Infection Control Meaures

Nur 105 Adult Health



Learning Objectives

Describe the purpose and components of the

immune systems.

Identify basic principles in infection control.

Define the six chains of infection.

Describe methods to break the chains of

infection.

Describe the causes for infusion-relatedinfections.

State measures to prevent and treat infections.



Immune System

The Body System that protects

the body from invasion of

pathogens.



The Immune Systems

Organs Primary

± Thymus and Bone Marrow

Secondary

± Lymph Nodes, Liver, Lungs

±S

pleen, Peyer¶s patches, appendix andTonsils and adenoids



Immune Systems

Defense Mechanisms Nonspecific Immune Responses

± Skin, mucous membranes, epiglottis,

respiratory tract, sphincters

± Tears, gastric acidity, vaginal secretions

± Lacrimation, intestinal peristalsis,urinary flow



Immune Systems

Defense Mechanisms Specific Immune Responses

± Active acquired and Passive acquired

±Leukocytes

± B and T Lymphocytes

± Immunglobulins

± Phagocytic cells

± Complement system



Immune Systems

Defense Mechanisms Impaired Host Resistence

± Primary immunodeficiency disorders

± Secondary immunodeficiency disorders



Principles of Infection Control

(Epideminology) Colonization

Dissemination

Nosocomial



Chains of Infection



Break the Chains of Infection

New Methods ± microbiology and epideminology

Survelience or Monitoring ± Quality

Improvement Programs and Risk Management

Pharmacology Treatment ± Stage 1

± Stage 2

Emporiatrics



IV Related Infections

Sources of Catheter-Related

Skin Organisms

Contamination of Catheter Hub

Contaminated Infusate

Contaminated Device (prior to insertion)

Hematogenous

Clinical Manifestations

± Cellulitis/Phlebitis ± warmth, swelling, erythema, pain,

discharge (serosanguineous or purulent)



IV Related Infections

Risk Factors

Host

Hematogenesis

Provider Catheter

Infusate Fluids



Treatment of Infections

Catheter ± Antibiotics

Infusate-Related

± Mechanism of contamination ± manufacturer

± during infusion

Duration and frequent interruption or manipulation

of access devices (ports)



Treatment of Infection

Prevention and Treatment Inspect All Infusates

± Before use check fluid for leaks, expiration dates, color,consistency

Preparation

Aseptic Techniques Periodic Replacement of

Administration Set

Monitor adjunct devices

Assess for infections

Obtain cultures

CDC Precauations ± Universal

± Transmission-Based Airborne

Droplet

Contact Hand Hygiene

Skin Antiseptics

Catheter site dressings

Sutures or sutureless

Topical Antimicrobial

ointments Antimicrobial catheters/cuffs

Anticoagulants and antibioticlocks



Summary



ParenteralS

olutions

Chapter 5



Purposes of IV Therapy

Maintenance

Replacement

Restoration



Components of

Parenteral Solutions

Water

Glucose

Amino Acids

Vitamins

Electrolytes

PH



Osmolarity of


Isotonic

Hypotonic

Hypertonic



Types of


Crystalloid ± Dextrose

± Sodium Chloride

± Dextrose with SodiumChloride

± Hydrating solutions

± Electrolytes Fluids

± Ringer¶s/LactatedRingers

± Alkalizing/Acidifying

± Potassium Chloride

Colloid ± Dextran

± Albumin

± Mannitol ± Hetastarch



Nursing Role

Check MD order

Check IV fluid three

times ± 5 R¶S

Check IV fluid for

± Color,

± Consistency,

± Expiration date, ± Leaks

Monitor IV Fluids

every hour

± Check IV site

No ³catch ups´

Check compatibility

Use aseptic technique



Summary



Parenteral Equipment



Infusion Container

Glass

Plastic

Use-Activated Containers



Basic Administration Sets

Single line or Y sets

Spike/piercing pin

Flange

Drop orifice

Drop chamber

Tubing

Roller Clamp

Injection ports

Backcheck valve

Hub

Final filter

Primary/Secondary



Administration Sets

Primary Y

Pump Specific Administration set

Lipid Administration

Nitroglycerin



IV Accessory Devices

Filters

± Different sizes (170 micorns to 0.22)

± Different locations( inline)

± Different types ( depth, membrane , bloodadministration)

± Follow agency policy and procedures

Extension tubing Adapters and Connectors (used atinjection site)



Accessory Devices

Stopcocks

Needleless System



Peripheral Infusion Devices

Scalp vein needles (butterfly); shorttherapy

Over-the-Needle Catheter ± most

commonly used; 14-22 gauge ± Thin wall, flashback chamber, wings, color

coding for sizes

DualLumen Through ±the-Needle Catheter

Midline Catheter



Infusion Regulation Devices

Mechanical Gravity Devices ± Dial ± A- Flow

Electronic Infusion Devices ± Controller

± Positive-Pressure Infusion Pumps

± Volumetric Pumps

± Peristalic Pumps

± Syringe Pumps/PCA

± Ambulatory Pump

± Multi/Dual ±Channel Pumps



Summary

iv fluids 2006 website

Documents