professor hill, rn,mn,msg. maintain daily fluid balance resore & maintain acid-base balance ...
DESCRIPTION
MAINTAIN DAILY FLUID BALANCE RESORE & MAINTAIN ACID-BASE BALANCE ROUTE FOR MED ADMINISTRATION ROUTE FOR BLOOD/BLOOD PRODUCT ADM NUTRITIONAL SUPPORTTRANSCRIPT
IV THERAPYPROFESSOR HILL, RN,MN,MSG
ANATOMY
MAINTAIN DAILY FLUID BALANCE RESORE & MAINTAIN ACID-BASE BALANCE
ROUTE FOR MED ADMINISTRATION ROUTE FOR BLOOD/BLOOD PRODUCT ADM
NUTRITIONAL SUPPORT
PURPOSE
Tunica Intima - inner layer
Tunica Media - middle layer
Tunica Adventia - outer layer
LAYERS OF THE VEIN
VALVES
INJECTIONS OF A SOLUTION/MEDICATION/ BLOOD OR BLOOD PRODUCT IN THE VENOUS SYSTEM
MOST RAPID & EFFECTIVE ROUTE OF MEDICATION ADMINISTRATION
BENEFITS: IMMEDIATE RESULTS
WHAT IS IV THERAPY?
ELDERLY POPULATION
Tunica Intima becomes thickens & less smooth
↑ed risk of platelet aggregation & thrombus formation
Lumen is smaller due to thickening
Slower perfusion Small spidery veins
ELDERLY POPULATION
YOU MUST KNOW:
FLOW RATE DROP FACTOR PRIMARY BAG PRIMARY LINE SECONDARY BAG SECONDARY LINE
TERMINOLOGY
IV FLOW
IV FACTORS (MUST KNOW)
FLOW RATE DROP FACTOR
THE NUMBER OF DROPS PER MINUTE (GTTS/MIN) DELIVERED.
# OF DROPS PER mL DETERMINED BY SIZE
OF LUMEN IN DRIP CHAMBER OF IV TUBING
MICRODRIP = 60 gtts/mL
BLOOD = 10 gtts/mL PRIMARY= 15 gtts/mL
SPIKE & DRIP FACTOR
IV BAGS
IV BAG
IV TUBING
IV CATHETERS
PROVIDES IV ACCESS INTERMITTENT INJECTION CAP
INFUSION OF SOLUTIONS/MEDICATIONS FLUSH WITH NORMAL SALINE
INFUSE MEDICATION FLUSH WITH NORMAL SALINE
SALINE/HEPARIN LOCK
A SET AMOUNT OF SOLUTION THROUGH AN INTERMITTENT INJECTION CAP
ENSURE PATENCY OF A DEVICE NOT IN CONTINUOUS USE
SOLUTIONS ARE TYPICALLY NORMAL SALINE (0.9%) OR HEPARIN SOLUTION
THAT IS 100 U/mL
FLUSH
IV PUMP
IV THERAPY THAT IS ADMINISTERED THROUGH A VEIN IN THE HAND, ARM, OR LESS FREQUENTLY THE LEG OR FOOT.
IDEAL FOR SHORT TERM USE.
PERPHERAL VENOUS CATHETER
- IV THERAPY ADM THROUGH A LARGE CENTRAL VEIN, R/L SUBCLAVIAN OR
JUGULAR USE FOR LARGE VOLUMES OF FLUID,
HYPERTONIC SOLUTION, MEDICATIONS, TPN
IDEAL FOR LONG TERM USE
CENTRAL VENOUS CATHETERS
INTERESTING???
INTRACELLULAR
INTERSTITIAL
INTRAVASCULAR
FLUID COMPARTMENTS
ISOTONIC SOLUTIONSEQUAL CONCENTRATION AS SERUM & OTHER BODY FLUIDS
SALINE/HEPARIN LOCK
HYPERTONIC SOLUTION
HYPOTONIC SOLUTIONS
IV SOLUTIONS
CRYSTALLOIDS COLLOIDS
ISOTONIC – NS, LR, D5W
HYPOTONIC – 0.45%NS, D51/2NS
HYPERTONIC -3%NS, D10W, D20W, TPN
BLOOD
BLOOD PRODUCTS
PLASMA EXPANDERS
IV SOLUTIONS
SOLUTIONS % IN SOLUTIONS
Body fluid compartments are affected depending upon the osmolarity of the IV solution in comparison to the patient’s serum osmolarity.
IV solution can actually expand one compartment while depleting another.
GRAMS OF DRUG PER 100 mL OF FLUID
E.G: D5w IS 5% DEXTROSE IN WATER
HYPERTONIC CONSIST OF NUTRIENTS GIVEN TO MALNOURISHED PTS UNABLE TO
EAT OR DRINK FOR LONG PERIODS OF TIME SHOULD BE INFUSED IN CENTRAL
CIRCULATION
OBSERVE FOR HYPERGLYCEMIA
TOTAL PARENTERAL NUTRITION(TPN)
COMPLICATIONS
INFILTRATION THROMBUS
LEAKAGE OF IV FLUID OR MEDICATION INTO THE EXTRACELLULAR TISSUE
COMMONLY CAUSED WHEN IV CATH SLIPS OUT OF THE VEIN
IV COMPLICATIONS
PHLEBITISTENDERNESS & PUFFINESS @ SITE
VEIN HARD WITH PALPATION
WARM @ SITE
INCREASED TEMP
REDNESS AT TIP & ALONG VEIN
SYSTEMIC COMPLICATIONS
PROBLEMS S/S
INFECTIONS - BACTREMIA, SEPTICEMIA
CIRCULATORY OVERLOAD
AIR EMBOLISM
FEVER, CHILLS MALAISE, CONTAMINATED IV SITE
SOB, RESP DISTRESS CRACKLES, ORTHOPNEA, INCREASED BP
SUDDEN CP, UNEQUAL BREATH SOUNDS, WEAK PULSE, TACHY,↓ BP,↓ LOC,↓
INTERVENTIONS
LOCAL SYSTEMIC
STOP INFUSION MAY APPLY HEAT IF
NOT CONTRAINDICATED
ELEVATE MONITOR RESITE & DOCUMENT
AIR –TRENDELENBURG POSITION & PLACE ON LEFT SIDE , ADM O2, CALL HELP
NOTIFY MD DOCUMENT OVERLOAD-PULSE OX,
↑HOB, O2, NOTIFLY MD, ADM MEDS AS ORDERED (LASIX)
PROFESSIONAL ORGANIZATION - SETS STANDARDS OF CARE FOR CLINICIANS PRACTICING IN THE FIELD OF INFUSION THERAPY
STANDARDS SET BY INS ARE RELECTED IN POLICIES & PORCEDURES RELATED TO INFUSION THERAPY
IN COURT OF LAW, THE STANDARDS SET BY INS ARE USED TO ASSESS CLINICIAN’S PERFORMANCE
INFUSION NURSES SOCIETYWWW.INS1.ORG
RESOURCES
QUESTIONS