Presentation on theme: "Intravenous Therapy IV Infusion Preparations Fluid and Electrolytes"— Presentation transcript:
1Intravenous Therapy IV Infusion Preparations Fluid and Electrolytes Sasha A. Rarang, RN, MSN
2Intravenous (IV)Therapy : Definition: Infusion of a fluid into a veinto prevent or treat fluid &/or electrolyte imbalance(s)to deliver medicationsto deliver blood productsVENIPUNCTURE: technique of accessing a vein via insertion of a needle or cathetersterile procedure because skin integrity is broken
3Purposes of Infusion Therapy: Provide fluids when PO intake not possiblereplace fluids/lytesMaintain normal electrolyte balancesProvide glucose as energy sourceProvide access for administration of medsAdminister blood productsEmergency accessMaintain urine output
4Distribution of Body Fluids & Electrolytes: Typical adult % body weight consists of fluid (water & lytes)varies with body fat content, age, sexex. fat cells contain little water; lean tissue is rich with waterex. infants have a high body fluid content (approx % of body weight)
5Fluid Distribution: INTRACELLULAR (ICF) EXTRACELLULAR (ECF) within the cellsapprox 2/3 of total fluid found within ICFEXTRACELLULAR (ECF)outside the cellsapprox 1/3 of total fluid found within ECFECF: 2 compartmentsIntravascular Within a vessel; PlasmaInterstitial/Extravascular Between & around the cells; Tissue Fluid
6Electrolytes:A substance that develops an electrical charge when dissolved in waterElectrolyte content of ICF is different from ECFMajor electrolytes in ICF: Potassium; Phosphate; MagnesiumMajor electrolytes in ECF: Sodium; Chloride; Bicarbonate; Calcium
7Movement of Fluids: Normal mvmt of fluids through capillary walls depends on 2 forces Hydrostatic Pressure - pressure exerted by the heart; pressure of blood volume in vesselsOncotic Pressure - pressure exerted by plasma proteins such as albuminWater is pulled toward higher oncotic pressure
8Movement of Fluids:When solutions are separated by a membrane impermeable to dissolved substances, a shift of water occurs through the membrane from an area of low solute concentration to higher solute concentrationMagnitude of this force dependent on the number of particles dissolvedOSMOLALITY: number of dissolved particlesTONICITY; OSMOLARITYamt of solutes (ex sugar, Na+, protein) in a liter of solution
9Intravenous Infusion Preparations Osmolality – osmotic pull or pressure exerted by all particles by unit of water( expressed in milliosmoles per kilogram)Osmolarity- is the osmotic pull by all particles per unit of solution. Unit of osmotic pressure – osmole ( Osm) and the milliosmole is mOsm is 1/1000th of an osmole. Osmotic cpressure determines osmotic activity.Osmotic pressure determines osmotic activity.
10OsmolalityInfluience by the quantity of dissolved particles that exerts an osmotic pull in the intracellular and extracelluar fluids.Primary solutes – serum sodium, urea, and glucose.Plasma (intravascular compartment ) contains protein and slightly higher osmolality than fluid in other areas.25% concentration only that found in the ICF.Interstitial fluid has little to no protein.It is the responsibuility of the nurse to knowwherther a prescribed infusate is hypertonic, hypotonic, or isotonic.
11Osmolality: The more solute present; the higher the osmolality ISOTONIC solutions have the same osmolality as body fluidsHYPOTONIC solutions have a lower osmolality as body fluidsHYPERTONIC solutions have a higher osmolality as body fluids
12Isotonic Solutions: same osmotic pressure as that found in the cell Will not alter intracellular fluid compartmentsex. Normal Saline (NS): used to expand ECF compartmentsex. Lactate Ringers (LR): similar to plasma content (Na, K, Ca, Cl, Lactate); used to correct ECF deficits
13Hypotonic Solutions: less osmotic pressure as that found in the cell have lower osmolality than body fluids within the cell (ICF)cause fluids to shift out of the vasculature (ECF) & into the cells (ICF)used to provide water, cellular hydrationex. 0.45% NS (“half Normal Saline”)ex. D5W (“5% dextrose water”)
14Hypertonic Solutions: greater osmotic pressure as that found in the cell HIGHER osmolality than body fluidscauses fluids to shift out of the cells (ICF) into the vascular spacerapid shift fr ICF into the ECF/ vascular bedsgiven to treat specific problemscan potentially have serious side effectsex. CHF, PE, overloadex. Hypertonic saline (3% or 5% NS)ex. TPNex. 50% dextrose
15Classification of Infusates CrystalloidColloidsHydrating SolutionElectrolyte SolutionDextrose Solution
16Crystalloids Materials that are capable of crystallization. Solution that when place on solvent , homogeneously mixed with and dissolved into a solution and cannot be distinguished from the resultant solution.Can be isotonic, hypertonic, or hypotonic.
17Hydrating Solution Provide free water for maintenance or hydration. When used chemical make-up or rate of administration is adjuted so the equilibria of fluids are not disturbed.E.g. glucose solution are most often used.Dextrose 21/2 % in 0.45 % salineDextrose 5% in waterDextrose 5% in 0.45 salineSodium Chloride 0.45%Dextrose 5% in 0.2% saline.
18Electrolyte SolutionSubstance capable of ionization such as sodium chloride
19Dextrose solutionsAre frequently used as infusates, are manufactured as percentage solutions expressed the numberof grams per 100 g of solvent,.A 5% dextrose in water (D5W) infusions contains 5 g of dextrose in 100 ml of water 1 ml of water equals 1 gr.
20ColloidsAre glutinous substances whose particles, when submerge into a solvent, cannot form a true solution because their molecules when thoroughly dispersed no not dissolve, but remained uniformly suspended and distributed throughout the fluid.Can raise osmotic pressure.Plasma or volume expander.E.g. dextran, plamanate, and artificial blood substitute, hetastarch.
21Indications for IV Therapy Fluid Volume maintenanceFluid Volume replacementMedication AdministrationBlood and Blood Producct Donation and administrationNutritional support.
22Equipment and Supplies Infusate container – glassPlastic – flexibleSemiregidInfusate administration containerDrop factorPrimary administration setSecondary administration setVolume control administration setBlood and Blood product administration setAccessory Devices for use with administration setNeedleless Systems and Needlestick Safety System