3 Intravenous Solutions Normal serum osmolarity for adults are 270 to 300 mOsm/L:Parenteral solutions are isotonic within that range.Fluids greater than 300 mOsm/L are hypertonic.Fluids less than 270 mOsm/L are hypotonic.
4 Isotonic Infusate Water does not move into or out of the body’s cells. Patients receiving isotonic solutions are at risk for fluid overload, especially older adults.
5 Hypertonic InfusateUsed to correct fluid, electrolyte, and acid-base imbalances by moving water out of the body’s cells and into the bloodstream.Parenteral nutrition is an example of hypertonic infusions.
6 Hypotonic InfusateMove water into the cells and expand them.
7 Blood Transfusions and Other Components Packed red blood cellsPlateletsFresh frozen plasmaAlbuminSeveral specific clotting factors
8 Blood Transfusions and Other Components (Cont’d)
9 Administering IV Medications Medication safetyRapid therapeutic effectNever assume that IV administration is the same as giving that drug by other routesPrescribing infusion therapy
10 Vascular Access Device (VAD) Short peripheral catheters:Superficial veins of the hand and forearmDwell for 72 to 96 hours and then require removal and insertion into another venous siteComplaints of tingling, feeling of “pins and needles” in the extremity, or numbness during the venipuncture can indicate nerve puncture.
12 Midline CatheterCatheter that is 6 to 8 inches long, inserted through veins of the antecubital fossaUsed for therapies lasting from 1 to 4 weeksShould not be used for infusion of vesicant medications, which can cause tissue damage if they escape into the subcutaneous tissue (extravasation)
13 Peripherally Inserted Central Catheter (PICC) Length ranges from 40 to 65 cmChest x-ray to determine placementIndications
14 Peripherally Inserted Central Catheter (PICC) (Cont’d)
15 Nontunneled Percutaneous Central Catheter Inserted through subclavian vein in the upper chest or jugular veins in the neckUsually 15 to 20 cm longTip resides in the superior vena cavaPlacement confirmed by chest x-ray examinationNo recommendations for optimal dwell time
16 Tunneled Central Catheter A portion of the catheter lying in a subcutaneous tunnel separates the point at which the catheter enters the vein from where it exits the skin.Tunneled central catheter is used for infusion therapy that is frequent and long-term.
18 Implanted PortsImplanted ports consist of a portal body, a dense septum over a reservoir, and a catheter.A subcutaneous pocket is surgically created to house the port body.Port is usually placed in the upper chest or the upper extremity.Port needs to be flushed after each use and at least once a month between courses of therapy.
20 Dialysis CatheterLumens are very large to accommodate the hemodialysis procedure or a pheresis procedure that harvests specific blood cells.This catheter should not be used for administration of other fluids or medications, except in an emergency.