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Principle Concepts of 1. RN: Monitor, Set, Regulate PCP: Determine IV Fluid Pharmacy: Preparation Education: Use of Equipment 2.

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Presentation on theme: "Principle Concepts of 1. RN: Monitor, Set, Regulate PCP: Determine IV Fluid Pharmacy: Preparation Education: Use of Equipment 2."— Presentation transcript:

1 Principle Concepts of 1

2 RN: Monitor, Set, Regulate PCP: Determine IV Fluid Pharmacy: Preparation Education: Use of Equipment 2

3  Primary line  Larger  Continuous unless secondary is active  Secondary line  Smaller volume  “Piggy-back”  Must not be introduced in high-alert fluid lines! 3

4  Injection ports  If pump is used, above the pump  If no pump, close to IV insertion site  Secondary infusion bags are always placed higher than the primary solution bags 4

5  Used to monitor flow by observing drops  Squeeze chamber to fill half-full with fluid  Allows drops to be observed easily  Prevents air from entering system 5

6  Roller clamps allow adjustment of flow  Auxiliary clamps can stop flow temporarily without changing the rate set by the roller clamp 6

7  May be for needle- or needleless system  Allow for injection of medication into the line  Allow for attachment of secondary line  Never puncture a needleless system port with a needle! 7

8  Designed to limit needlestick injuries  Ease of disposal  Reduces potential bacteremia 8

9  IV fluids flow by gravity  Must be above patient’s heart level  3’ above the heart is the desired height  As the patient’s position changes, the IV bag height must be adjusted 9

10  At a minimum, every hour  After every position change  More frequently for pressors, antiarrhythmics, and other critical drugs and fluids 10

11  Infusion of medications  Intermittent  IVPBs hang higher than primary bag  Gives IVPB bag greater pressure  Causes IVPB to infuse first  IVPB set includes an extender to be used on the primary bag  When IVPB complete, primary bag will begin its flow automatically 11

12  Prepackaged  Mixed by Pharmacy  Mixed by RN on unit 12

13 13

14  Used for greater accuracy in measuring smaller volumes  100-150 ml  Measured in microdrops  Chamber filled from primary IV to desired amount  Medication injected into port  Desired rate set manually or through pump 14

15  Can deliver volumes too small to measure by drips (e.g., 0.1 ml per hour)  May be large volume (replacement fluids) or small volume (insulin, hormones)  May come with several safety features (flow alarms, air alarms, drug libraries)  Or, may flow even when infiltration occurs  Never turn off an IV alarm! 15

16 DEXTROSE: “D” May be in various percentages: D5, D10WATER: “W” Refers to sterile waterSALINE: “S” May be Normal Saline (NS or 0.9%), ½ NS or ¼ NS ELECTROLYTE SOLUTION: “LR” or “RL” or “RLS” Ringer’s lactate Lactated Ringer’s 16

17  Drops per mL (gtt/mL) required to calculate any flow rate  Will be identified on IV tubing packaging  “Microdrip” is always 60 gtt/mL 17

18  Ratio and proportion method  Dimensional analysis method  Formula and division method  Division factor method Any of these methods is helpful if you understand the principles behind it! 18

19  First find the mL per min by dividing the mL per hour by 60 (60 minutes in 1 hour): 125 mL ÷ 60 = 2 mL/ min  If we know we are to give 2 mL per minute, set up a proportion using the known drops per mL based on the type of tubing used (e.g., 10 gtt/mL) : 10 gtt = x gtt = 20 gtt/min 1 ml 2 mL 19

20  Must have rate in mL per hour  Your unknown is in gtt/min  Therefore, start with your drop factor to have gtts = gtts in your answer: gtt = 10 gtt min 1 mL  Add the “desired” mL per hour rate : gtt = 10 gtt x 125 mL min 1 mL 1 hr  Add neutral time value: 1 hr 60 min  Cancel repeating numerator/denominator values:  gtt = 10 gtt x 125 mL x 1 hr = 21 gtt/min 1 mL 1 hr 60 min 20

21  Useful only in small volumes  Must be completed in less than 60 minutes Flow rate = mL/hr Volume x set calibration Time (60 min or less) 125 mL x 10 gtt/mL = 21 gtt/min 60 min 21

22  Must have rate as mL/hr  Can similarly divide the mL per hour by the constant drip factor  Drip factor is obtained by dividing set calibration into 60: 60 ÷ 10 gtt/mL = 6 60 ÷ 15 gtt/mL = 4 60 ÷ 20 gtt/mL = 3 60 ÷ 60 gtt/mL = 1 22

23 1 125 mL x 10 gtt/mL = 21 gtt/min 60 min 6 …is the same as: 125 ÷ 6 = 21 gtt/min 23


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