Medical-Surgical Nursing: An Integrated Approach, 2E Chapter 11 IV Therapy

Administration of fluids, electrolytes, nutrients or medications by the venous route.

Parenteral Fluids Hypotonic Fluids – lowers the osmotic pressure and causes fluid to move into cells Isotonic Fluids – increases extracellular fluid volume Hypertonic Fluids – increases osmotic pressure, drawing fluid from cells

Equipment Needed IV Filters – remove particulate matter from solutions Needles & Catheters – provide access to venous system Peripheral IV & Heparin locks – establish a nenous route in those clients whose condition may change rapidly Vascular Access Devices – allow long-term IV therapy

Preparing a Solution Review agency policies Verify the expiration dates

Initiating IV Therapy Use the shortest needle and smallest gauge Consider the client’s age, health and skin condition In general, begin with the hand and move up the arm

Locating a Vein Place a tourniquet on patient’s arm Palpate for vein with index and middle finger of non-dominate hand

Placing the Needle Prepare selected site according to institution standards Hold the needle at a degree angle

Administering Flow-Rate Flow Rate must be calculated Period of administration may vary

Calculating Flow Rate Total Volume = mL/hour infusion rate Hours of Infusion For example: 1000 mL = 125 mL/hour infusion rate 8 Hours

Managing IV Therapy IV Therapy requires constant monitoring Concerns may be: Hypervolemia (increased fluid volume) Infiltration (seepage of foreign substances) Phlebitis

IV Drug Therapy The IV route is used when a rapid effect is desired An immediate impact may be realized

Methods of IV Drug Therapy Intravenous fluid container Volume-control administration set Intermittent infusion by piggyback or partial fill IV push or bolus

Blood Transfusions Designed to replace blood loss with whole blood or blood components Used to restore blood volume after severe hemorage

Whole Blood Contains red blood cells (RBCs) and plasma

Administering Blood Follow institution guidelines Verify consent form Watch for reactions: Allergic Febrile Hemolytic