Nursing Care of Patients Receiving IV Therapy Chapter 7 Nursing Care of Patients Receiving IV Therapy

Intravenous (IV) Therapy The Administration of Fluids or Medication Via a Needle or Catheter (Cannula) Directly Into the Bloodstream

Indications for IV Therapy Hydration Electrolyte Replacement Nutrition (PPN or TPN) Medication Administration Blood Product Transfusions

Types of Infusions Continuous Intermittent Direct Injection/IVP Piggy Back Injection Caps Direct Injection/IVP

Methods of Infusion Gravity Drip Electronic Infusion Devices (EIDs) Mechanical Controllers

Factors Affecting Flow Change in Catheter Position Height of Solution Patency of Catheter

Calculation Practice You need to administer 1,000 mL of 0.9% sodium chloride over 6 hours. You have tubing with a drop factor of 10. How many drops per minute will you deliver?

Calculate Drip Rate 1,000 mL 1 hour 10 gtt = 28 gtts 6 hours 60 minutes 1 mL min

Types of Fluids Dextrose Solutions Sodium Chloride Solutions Balanced Electrolyte Solutions

Osmolarity of IV Solutions Isotonic e.g., 0.9% Sodium Chloride Hypotonic e.g., 0.45% Sodium Chloride Hypertonic e.g., Dextrose 5% in 0.9% Sodium Chloride

Access Peripheral Central

Starting a Peripheral Line

Nursing Care Fear Impaired Physical Mobility Risk for Infection

Gerontological Issues Monitor for Fluid Overload Elevated Blood Pressure Increasing Weight Bounding Pulse Shallow, Rapid Respirations Jugular Venous Distention (JVD) Increased Urine Output Crackles

Local Complications Hematoma Thrombosis Phlebitis Infiltration/Extravasation Local Infection Venous Spasm

Systemic Complications Septicemia Circulatory Overload Venous Air Embolism Speed

Central Venous Catheters Types Non-tunneled Central Catheter Tunneled Catheter Picc Ports Rationale for Use

Central Venous Catheters (cont’d) Please refer to figure 6.8C, page 88. Tunneled catheter.

Nutritional Support Rationale Contents For Patients Unable to Eat or Tolerate Tube Feedings Contents Carbohydrates (CHOs) Amino acids Electrolytes Trace Elements Vitamins Lipids

Nursing Care of Patients Receiving TPN Initial and Ongoing Assessment Monitor Blood Glucose Monitor Signs and Symptoms of Infection Initiate and Discontinue Slowly

Home IV Therapy Fluid Replacement Treatment of Infection Nutritional Support