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Intravenous Therapy & Medications

IV
by

Alyssa Zweifel

on 25 October 2017

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Transcript of Intravenous Therapy & Medications

Intravenous Therapy
& Medications
Advantages:
Immediate Effects
Fast-acting
Controlled blood levels
Emergencies
Client unable to ingest
No muscle mass
Uses:
NPO status
Fluid & electrolyte imbalances
Medications
Blood transfusions
Disadvantages:
Discomfort at IV site
Drug and Solution Incompatibility
Adverse Reactions
Infection
Complications
Overdose
Fluid overload
Cost
Types of fluids
Types of Isotonic Fluids and Uses
Normal Saline (0.9% sodium)
General fluid replacement
Blood transfusions
Hypercalcemia
Shock
Hyponatremia
Resuscitation
Types of Hypotonic Fluids and Uses
Half Normal Saline (0.45% sodium)
Water Replacement
Treats dehydration
Sodium and chloride depletion
Gastric fluid loss

Types of Hypertonic Solutions and Uses
Dextrose 5% in half-normal saline (D51/2)
Prevents hypoglycemia
Used in patients with DKA after initial treatment
Dextrose 5% in normal saline solution (D5NS)
Hypotonic dehydration
Circulatory insufficiency
3% sodium chloride solution
Severe hyponatremia
Dextrose 10% in normal saline solution (D10NS)
Conditions in which some nutrition with glucose is required
Lactated Ringer's solution
most physiologically adaptable
burn injuries
third space fluid shifts
Patient's requiring electrolyte replacement
Selecting a peripheral IV site
Risk of thrombophlebitis
Needle Size
The higher the gauge the smaller the needle
18 gauge (big)
24 gauge (small)
Complications
Infiltration
Signs & Symptoms:
Coolness
Pain, tenderness
Edema, swelling
Lack of blood return
Leaking
Stop the infusion
Remove IV catheter
Elevate extremity
Apply warm compresses
Document findings & action
Treatment
Use smallest possible catheter
Monitor IV site frequently (usually q 1 hr)
Anchor the IV
Have patient report pain or swelling
Prevention
Phlebitis
Signs
Pain
Redness
Swelling/edema
Induration
Red, streaking line
Sluggish or absent flow
Remove IV
Monitor VS
Monitor S&S infection
Apply Warm compress (controversial)
Notify MD
Treatment
Proper insertion techniques
IV's to upper extremities
Avoid joints or areas of flexion
Prevention
Extravasation
Signs
Leakage of fluid into tissues
Blistering
Necrosis
Burning at site
Skin tightness
Blanching
Lack of blood return
Inflammation
Pain
Stop the infusion and remove IV
Administer antidote if possible
Notify MD
Apply ice first
Warm soaks later
Elevate extremity
Assess circulation and nerve function
Treatment
Other Problems
Fluid overload
Allergic reactions
Speed Shock
Documentation
Date, time, signiture
Type, length, and guage of catheter
Site of insertion and appearance
Patient's response
Number of atempts
Type of dressing, and type/amount of fluid
Patient's tolerance and response to therapy.
Patient teaching and understanding.
5% dextrose (D5W) starts as *isotonic then turns to hypotonic due to the dextrose as sugar metabolizes it leaves water in your body and sends water into the cell.
Check fluid for expiration date
Change after 24 hours
Check for discoloration or sediments
Check patient identifiers
Check medication rights
Reminder:
Scrub the Skin site for 30 seconds
Scrub the tubing or injection hub for 15 seconds
IV Medications
IV Medications
IV Medication References
Find a reference your comfortable using and stick with it!
NICU & pediatrics, small doses with controlled delivery time.
Prime the tubing......
Label the tubing.....
Fluid leaks into surrounding tissue
IV vesicant leaks into surrounding tissues causing tissue damage, even death of cell tissue
Develops from injury to vein wall, from insertion or during therapy causing a thrombus to form
Inflammation of the vein
Embolus
Infection
IV Removal
Educate patient
Remove tape & dressing
Use cotton ball or 4x4 to hold pressure on insertion site
Check to make sure catheter is intake
Assess site for bleeding, bruising, swelling ect.
Document
When hanging IV fluids:
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