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IV Therapy NCTC
| Question | Answer |
|---|---|
| Crystalloid Solutions | dissolved crystals NaCl C6H12O6 |
| IV order includes: | a. Date & time of order b. Type, amt of solution c. Any additives d. Rate of infusion e. Duration of infusion f. Dr’s signature |
| a. Isotonic-osmolarity is equal to blood/serum | i. Expands intravascular compartment only ii. Safest iii. LR, NS, D5 |
| Hypotonic-osmolarity lower than blood | i. Shifts F&E out of intravascular compartment, hydrating intracellular & interstitial compartments ii. ½ NS, 33% NS, D2.5% |
| c. Hypertonic-osmolarity higher than blood | i. Draws F&E into intravascular compartments from intracellular & interstitial compartments D5 in 1/2NS (D51/2), D5 in NS (D5NS), D5 in LR(D5LR) |
| 14,16,18 Gauge used for: | trauma, surgery, blood |
| 20 Gauge used for: | blood, IVF, IVPB or IVP meds; most common |
| 22 Gauge used for: | elderly, children, infants |
| 24, 26 Gauge used for: | neonates, infants, very fragile, small veins |
| IV pumps positive | a. Maintain preset flow rate b. Allows: infusion of viscous solutions, infusions into small gauge IV’s c. May adm IVPB per pump d. Regulates IV rate easily e. Reduces risk of overload f. Alarms if IV empty, air in line |
| IV Pumps Negative | Increases risk of undetected infiltration |
| Assess site | beginning of shift, then at least q 2 hours |
| Pt teaching | a. Why IV therapy is needed & how long if known b. Describe procedure in detail: transient pain, IVF cold, call for burning, swelling, pain, alarm on pump. Teach: IV easy to remove, no long term issues. |
| Uses of IV therapy | a. F&E balance-so interdependent that any change in 1 results in change in the other b. Drugs/meds-may be given IVP or IVPB or continuously c. Transfusions- to replace blood & O2 carrying capacity, prevent shock, restore or maintain homeostasis/ |
| Advantages of PIV | a. easy access to veins b. allows rapid administration of solutions, blood, drugs c. produces rapid systemic changes d. easy to assess site |
| Disadvantages of PIV | a. Risk of infection, bleeding b. Some IV meds administered rapidly can have irreversible adverse effects c. may be used only temporarily-up to 4 weeks d. cost more than PO, SQ or IM meds |
| PIV site selection | a. Consider: vein location, condition, purpose of infusion, duration, cooperation of pt, pt preference b. Usually non-dominant hand c. Avoid areas of edema, redness, etc d. Start distal and move proximal to previous sites/attempts |
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