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Ward Class Powerpoint On Intravenous Fluids Infusion
Ward Class Powerpoint On Intravenous Fluids Infusion
It is useful in safely delivering vitamins and medications that can be quickly and efficiently absorbed into the body. Why the veins?
Veins are highly distensible, thin walled vessels. They act as a volume reservoir for circulatory systems. At any given time, the veins carry about fifty percent of the bodys blood volume. The veins transport blood back to the lungs and heart.
reasons why IV therapy can be more effective than administering vitamins and medications orally First, absorption into the blood stream is complete and bioavailability of the substances is immediate. Second, there is no "first pass" effect in the liver, thus the procedure lessens the workload on the liver.
Another thing to consider is that the absorptive capacity of the bowel may be decreased with age, and this along with a decrease in the natural production of hydrochloric acid and pancreatic enzymes can result in nutritional deficiencies because the body is no longer properly breaking down and absorbing nutrients from the foods we eat.
IV repletion leads to a rapid increase in nutrient levels in the blood, meaning that the nutrients are able to get into the cells as needed and increase cell metabolism.
Maintenance Solutions isotonic, usually contain water, a carbohydrate for basic caloric needs, and basic electrolytes
Ex: a. LR Na, K, Ca, Cl, and lactate in roughly same concentration as plasma b. D5LR
Replacement Solutions used to replace concurrent losses of water and electrolytes in normal amounts
Complications of IV therapy site 1. Phlebitis inflammation 2. pain, warmth, redness traveling along vein 3. Infiltration no longer in vein 4. Swelling, pallor, cool 5. Elevate extremity, apply warmth 6. Infection 7. Pain, erythema (redness), purulent drainage 8. Bleeding
Infection Control of IV Therapy IV bags change every 24 hours, 4hours for blood
Potential complications
pyogenic reaction first reaction, fever, chills hemolytic reaction STOP IMMEDIATELY ABO incompatibility severe flank back pain chest pain blood in urine increased HR and BP fullness in head within minutes allergic - rare itching hives STOP INFUSION potassium excess circulatory overload (particularly with frail elderly and people with cardiac and lung problems) serum hepatitis/HIV
PINK RED ORANGE GREEN DARK BLUE LIGHT BLUE YELLOW YELLOW GREEN VIOLET
D5 WATER
D5 NM PLAIN NORMAL SALINE SOLUTION PLAIN LACTATED RNGERS D5 0.3% NaCl D5 NSS D5 NR D5 IMB
IV CANNULA
Size (gauge) 14 16 17 18 20 22 24 CATHETER
COLOR
IV INSERTION
step 1. Finding a vein First you must select an area for venous cannulation. Apply a constricting band to the patients forearm proximal to the annicupital space (the crux of the elbow). This should cause the veins to engorge with blood and swell.
step 2. Select a catheter You must now prepare the equipment to cannulate the vein. You will need: 1-IV catheter 1-.9% NS flush 1-Saline lock or 1 bag of LR, .9% NS, or D5W/D25W 1-alcohol prep 1-2x2 bandage 1-sharps container tape to secure the IV to the skin
step 3. Clean the site and prepare the vein palpate the vein looking for any valves or pulsations (which would indicated that it is an artery). Run your finger along the length of the vein to determine how it runs, its length, etc. Open the alcohol prep and clean the area very well. step 4. Insert the IV catheter Pull the skin taunt behind the vein and insert the catheter slowly just under the skin MAKE SURE THE BEVEL OF THE NEEDLE IS UP. Also please remember that you must run the needle TOWARD the heart.
Advance the needle VERY VERY slightly then push the catheter over the needle to that it slides into the vein. If you encounter resistance, stop and remove the catheter. As you pull the needle out make sure to occlude the vein by pressing firmly down just distal to the end of the catheter. This will stop blood from flowing out of the vein. IMMEDIATLY and CAREFULLY waste the needle in an approved sharps container.
step 7. Check the line evaluate the line for patency. If the patient complains of burning pain or if tissue edema/swelling/redness etc is noted at the injection site, the IV has infiltrated and must be removed immediately. step 8. Secure the line and monitor Secure the line by tearing a piece of medical tape in half. Slide the half under the catheter and fold it in toward itself. This is called a "butterfly". Tape two or three more pieces of tape to secure the heplock etc to the arm PRN. ALWAYS check the line for patency as often as possible and before using it to give medications/fluid challenge.