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infusion or administration of fluid, medicines and nutrients through the vein
To restore and maintain fluid and electrolyte balance To administer medication To transfuse blood or blood components To deliver parenteral nutrition
Delivery Method: Peripheral IV Therapy
Administration of IV through the vein the lower and upper extremities
Central Venous Therapy
Administration of IV solution through central vein such as the right or left subclavian or the internal and external jugular vein.
Types of IV Solution Hypertonic Solution
has an osmolarity higher than that of serum. It draws fluid and electrolyte into the intravascular compartment form the intracellular and interstitial compartment.
25% dextrose in water .25% sodium chloride solution
33 % sodium chloride solution Isotonic Solution Has an osmolarity about equal to that of serum. It expands the intravascular compartment only. Examples: 5% dextrose in water .9% sodium chloride (D5. hydrating the intracellular and interstitial compartment. . It shifts fluid and electrolyte out of the intravascular compartment.9% sodium chloride Lactated Ringers solution Hypotonic Solution has an osmolarity lower than that of serum. Examples: 5% dextrose in .9 normal saline) 5% dextrose in lactated ringers solution (D5LRS) 10% dextrose in water (D10water) 50% dextrose in water (D50water) TYPES OF INFUSION SET Micro Infusion set Drop factor: 60 micro drops per minute Macro Infusion Set Drop factor: 15-20 drops per minute .
Administer the Right Drug. Find out if the patient has any drug allergies. 2. Take a complete patient History. Administer the right drug at the Right Time. Intravenous Push This is the intravenous administration of an undiluted drug directly into the systemic circulation. Administer the right drug by the Right Route. 5. 3. 9. Administer the Right Dose. 8. 7. . Administer the right drug to the Right Patient.COMPUTATION Formula: flow rate = Total Volume x drop factor # of Hours x 60 seconds Time = Total Volume x drop factor Flow rate 60 secs 10 Golden Rules FOR ADMINISTERING DRUG SAFELY 1. 10. 4. Documentation of each drug you administer. Be aware of potential drug-drug or drug-food interactions. 6. Teach your patient about the drugs he is receiving.
Major Disadvantages: . Before administering a bolus. Vein Selection . .The drug maybe irritating to the lining of the blood vessels. the nurse should look up for the maximum concentration recommended for the particular drug and the rate of administration.Any Error in administration cannot be corrected after the drug has entered the client. It can be introduced directly into a vein by venipuncture or into an existing IV line through an injection port or through an IV lock.
4. location. flow rate and drug to be incorporated if any) Observe for 10 R’s when preparing and administering IVF Explain procedure to reassure patient or SO. Accessory Cephalic vein 4. Basilic vein 5. Assess patient’s vein. Digital Dorsal veins Dorsal Metacarpal veins Dorsal venous network Cephalic vein Basilic vein 1. Prepare necessary materials for procedure. choose appropriate site. Median antebrachial vein ADMINISTRATION OF AN INTRAVENOUS INFUSION Check Physician’s order (verify for the type of solution. Median Cubital vein 3. secure consent if necessary. Cephalic vein 2. -IV tray with IV solution -IV cannula -Forceps soaked in antiseptic solution -Plaster -IV infusion set . 5.Veins of the Forearm Veins of the Hand 1. Perform hand washing before and after the procedure. Cephalic vein 6. 2. 3. size or condition.
Note: CDC Universal precaution: always wear gloves when doing any venipuncture. Open IV administration set aseptically and close the roller clamp and spike the infusate container aseptically Fill drip chamber to at least half and prime it with IV fluid aseptically. Prepare site with effective topical antiseptic or cotton balls with alcohol in circular motion and allow 30 seconds to dry. drug incorporation. Expel air bubbles if any and put back the cover to the distal end of the IV set.-tourniquet -IV stand -gloves -Cotton swabs or balls soaked in alcohol with cover -splint -Sterile 2x2 gauze Check the sterility and integrity of IV solution. solution. . (2-6 in. Check for radial pulse below tourniquet. Place IV label on IVF bottle duly signed by RN who prepared it (pt’s name. room #. Apply tourniquet 5 to 12 cm. (…get ready for IV insertion). Open the seal of the IV infusion aseptically and disinfect rubber port with cotton ball with alcohol.) above injection site depending on condition of patient. IV set and other devices. Time and date. bottle sequence and duration.
Open the clam. Upon flashback visualization decease the angle. Slip a sterile gauze under the hub. Hold stylet stationary and slowly advance the catheter until the hub is 1 mm to the puncture site. With steel winged needle. Using the steel-winged needle. Note: When steel-winged needle (butterfly) is used: Connect the IV tubing to the steel-winged needle connector and prime the needle with IV fluid. Position the IV catheter parallel to the skin. check if tip of catheter can be rotated freely inside the vein. Anchor needle firmly in place with the use of: o o transparent tape/dressing directly on the puncture site Tape (using any appropriate anchoring style) Band aid o . advance the catheter and stylet (1/4 inch) into the vein. Using the appropriate IV cannula. with the bevel up. regulate the flow rate. parallel on the skin. enter the vein directly and advance needle ¼ inch after successfully performing venipuncture check for backflow. Remove tourniquet. pierce skin with the needle bevel up. remove the stylet while applying digital pressure over the catheter with one finger about 1-2 inch from the tip of the inserted catheter. pierce skin with needle positioned on a 15-30 degree angle. position on a 5-10 degree angle. Release the tourniquet.
D. Instead place a small piece of sterol OS and then secure it with adhesive tape. Incorporation of drug into IVF bottle/bag Verify the written medication card against the M. Verify for skin test of drug for IV incorporation (if skin testing is necessary). . observe hospital policy on drug administration. Observe 10 R’s Explain procedure (Medication and action) to reassure patient & SO and check patency and IV site. Label with plaster on the IV tubing to indicate the date when to change the IV tubing\ Observe patient and report any untoward effect Document in the patient’s chart and endorse to incoming shift Discard sharps and waste according to Health Care Waste management of DOH/DENR. Perform hand washing before and after the procedure.Note: Never place unsterile tape directly on IV insertion site. prescription. Tape a small loop of IV tubing for additional anchoring. apply splint if needed Calibrate the IV bottle and regulate flow of infusion according to prescribed duration Label on IV tape near the IV site to indicate the date of insertion. type and gauge of IV catheter and counter sign.
CHANGING AN IV SOLUTION Check Physician’s order (countercheck IV label. maintain sterility and incorporate prepared drug into the airway aseptically. Swirl the IV bottle to mix the drug with IVF and regulate the flow rate accordingly. Observe for 5-10 minutes for any drug interaction while reassuring the patient. infusate sequence. type. Recap airway after. Note: If the administration set has no airway. additives (if any). Prepare necessary materials needed for the procedure such as: o o o injection tray syringes Right drug to be incorporated either vial or ampule. IV card. Observe for 10 R’s . pull out the set and incorporate the prepared drug and re-spike the IV set to the bottle then place the label. monitor V/S. Document in the patients chart Discard sharp and other waste according to Health Care Waste Management of the DOH/DENR. and duration of infusion. amount. Disinfect injection port of the vial & the ampule before breaking then aspirate the right dose aseptically Remove the cover of the administration set.
Perform hand washing before and after the procedure. Expel air bubbles (if any) Reiterate assurance to patient and significant others. Check sterility and integrity of IV solutions. Discard all waste materials according to Health Care Waste management of DOH/DENR. Document and endorse accordingly Discontinuing AN IV INFUSION Check Physician’s order to discontinue IV including medicines. Open and disinfect rubber port of IV solution to follow. Prepare necessary materials. has lapsed after IV insertion. Calibrate new IV bottle according to duration of infusion as per prescription. Observe 10 R’s Assess and inform the patient of the discontinuation of IV infusion and of any medicine . etc. Explain procedure to reassure the patient and significant others and assess IV site for redness. swelling and pain. place on IV tray. Place IV label on the IV bottle. Close the roller clamp and spike the container aseptically Regulate the flow rate based on the prescribed infusion rate of infusion. Change IV tubing’s and cannula if 48-72 hrs.
remove plaster gently. SET 2. Prepared by: BSN2. Use pick up forceps to get cotton ball with alcohol and without applying pressure. Document time of discontinuance. GROUP D BALISI. JAMYKA TAYLAN. plaster. Closed the roller clamp of the IV administration set Moisten adhesive tapes around the IV catheter with cotton ball with alcohol. status of insertion site and integrity of IV catheter and endorse accordingly. PRINCESS IBANEZ. IV tray or injection tray with sterile cotton balls with alcohol. kidney basin. Place dressing over the venipuncture site Discard all waste materials including IV cannula according to Health Care Waste management of DOH/DENR. JEANDALE BINAS. pick up forceps in aseptic solutions. Prepare the necessary materials. Perform hand washing before and after the procedure. remove needle or IV catheter then immediately apply pressure over the venipuncture site. Inspect IV catheter for completeness. JAM ANGELICA GAYAGOY. CHARISSE . ROSEANN GARCIA.
PATRICIA USITA. RONEL .TUNQUE.