Assisting in Intravenous

Infusion
Definition:
Is an administration of fluid, electrolytes,
or nutrients through a needle or cannula
inserted into a vein.
Purpose:
To administer fluids intravenously when
clients are unable to take fluids orally.
To establish a lifeline for rapidly needed
medication.
 Principles

1. Assess vital signs for baseline data

2. Assess bleeding tendencies
3. Assess disease or injury to extremities
4. Assess status of veins to determine
appropriate venipuncture sites
5. Observe appropriate infection control
procedures
Equipment:

IV solution
IV tubing
IV catheter or needle
IV pole for gravity infusion
Adhesive or non- allergenic tape
Clean gloves
Rubber Tourniquet
Antiseptic swabs
Antiseptic ointment such as Povidone Iodine
Sterile gauze, Dressing or transparent occlusive
dressing
Arm splint (if required)
 Types of Fluids

ISOTONIC SOLUTIONS

has same osmolarity (or tonicity) as serum and other

body fluids.

a. Lactated Ringer’s
b. Normal Saline
c. D5 Water
Indication
-hypotension due to hypovolemia.
 HYPERTONIC SOLUTIONS

➢ Has an osmolarity higher than that of serum.

▪ D5Nss
▪ D5LR
▪ D10W
▪ D5 IMB
 HYPERTONIC SOLUTIONS

➢ Indications
▪ Post-operative patient
- reduces the risk of edema
- stabilizes the blood pressure
- regulates urine output
▪ treats hypoglycemia
 HYPOTONIC SOLUTIONS

➢ Has an osmolarity lower than serum osmolarity.

a. .33% NaCl
b. Dextrose 2.5% in water

➢ Indication
- Hyperglycemia
 Parts of Intravenous tubing

1. Spike
2. Drip chamber
❖ permits a predictable amount of fluids to be
delivered.
❖ 10-20 drops set delivers macro drip per milliliter of
solution.
❖ 60 drops set delivers micro drip per milliliter
of solution.
3. Roller valve or screw clamp- controls the rate of
the flow
4. Injection port- administering IV medication or
secondary infusion.
 Vein selection

1. Use distal veins of the arm first.

2. Use non dominant hand if possible.
3. Select the vein that is
a. Easily palpated & feel soft and full
b. Naturally splinted by bone
c. Large enough to allow adequate
circulation around the catheter
4. Consider the catheter length.
 Procedure

Step Rationale

Check the doctor’s order For legal purposes.

To determine the kind of
solution, flow rate and
other instructions
Step Rationale

Explain the procedure to To facilitate acceptance

the patient & willingness to
cooperate since
venipuncture can
cause discomfort.
Step Rationale

Wash hands. Gather all Washing of hands

equipment prevents spread of
microorganisms.
Gathering of
equipment can save
time & effort.
Step Rationale

Inspect the solution of To check if the order

the following: kind of reflects the patient’s
solution ordered, actual condition.
volume ordered & Cloudiness is an
clearness & expiration evidence that the
date container has been
opened previously.
Leaks indicate possible
contamination.
Step Rationale

Open the vacodrip set In preparation for the

following the insertion.
manufacturer’s
instruction
Step Rationale

. A. For bottle solution: In preparation for the

Remove the bottle’s insertion
metal cap & inner
disk on a stable
surface & wipe
rubber stopper with
an alcohol sponge,
insert the spike
Step Rationale

B. For bag solution: In preparation for the

Place the bag flat insertion
on stable surface,
remove protective
cap, insert the spike
How it is done
Step Rationale

Hang IV bottle/pack on Container should be

IV pole & prepare suspended about 1m(3ft)
strips of plaster. above the client’s head.
This height is needed to
enable gravity to
overcome venous
pressure & facilitate flow
of the solution into the
vein. Strips of plaster are
used to tape the
catheter later.
Step Rationale

. Open the regulator & Allowing the IV fluid to

allow the solution to completely displace the
run through the tubing , air in the tubing
then close the (Prime the chamber one
regulator. third to one half full by
pressing it between
thumb and index
finger)
Step Rationale

The tourniquet is used to dilate the

Doctor applies tourniquet vein making it easier to insert the
needle properly. And should be
& offer cotton ball place firmly to15 to 20 cm above
w/alcohol to the doctor the venous flow. If the radial
pulse can be palpated, the
& instruct patient to arterial flow is not obstructed.
Cotton ball w/ alcohol is used to
make a fist. disinfect the site. The client
should make a fist to contract the
muscles which compresses the
distal veins & distending them.
Tapping lightly the vein w/ your
fingertips may also distend the
vein.
Step Rationale

Once backflow is The doctor holds the

present, remove the needle pointing in the
needle & connect the direction of blood flow
end part of the tube. at a 30o angle w/ bevel
Release tourniquet & up & pierce the skin
instruct patient to open beside the vein about
the fist, then open the 1cm (1 ½ in) below the
regulator. site planned for
piercing.
Step Rationale

Offer plaster & . Plaster is used to

assist in anchoring secure the needle
properly. (chevron
method) a small gauze
under the needle is
required keeping the
needle in position in
the vein.
Step Rationale

Adjust the arm board or Arm board or splint is

splint, bandage, and used to stabilize the
anchor securely. arm as well as the
tubing.
Step Rationale

Regulate the flow of the To ensure appropriate

solution as ordered. infusion flow.
Step
Instruct the patient or
watcher to call when
there is a change in the
rate of flow, or when the
solution stops flowing,
when the site is painful or
bulging, when the
solution is almost
consumed and when
there is air or blood in the
tubing.
Rationale
The watcher should
observe the patient all
the time and call the
nurse when there is a
problem. Proper
communication should
be established. This is to
prevent complications
associated with IV
therapy.
Step Rationale

Leave the patient in a Assess the patient’s

comfortable position. difficulties after the
infusion. This also
allows the patient to
verbalize concerns.
Step Rationale

Carry the tray to the For doing the after care.

utility room. Wash your Washing of hands
hands. prevents spread of
microorganisms.
 Termination

Step Rationale

Close the regulator if So that blood would not

bottle/pack is almost get in the tubing when
empty. fluid is consumed.
Step Rationale

Remove the adhesive For easy removal of the

tape. IV catheter.
Step Rationale

Apply pressure using Pressure helps stop the

Cotton ball with alcohol bleeding and prevents
over the point of hematoma formation.
insertion and withdraw
the needle quickly.
Step Rationale

Dry the area with cotton To facilitate placement of

ball and apply adhesive the adhesive to prevent
tape. the open skin from
infection and for
continues application
of force and pressure
on area.
Step Rationale

Leave the patient Assess any difficulties

comfortably and tidy the patient feels and
the unit. apply appropriate
nursing interventions to
settle the problem.
Making the unit tidy
promotes orderliness.
Step Rationale

Chart: Date, time, solution For documentation

used, bottle/pack number,
amount rate per minute, purposes and further
site and doctor who use.
inserted the needle. In
numbering bottles/packs
used, ascertain whether the
number is for the whole
series or one day series.
Record the unusual
reaction of the patient or
the treatment, if there is
any.
COMPLICATIONS OF IV
THERAPY
 COMPLICATIONS OF IV THERAPY

INFILTRATION
- when IV needle becomes dislodged from the vein. Fluid
flows into interstitial tissue.
- swelling, coolness, pallor & discomfort at the IV site.
PHLEBITIS
-a result of injury to a vein
- heat, pain, redness, and edema develop around the site.
AIR EMBOLISM
-Air in tubing delivered by IV push or infused by infusion
pump
- decrease BP, cyanosis, tachycardia, jugular vein
distention, loss of consciousness
 COMPLICATIONS OF IV THERAPY

ALLERGIC REACTION
Minor reaction
- Rash, redness and itching
Major reactions
- Coughing, dyspnea, swollen tongue, cyanosis,
unconsciousness and death
CIRCULATORY OVERLOAD
Delivery of excessive amounts of IV fluid
-Pulmonary edema, dyspnea, pink sputum,
jugular vein distention.
 IV FLUID COMPUTATION

For macro drip chamber, the drop factor is 15gtts/ml

This is used for adults unless specified
2. For Micro drip, the drop factor is 60mcgtts/ml
Indicated for pediatric patients.
A. gtts/min= Vol. of fluid in cc x gtt factor
Hours to administer x 60 mins./hr

B. cc/hour= Amount of fluid in ml

# of hours to administer

C. Time consumed = Amount of fluid in ml x drop factor

( Hour) gtts. /min x 60 min/hr

KVO or Keep Vein Open is 10ml/hr

 Situation

 A physician ordered D5LR 1 liter to run for 8hour for

an adult patient, the nurse started the infusion at
7:00 am Solve for:
a. gtt/minute
b. cc/hr
c. time the IV will be consumed
a. 1000ml x 15gtts/min
8 x 60mins
= 15,000gtts
480mins
= 31gtts/min
b. 1000ml
8
= 125 cc/hr
c. 1000ml x 15gtts/min
31gtts/min x 60min/hr
= 15,000gtts
1860gtts/hr
= 8 hours

at
3pm IVF will be consumed
7am-time started
8am-1
9am-2
10am-3
11am-4
12nn-5
1pm-6
2pm-7
3pm-8= time consumed-3pm
Thank You!
 Compute the following
 A case of 16 years old female admitted to JRB with chief
complaints of labor pain. Upon assessment at the emergency
room findings reveals 5cm cervical dilatation, 10 minutes
interval, 5minutes duration. Attending physician ordered to
start D5LR 1 L at 30gtts/min. The nurse started the infusion at
around 8am. Compute for the following:
A. Number of hours to consume.
B. Cc/hour
C. At what time the IVF consume?
2. After 5 hours of the delivery of the baby IVF consumed and
followed up with D5LR 1 Liter plus 20 units oxytocin to run to 10
hour started 3pm. Compute the following:
A. Gtts/minutes
B. Cc/hour
C. At what time the IVF consume?