IVT using

Infusion
pump
Carmencita R. Pacis PhD MAN RN
 • Review knowledge and skills of
intravenous therapy (IVT)
• Implement safe and quality nursing
Learning care in the performance of IV therapy
by using Infusion pump
objectives:
• Practice skills in promoting
physiologic responses in the
administration of IV therapy.
 Intravenous Therapy
(IVT)
• Efficient and effective method of
supplying fluids directly into the
intravascular fluid compartment
and replacing electrolyte losses.
• IVT includes: IV solutions,
venipuncture sites, IV equipment
 Purpose of Intravenous Therapy (IVT)
• To supply fluid when clients are unable to take in an
adequate volume of fluids by mouth
• To provide salts and other electrolytes needed to
maintain electrolyte imbalance
• To provide glucose (dextrose), the main fuel for
metabolism
• To provide water-soluble vitamins and medications
• To establish a lifeline for rapidly needed medications.
INTRAVENOUS SOLUTIONS
• Classified as:
• Isotonic – same concentration as
blood plasma
• Hypotonic – lesser concentration of
solutes
• Hypertonic – greater concentration of
solutes than plasma
• Isotonic solutions - same
concentrations of solutes as blood
plasma. When infused, isotonic
solutions expand both the
intracellular fluid and
extracellular fluid spaces,
equally. It does not cause red
blood cells to shrink or swell.
Isotonic solutions are often used to
restore vascular volume.
• Examples include 0.9% NaCl (NSS),
Lactated Ringer’s solution (a balanced
electrolyte solution), and 5% Dextrose
in water (D5W).
• Hypotonic solution – have a lesser
concentrate of solutes. They cause
fluid shifts from the extracellular
fluid compartment into the
intracellular fluid compartment to
achieve homeostasis, therefore,
causing cells to swell and may
even rupture
• Examples are: 0.45% NaCl (half
normal saline) and 0.33% NaCl
(one-third normal saline
• Hypertonic solutions – have a greater
concentration of solutes than plasma
and cause fluids to move out of the
cells and into the extracellular fluid
compartment in order to normalize
the concentration of particles
between the two compartments. This
effect causes cells to shrink and may
disrupt their function. Example
solutions are 5% Dextrose in normal
saline (D5NS), 5% Dextrose in 0.45%
NaCl (D5 1/2NS), and 5% Dextrose in
lactated Ringer’s (D5LR).
INTRAVENOUS SOLUTIONS
• Categorized according to its purpose:
• Nutrient solutions – useful in preventing
dehydration and ketosis but do not provide
sufficient calories
• Electrolyte solution – used to restore vascular
volume and replace electrolytes
• Alkalinizing solution – given to treat metabolic
acidosis
• Acidifying solution – counteract metabolic alkalosis
• Volume expanders – used to increase blood volume
following severe blood or plasma loss
LOCAL IVF COLOR

PNSS D5NR

D5
PLR D5LR
0.3NaCl

D5W D5NM D5IMB

11
 VENIPUNCTURE SITES
• Site varies with client’s age, length
of time the infusion is to run, type
of solution, and the condition of
veins
• Sites:
• Adults: veins in the hand and arm
• Infants: veins in the scalp and dorsal
foot veins
 Vein selection
• Use distal veins of the arms first
• Use the client’s nondominant arm whenever possible
• Select a vein that is:
• Easily palpated and feels soft and full
• Naturally splinted by bone
• Large enough to allow adequate circulation around the
catheter
• Avoid using veins that are:
• In areas of flexion (ex. Antecubital fossa)
• Highly visible
• Damaged by previous use
• Continually distended with blood, or knotted or tortuous
• In a surgically compromised or injured extremity
 Intravenous
Equipment
• IV solutions
• Infusion sets
• IV Catheters and
needles
• Tourniquet
• Clean gloves &
alcohol swab
• Dressing &
stabilization supply
• IV pole
• Infusion pump
IV catheter Butterfly IV needle
 RECOMMENDED GAUGES
Size Color Recommended use

14G Orange In massive trauma situations.

16G Gray Trauma, surgeries, or multiple large-volume infusions

18G Green Blood transfusion, or large volume infusions.

20G Pink Multi-purpose IV; for medications, hydration, and routine therapies.

Most chemo infusions; patients with small veins; elderly or pediatric

22G Blue
patients

24G Yellow Very fragile veins; elderly or pediatric patients

 Infusion Pump
• A medical device used to deliver
fluids into a patient’s body in a
controlled manner
• Capable of delivering fluids in large
or small amount and may be used to
deliver nutrients or medications
• Advantages:
• Deliver fluids in large or very small
volumes
• Deliver fluids at precisely programmed
rates or automated intervals
 IVT Complications
• Infiltration
• Phlebitis
• Extravasation
• Circulatory overload WATCH
May WATCH
WATCHresult
• labored
OUT
MANIFESTATIONS:from
OUT
OUTFOR;
tying
FOR;
FOR;
the arm too tightly to the splint
•WATCH
Chest, OUT breathing,
swelling,
shoulder, FOR;orcoolness,
back pain and pallor within the
• Air embolism
dyspnea, coughing
• burning,
skin redness
••MANIFESTATIONS:
Hypotension,
insertion
bounding
Adhering tostinging
site. pain
Dyspnea
pulses
aseptic complains
technique is of the
vital in client
the
• redness
warmth
••Cyanosis, and be
Tachycardia
followed swelling
by on the
blistering, insertion
tissue necrosis site.
• Speed shock •Increased
•NURSING
Crackles
Immediately
Numbness
prevention
• andTo
the
venous
Clients of may
may
ulceration.
avoid
of fingers
intravenous
pressure,
this,
INTERVENTION
IV cannula
NURSING INTERVENTIONS
the
heard
stop the
and over
hands
related the
infusion
Loss of consciousness
complain
nurse must
when
of burning
this ensure
is
lung
and
observed.
fields.
infections.remove
pain
correct

• Site Infection •
Do
Asepsis
along the
regulation
Massage
Apply
not allow
*Thephysician.should
nurse must
Instruct
“Prime” IV tubing
adequate
area
IVwarm ofcourse
bottle
be
the
and
to IV
move
compress
“run
of the
fluid
maintained
immediately
theIfbefore
this
patient
blood complication
to open
starting
flow
rateinflamed
shoulder
dry” for
at
as
STOP
and
infusion
to the
ordered
through
return
insertion,
close the
occurs,
site.
vein.
of
hand
byROM
its the
during
infusion,
slow the
several
clinical use and at removal of the device.
• Nerve damage leave
Turn
remaining
theoccurs,
infusion
*If this
times
patient
air to
catheter
torate
each
•allowimmediately.
Restart drug,
rise
lefthour
in
IV side
if
the A
ininplace
and
the
any,
right
infusion and apply warm compress.
Physical therapy
refer
nurse
infusion
may and
diuretic
sidebe
and
tomust
notify
of the
aspirate
the
the Trendelenburg
in
physician
another
the
medication
stop
heart.
required
the
the To
position.
site
This
distal
physician.
may be
prevents
to
the infiltrated
pulmonary
ordered embolism
to remove site.thefinger
excess fluid.
NOTE: Apply splint with the free to move
Starting an IV infusion
using infusion pump
•Determine the following:
• Type and amount of solution to be MACRO DROPS
FLOW RATE = Volume.in cc x drop factor (15 or 20)
infused no. of hrs to run x 60 mins

• Exact amount (dose) of MICRO DROPS

FLOW RATE = Volume.in cc x 60 ugtts/mL
medications to be added no. of hrs to run x 60 mins

• Rate of flow or time the infusion cc per hour = Volume in cc

hours to run
will be completed
 IV Drip Rate Calculation:

ml to infuse (X) drip factor

--------------------------------------- = gtts/min
minutes (min.) to infuse
The doctor has ordered 1,000 mL Lactated Ringers to
infuse over 8 hours. You have a macrodrip tubing with a
drop factor of 15 gtts/mL. Calculate how many gtts/min to
set as the IV flow rate.

Answer?
Calculate the IV flow rate for 200 mL of 0.9% NaCl IV
over 120 minutes. Infusion set has drop factor of 20
gtts/mL.

Answer?
 Starting an IV infusion
using infusion pump

• Prepare the patient

• Perform hand hygiene
• Open and prepare the infusion set
• Spike the solution container
• Apply a medication label to the
solution container if a medication is
added
• Apply a timing label on the solution
container
 Starting an IV infusion
using infusion pump

• Hang the solution container

on the pole
• Partially fill the drip chamber
with solution
• Prime the tubing
• Fix the infusion pump on the
stable IV pole
 Starting an IV infusion
using infusion pump

• Power on the IV infusion pump

machine
• Set up information (IV fluid, flowrate,
amount, and # of hours to run) in the
infusion pump
• Place IV tubing to loading set properly
• Unclamp or open the roller clamp
• Connect to patient IV cannula (already
inserted to client)
• Press start on the machine to start
infusion to patient
 Starting an IV infusion
using infusion pump
• Document the procedure and relevant data:
• Date and time of insertion
• Gauge and length of catheter
• Site of venipuncture (ex. Right or left Hand,
forearm, antecubital fossa, etc.)
• Type and amount of solution hung
• Use of infusion pump
• Rate of infusion
• Any untoward reaction
• Any interventions taken to resolve an IV
problem
• Notification of Doctor
• Watch the link for the procedure:
• https://www.youtube.com/watch?v=YBmws1spOCA&list=WL&index=3&t=120s
THANK YOU!