Be a PILOSOPO Read, read and read Think before you act Answer all possible questions 10% memorization,

, 90% analysis/ understanding

A presentation by: Marie Coreen E. Mangaoang RM, RN

A proud product of DMMMSUICHAMS

It

is the insertion of a needle or cannula to a vein connected to a tubing and a fluid container

 Hydration
Parenteral

nutrition Administration of medication Blood transfusion

 Administration

of irritant fluids or drugs through peripheral

 Physicians
Dentists Nurses Midwives Pharmacists Other

licensed health care professionals

 Right

drug Right patient Right dose Right route Right time

Right

Documentation Right health teaching Right patient drug history Right drug- drug interactions Right drug allergies

 Patients

name type and amount of solution the flow rate the type, dose and frequency of medications to be incorporated/ pushed

 clinical

status of the patient patients diagnosis patients age dominant arm (non) condition of vein/ skin cannula size type of solution

3 Common Types of IV systems/equipment

Luer Lock injection w/ J-loop IV fluid or medication on an infusion pump IV fluid Gravity Flow infusions using the macro/microdrip or Y type tubing

This device maintains patent venous access in patients receiving IV therapy regularly or intermittently

To transfuse accurate dosages To deliver very large or small amount of fluid accurately To minimize risk for fluid overload

 Emergency

fluid resuscitation Short term medication infusion Blood and blood products Colloid administration

 Protective
Spike Medication

cap

port Drip chamber Tubing Nozzle/ thumbwheel/roller clamp/ regulator Rubber medication port/ y-port Luer connector/ connector

 G26

(violet)- neonates G24 (blue)- children/elderly/medical/post op surgical patients G22 (yellow)- children/medical/post op surgical patients G20 (pink)- adult/medical/ post op surgical patients G18 (green)- surgical patients/ BT G16 (gray)- trauma patients G14 (red)- trauma patients

Consider Patients: Medical history Age Body size Weight Conditions of vein and skin Type of fluid/medication Duration of therapy Skill at venipuncture

 Flexed

areas Extensive scars Hematoma Infiltrarion of phlebitis site Fistula Skin disease Reminder: If the patients chosen IV site is hairy, dont shave the area, instead, clip/cut the hair. The IV site and IV tubing is good for 72 hours

3 Fluid Types:

Isotonic Hypotonic Hypertonic

REMINDER: A bottle (1000ml or 500ml) of IVF is good for 24 hours only. If not consumed, discard and hook a new IVF

 Same

osmolarity as serum Remain inside intravascular For hypotensive/ Hypovolemia Risk for overload

Examples:
PNSS- Plain Normal Saline Solution or 0.9 % NaCl Solution (green) D5W (5% dextrose in water) (red) PLRS- Plain Lactated Ringers Solution (dark blue)

 Less

osmolarity than serum Causes swelling of the cells For dehydration For hyperglycemia May cause increased ICP and cardiovascular collapse

Examples: Distilled water 0.18% NaCl 0.45% NaCl (half strength normal saline) 0.33% NaCl ( one third strength normal saline)

Higher osmolarity than serum Shrinking of cells For BP stabilization, increase urine output, reduce edema

Examples:

Blood products Albumin D5NSS (5% Dextrose in normal saline solution)\ D5 in 0.45% NaCl ( 5% Dextrose in half strength normal saline) D5LR (5% Dextrose in Lactated Ringer's Solution) D10W ( 10% Dextrose in water) D50W50 (50% Dextrose in 50 ml of water)

Local Complications: Hematoma Thrombosis Phlebitis Infiltration/ Extravasation Local infection Allergic reactions

Systemic Complications: Venous spasm Speed shock Septicemia Air embolism Circulatory overload Catheter embolism

 Fluctuating
Runaway

flow rate

IV Sluggish IV Tubing/ loose Connection/ disconnection Blood back flow in tubing IV line obstruction/ kinking of IV tubing Clogged filter Break in antiseptic technique leaks due to inappropriate device

 1.

Infectious organism exposure 2. Needle stick injury 3. Chemical exposure

 Position

the hand Check the site of insertion for any complications Expel air bubbles Check for any kinks Check for clogging Re-plaster Pinch tubing Check for back flow

Amount of IVF (ml or cc) x drop factor (gtts/ml)

X = Hours to be infused (hr) x 60 min/hr (constant)

Amount of IVF -adult 1000 ml -pedia 500 ml -or it depends upon the doctors order or available stock Drop factor - adult/macropdrop = 15 gtts/ml - pedia/microdrop = 60 gtts/ml