Infusion Therapy

Parenteral Nutrition

• Formulas: dextrose, protein, fat,

vitamins, and numerous trace elements
tailored to the specific metabolic needs
of the client
• Only used when the gastrointestinal
tract cannot be used
• Central
• Peripheral
Blood Transfusions and Other
Components
• Packed red blood cells
• Platelets
• Fresh frozen plasma
• Albumin
• Several specific clotting factors
Medications

• IV medications provide a rapid

therapeutic effect but can also lead
to immediate serious reactions.
• Prescription for infusion therapy is
necessary.
Vascular Access Device (VAD)
• Short peripheral catheters
– Superficial veins of the hand and forearm
– Dwell for 72 to 96 hours and then require
removal and insertion into another
venous site
• Complaints of tingling, feeling of “pins
and needles” in the extremity, or
numbness during the venipuncture
can indicate nerve puncture.
Midline Catheter

• Catheter that is 6 to 8 inches long, inserted

through veins of the antecubital fossa
• Used for therapies lasting from 1 to 4
weeks
• Should not be used for infusion of vesicant
medications, which can cause tissue
damage if they escape into the
subcutaneous tissue (extravasation)
Peripherally Inserted Central
Catheter (PICC)
• Length ranges from 40 to 65 cm.
• Basilic vein is the preferred site for
insertion; cephalic vein can be used.
• Placement is confirmed by chest x-ray
examination.
• No information is available on optimal
dwell time.
• Teach clients to perform normal ADLs,
avoiding excessive physical activity.
Nontunneled Percutaneous
Central Catheter
• Inserted through subclavian vein in the
upper chest or jugular veins in the neck
• Usually 15 to 20 cm long
• Tip resides in the superior vena cava
• Placement confirmed by chest x-ray
examination
• No recommendations for optimal dwell
time
Tunneled Central Catheter

• A portion of the catheter lying in a

subcutaneous tunnel separates the
points at which the catheter enters
the vein from where it exits the skin.
• Tunneled central catheter is used for
infusion therapy that is frequent and
long-term.
Implanted Port
• Implanted ports consist of a portal body,
a dense septum over a reservoir, and a
catheter.
• A subcutaneous pocket is surgically
created to house the port body.
• Port is usually placed in the upper chest
or the upper extremity
• Port needs to be flushed after each use
and at least once a month between
courses of therapy.
Dialysis Catheter

• Lumens are very large to

accommodate the hemodialysis
procedure or a pheresis procedure
that harvests specific blood cells.
• This catheter should not be used for
administration of other fluids or
medications, except in an
emergency.
Infusion System
• Containers
• Administration sets
• Add-on systems
• Needleless connection devices
• Rate controlling devices:
– Controller
– Pumps
• Syringe pumps
• Ambulatory pumps
Catheter Care and Maintenance

• Educating the client

• Confirming tip location
• Performing the nursing assessment
• Securing and dressing the catheter
• Changing administration sets and
needleless connectors
• Controlling infusion pressure
(Continued)
Catheter Care and Maintenance
(Continued)

• Flushing the catheter

• Obtaining blood samples from the
catheter
• Removing the catheter
Alternative Sites for Infusion

• Arterial therapy
• Intraperitoneal infusion
• Subcutaneous infusion
• Intraspinal infusion
• Intraosseous therapy
•Types of catheter
malposition