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Iv   fluids
 

Iv fluids

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medication administration

medication administration

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    Iv   fluids Iv fluids Presentation Transcript

    • IV FLUIDS MONITORING & FLUID BALANCE
    • IV THERAPY
      • The goal to fluid administration:
      • To correct or prevent Fluid & Electrolyte Imbalances.
    • IV THERAPY
      • Nurses need to know:
      • Correct solution
      • Correct equipment
      • Correct infusion rate EN (check)
      • System initiation
      • System maintenance
      • System monitoring EN (monitor)
      • Problem identification EN (report)
    • IV THERAPY
      • Problem correction
      • Discontinuation of infusion
      • REMEMBER:
      • IV Fluids are Medications.
    • INTRAVENOUS THERAPY
      • Intravenous – within a vein
      • Infusion - administration of fluids into a vein via a plastic catheter (cannula)
    • INTRAVENOUS THERAPY
      • Purpose :
      • Fluid replacement
      • To correct fluid volume deficits
      • To maintain fluid & electrolyte balance
      • To administer intravenous medications e.g:IV antibiotics
      • To prolong nutritional support e.g:parental nutrition
    • INTRAVENOUS THERAPY
      • Components :
      • IV cannula
      • IV giving (administration) set
      • IV fluids ( as per orders/different fluids for different situations)
      • An intravenous pump
      • IV fluid documentation (Medical Officers order & fluid balance chart)
    • INTRAVENOUS THERAPY
      • Fluid Rate :
      • This is determined by the Medical Officer in accordance with the patients condition.
      • Orders must be documented & signed.
      • The flow rate should be checked every 15 minutes initially. Then as per policy.
      • If not monitored, the patient could become under hydrated or over hydrated.
    • TYPES OF IV SOLUTIONS
      • Hypotonic : these solutions promote osmosis of extracellular fluid into the cells.
      • Hypertonic : these solutions promote osmosis of fluid out of the cells.
      • Isotonic : these solutions do not promote osmosis, but increase extracellular fluid volume.
    • CONTROL OF IV RATE
      • Equipment used :
      • An infusion pump
      • A microdrip IV giving set
      • A burette
    • THE RN’S RESPONSIBILITY
      • To add any drugs (ordered) to the infusion
      • To adjust the rate
      • To label and sign for any additives (drugs) to the IV fluid
      • To review and initiate any action in response to the EN’s concerns regarding the IV infusion or patient wellbeing.
    • GUIDELINES FOR OBSERVATIONS
      • Know the patients normal range of vital signs to be able to identify the abnormal .
      • Note:
      • Dehydration : hypotension / tachycardia
      • Fluid overload : hypertension / bounding
      • pulse
    • OBSERVATIONS
      • Observe, record & report :
      • Unusual changes in the patient e.g: pallor / flushes / pain / temperature
      • Any concerns verbalised by the patient
      • If IV therapy has stopped
      • If blood is noticed in the IV line
      • Check IV line for kinks / or air in the line
      • Check drip rate
      • Note fluid remaining in bag.
    • OBSERVATIONS
      • Inspect the IV site :
      • For redness
      • Any tissue swelling
      • Ask the patient about pain or burning at IV site
      • Note any moisture leakage
      • Note if IV line is intact or has become disconnected
      • Note positioning of IV & any effect on drip rate
      • Note any coolness around IV site
    • COMPLICATIONS
      • Infiltration :
      • Needle / cannula displacement
      • Blood leak from IV site
      • Air Embolism :
      • Air in IV tubing (IV bag has emptied)
      • Infection :
      • Note any signs of redness / pain / swelling/ hot to touch
    • COMPLICATIONS
      • Circulatory (fluid) overload :
      • The cardiovascular system is unable to cope with the IV rate & volume.
      • The patient becomes pale / sweaty / short of breath.
      • Allergic reaction :
      • Note any known allergies & document
      • Observe for any reaction to IV additives e.g:IV antibiotics / blood products
    • COMPLICATIONS
      • Signs & Symptoms
      • Infiltration : pain/redness/swelling/diminished flow rate.
      • Air embolism : decreased BP/weak, rapid pulse/cyanosis
      • Infected site :redness/pain/swelling/hot to touch/+/- yellow discharge
      • Circulatory overload :headache/dysponea/raised BP/flushed skin/fluid imbalance(volume infused vs volume excreted)
    • DO NOT…
      • Use marking pens to write on IV fluid bags. Use appropriate stick on labels.
      • Adjust the flow rate, unnecessaraliy
      • Insert an IV cannula
      • Remove an IV cannula (without clarifying with RN)
    • DO….
      • Turn the IV fluid line off if it has ‘run through’
      • Turn the IV fluid line off if it has dislodged at the IV site.
      • Check the IV insertion site every shift for localised reaction & document this in the patient progress notes.
      • Thank-you.