Iv   fluids
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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.