Educative and good for learning

2. INTRAVENOUS THERAPY
PREPARATION AND ADMINISTRATION
GIDEON MAXWELL AMOAH
BSc. PUBLIC HEALTH (EDUCATION)
DIP. EDUCATION, DIP. (NURSING), RGN

3.  Intravenous simply is defined as ‘within a Vein’.
 Intravenous therapy therefore the administration
of an infusion of liquid substances directly into a
vein.
 It provides a speedy and effective method of
delivering medication, fluids, parenteral nutrition
and blood products.
 It can be intermittent or continuous

4. Steps to take before carrying out an IV Therapy
 Educate patient on the procedure, purpose,
possible discomfort and potential risks.
 Gather all necessary equipment
 Assess veins for size, straightness and ease of
access.

5. Uses of IV Therapy
 To correct electrolyte imbalance
 To deliver medications
 For blood transfusions
 As replacement therapy in cases of dehydration

6. Common Vein sites
 Back of the hand
 Arm
 Foot
 Scalp
 Femoral
 jugular

7. Nursing assessment/ observation to be made
during intravenous therapy
 Monitor the patient closely for any acute weight
gain or loss
 Keep an accurate record of all intake and output
 Assess for any signs of oedema
 Auscultate the lung sounds (crackles may be
heard for fluid volume overload)
 Notify the doctor if urine output is less than
30mls within 2hours
 Examine the site for swelling, dislodgement of
cannula, extravasation (infiltration) of leakages.

8. Nursing assessment/ observation to be made
during intravenous therapy cont.
 Observe for any discomfort
 Observe the drip chamber and ensure that it is
not empty
 Observe the flow rate frequently
 Observe for signs of over- infusion such as
dyspnoea, cough and enlargement of cervical
veins. (What will you do if you observe these?)

9. Commonly used intravenous solutions
 Hypertonic solution
- 5% dextrose in R/L
- 5% Dextrose in N/S
- 5% Dextrose in 0.45% N/S
Have higher osmotic pressure, thus pulls or draws
fluid out of the cell into the extracellular space
thereby increasing intravascular volume.

10. Commonly used intravenous solutions
 Hypotonic solution
- 0.45% N/S
- 0.33% N/S
Pushes fluid from the vascular space into the cells
because they have lower osmotic pressure.

11. Commonly used intravenous solutions
 Isotonic solution
- Ringers Lactate
- 5% Dextrose in water
- Normal saline (0.9% NaCl)
Have same osmotic pressure as that found in cells
hence fluid moves equally between all
compartments.

12. Commonly used intravenous solutions
 Other solutions include:
- 5:4:1 commonly used for Cholera patients
- Badoe’s solution

13. Calculating the flow rate of an infusion
Flow rate = volume of solution(mls) x drop factor
duration of infusion(mins)
(try some questions in scenarios)

14. Types of Cannulas used for intravenous therapy

17. Parts of a Cannula

19. The 10 Rights of Drug Administration
- Right medication
- Right client
- Right dose
- Right time
- Right route
- Right client education
- Right documentation
- Right to refuse
- Right assessment
- Right evaluation

20. Types of Intravenous Fluids
Crystalloids
They are aqueous solutions of mineral salts or water
soluble molecules commonly used for rehydration
and electrolyte replacement.
Eg. N/S, R/L, Dextrose Saline

21. Types of Intravenous Fluids cont.
Colloids
They are large insoluble molecules are used to
replace lost blood, maintain healthy blood pressure
and volume expansion.
Eg. Haemacel, Dextran, hetastarch, Blood etc.

22. Complications/ Risks of IV Therapy
- Infection
- Phlebitis
- Infiltration/ extravasation
- Fluid overload
- Electrolyte imbalance
- Embolism
- Hypothermia
- Shock
- Nerve damage

23. ASSIGNMENT
Preparing trolley and setting up Intravenous
Infusion

24. GIDEON MAXWELL AMOAH
BSc. PUBLIC HEALTH (EDUCATION)
DIP. EDUCATION, DIP. (NURSING), RGN

25. ADMINISTERING
BLOOD TRANSFUSION

26. BLOOD TRANSFUSION
 Is the intravenous administration of whole or
component of blood into direct circulation to
restore blood volume, increase haemoglobin
levels or combat shock
 The transfer of blood or blood products from one
person (donor) into another person’s blood
stream (recipient).

28. BLOOD TRANSFUSION
 Autologous blood transfusion?
 Heterogeneous (donor) blood transfusion?

29. Indications of blood transfusion
 To increase blood volume after surgery,
haemorrhage or trauma
 To provide clotting factors (in plasma) for
patients with DIC, haemophilia etc.
 To increase the number of RBC’s in clients with
anaemia

30. Indications of blood transfusion cont.
 To provide platelets to patients with low platelet
count, especially those on chemotherapy
 To replace lost plasma proteins in severe burns

31. DISCUSS BLOOD GROUPINGS AND
WHO CAN DONATE TO WHO
• (A, B, AB, O)
• Rhesus + , -
• Universal donor and recipient

33. Forms of blood transfused include:
 Platelets
 Fresh frozen plasma
 Whole blood
 Packed cells

34. Nurses responsibilities for safe blood transfusion

35. Nurses responsibilities for safe blood transfusion
 Explain procedure and obtain informed consent
 Never order a blood to be transfused to patient
 Two nurses are required to crosscheck blood for
the right patient, correct blood type, expiry date.
(they must both sign their names in the nurses notes)
 Check patency of IV line
 Check patient’s vital sign and observe any
anomalies.

38. Nurses responsibilities for safe blood transfusion
 Administer pre medication if prescribed
 Offer bed pan or urinal bowl before
commencement of blood transfusion.

40. Nurses responsibilities during blood transfusion
 Check vital signs 15minutes after the
commencement of transfusion, after 30 minutes,
then hourly till transfusion is completed.
 Monitor the flow rate
 Observe for signs of transfusion reaction such as
urticaria rash, elevated temperature, shivering
etc. (what will the nurse the nurse when he/she observes this?)

41. Nurses responsibilities during blood transfusion
 Observe for signs of circulatory overload
 Monitor urine output and report any
abnormalities.

42. Nurses responsibilities After blood transfusion
 Clip the roller clamp off and flush the
intravenous line with N/S.
 Make patient comfortable in bed
 Discard trolley and used transfusion set
appropriately.
 Document procedure (what does the nurse write?)
 Monitor vital signs one hour after completion to
detect delayed transfusion reactions.

43. Complications of blood transfusion
 Infection usually with fever
 Embolism
 Circulatory overload
 Hyperthermia
 Coagulopathy
 Urticaria rash
 Pulmonary oedema characterised by dyspnoea
 Hepatitis B
 HIV
 Shock