1. Intravenous therapy involves administering fluids directly into the bloodstream through a catheter or needle inserted into a peripheral vein to replace water, electrolytes, and nutrients. 2. IV therapy is used for patients unable to take oral intake, to rapidly replace fluids and nutrients, for unconscious patients, and during surgery or shock. 3. Solutions administered intravenously can be hypertonic, hypotonic, or isotonic depending on their electrolyte concentration relative to body fluids. The most commonly used solutions, like normal saline and lactated Ringer's, are isotonic.

1. Intravenous therapy
By-
Dr. ASHOK DHAKA BISHNOI
Director, JINC

2.  It is the administration of fluid in to blood stream
by I/V catheter or butterfly needle inserted in to a
peripheral vein replace water, Electrolyte &
Nutrients
Introduction:-

3. 1. Used to clients who are unable to take orally.
2. Replaces water, electrolytes, & nutrients more
rapidly than oral administration
3.Unconcious patient
4.Hypovolumic shock
5.During surgery
uses:-

4.  I/V:- 30-60 second (Give quick effect in all
parental route)
 IV injection (IV push) = 1-60 ml

5. Types of solutions:
1. Hypertonic solutions
2. Hpotonic solution
3. Isotonic solution
Osmolality:- Concentration of a solution expressed as the total
number of solute particles per kilogram.
270-300 Mosm/kg water
Osmolarity :-the concentration of a solution expressed as the
total number of solute particles per litre.
 Measured by Osmometer.
Osmoler Gap :-Deference B/W Osmolality & Osmolarity
normal osmol gap is < 10 mOsm/kg .

6. 1.Hypertonic solutions:-more concentrated than
body fluids.
 Causes movement of H2O from cells into the
extracellular fluid.
Eg.
 3% NS
 5% NS
 10% dextrose in water (D10W)
 5% dextrose in 0.45% sodium chloride (NS) (D5W/½
NS)

7. 2.Hypotonic solution:-Solutions that are more dilute or have a lower
osmolality than body fluids.
 Causes movement of water into cells by osmosis.
 Administer slowly to prevent edema.
Eg.
 0.45% sodium chloride (NS ); (½ NS) Osmolarity of 154 mOsmol/L
 0.225% sodium chloride (NS); (¼ NS)
 0.33% sodium chloride (NS); (⅓ NS)


8. 3.Isotonic solution:-Solution that have the same
osmolality as body fluids.
 It increases extracellular fluid volume.
 These solutions do not enter the cells because no
osmotic force exists to shift the fluids.
 Eg.
 0.9% sodium chloride (NS); (0.9% NS)
 5% dextrose in water (D5W)
 5% dextrose in 0.225% saline (D5W/¼ NS)
 Lactated Ringer’s (LR)/Sodium lactate solution / Hartmann's
solution
.

9. Lactated Ringer’s (LR)/Sodium lactate solution / Hartmann's
solution
Composed of
 sodium chloride 6 g/L,,,,,,sodium lactate 3.1 g/L
 potassium chloride 0.3 g/L……..calcium chloride 0.2 g/L.
Lactated Ringer's contains ions of
 Sodium 130 mEq/L……..Potassium 4 mEq/L
 Calcium 2.7 mEq/L …….Chloride 109 mEq/L
 Lactate 28 mEq/L.
Uses:-
 Low blood volume,Low BP,Burn
Contraindication:-
 RF

10. 0.9% sodium chloride (NS); (0.9% NS)
 Half-NS (0.45% NaCl)
 Quarter-NS (0.22% NaCl) used alone in Neonatal Intensive Care Units.
 pH of NS is 5.5 (4.5 to 7.0)
Composition:-
 9 g/L Sodium Chloride
 Osmolarity of 308 mOsmol/L. It contains 154 mEq/L Sodium &Chloride (GMCH).
Uses:-
 Clean wounds, help remove contact lenses
 Dehydration
 Dilute BCG (AIIMS Bhubaneswar 2018)
 Nebulization .Hemodialysis, Hyponatremia
Contraindication:-
 HT, PE, CHF,Pre-eclampsia

11. Types of volume expanders
1.Crystalloids:-contain electrolyte.
 Used for fluid volume replacement.
 Eg. Ringer's solution & 5% dextrose in water.
2.Colloids/Plasma expanders.
 It pull fluid from the Interstitial compartment into the
vascular compartment
 Used to increase the vascular volume rapidly.
Eg.Hemorrhage or severe hypovolemic.
 Eg. Albumin, Hetastarches (starches), Dextran

12. Size of cannula according to color:-

13. 
16 G needle used if Major Surgery/RTA accident
require massive fluid

18 G needle Used in Blood and lots of fluid

20 G needle is a Universal

22 G needle used in Small and elderly (Appropriate
for fluid maintenance)

15. Containers:-
 1. Container may be glass or plastic.
 2. Squeeze the plastic bag to ensure intactness &
assess the glass bottle for any cracks before
hanging.
 Range in size from 50 mL to 1000 mL
 Note:-Do not write on a plastic IV bag with a marking pen
because the ink may be absorbed through the plastic into the
solution.
 Use a label & a ballpoint pen for marking the bag, placing the label
onto the bag.

16.  Note:- During I/V therapy , hang the bottle on the
I/V pole about 18-24 inch height.

17.  The needle is 0.5 to 1.5 inches in length with 16 to 26 G.
 The smaller the gauge number, the larger the outside
diameter of the cannula.
 For peripheral fat infusion (lipids), a 20 or 21 gauge is
used.
Instruction which follow during administration of I/V
fluid:-

18. The micro drip chamber delivers about 60 drops or
gtt/ml.
 Micro drip chamber are used if the fluid will be infused at a slow rate
(<50ml/Hr)
 Macro drip chamber deliver 15 (10-20) drops or
gtt/ml.

19. Formula:-

20. 1.The physician orders dextrose 5 % in water, 1,000
ml to be infused over 8 hours. The I.V. tubing
delivers 15 drops/ml. Nurse John should run the
I.V. infusion at a rate of:
 a. 30 drops/minute
b. 32 drops/minute
c. 20 drops/minute
d. 18 drops/minute
 b. 32 drops/minute

21.  Change the filter/Drip set every 24 to 72 hours to
prevent bacterial growth.
 Veins in the hand, forearm & antecubital fossa are
suitable sites.

22.  The most frequently used sites are the veins of
the forearm because the bones of the forearm act as a natural support &
splint.
 Veins in the hand (Cephalic vein) , forearm (Basilic vein) &
antecubital fossa are suitable sites in adult.
 Veins in the scalp & feet (Sephanous vein)may be suitable
sites for Infants

23. Site Selection:-
 Short term:- (Peripheral vein (7days)
 Mid term:- (anterior Jugular vein, Subclavian vein (4Week)
 Long term:-( PICC Line)-Peripheral insert Central catheter)
(6Month)
 Incase of 3-5 year (Port Implant –Cancer patient-Superior vena-
cava & Rt Atrium

24.  Before inserting the IV line. Clean the IV site, skin &
an antimicrobial solution, using an Inner to
outer circular motion.

25.  If client with CHF usually not giving a solution
containing saline because it increase water
retention of water.
 If client with DM usually does not receive dexrose
(Glucose) solution.
 RL Solution contain Potasium & should not be
administered to client with renal failure

26. IV Complications:-
 Phalibitis:-An inflammation of the vein.
 Thrombophalibitis:- Development of a clot & infection of vein
 (Thrombophob Ointment used to minimize clot)
 Infiltration:-Seepage of Intravenous fluid out of the vain& in to the
surrounding in to the interstitial space.
 Air embolism
◦ Air enters blood stream
 Infection
◦ Localized or systemic
 Tissue damage
 Hematoma

27.  A client is nauseated, has been vomiting for several
hours, and needs to receive an antiemetic (anti-
nausea) medication. Which of the following is
accurate?
A. An enteric-coated medication should be given.
B. Any medication will not be absorbed as easily
because of the nausea problem.
C. A parenteral route is the route of choice.
D. A rectal suppository must be administered.
 C. A parenteral route is the route of choice.
MCQ