Iv therapy


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Intravenous Therapy

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Iv therapy

  2. 2. TABLE OF CONTENTS<br />1. Basic Principles of IV Therapy
2. Fluids and Electolytes
3. IV Delivery Systems
4. Peripheral IV Therapy
5. Central IV Therapy
6. IV Therapy and the Nursing Process
7. Crystalloid Solutions
8. Colloid Solutions
9. Blood Component Therapy
10. Parenteral Therapy
11. Iv Pharmacological Therapy
12. IV Therapy and Infants and Children
13. IV Therapy and the Elderly
14. IV Therapy within Community-Based Settings<br />
  3. 3. Why is IV Therapy important?<br />As many as 75% of patients admitted into the hospital receive some type of IV therapy.<br />http://www.fastbleep.com/medical-notes/other/15/31/205<br />http://www.pearsonhighered.com/samplechapter/0131186116.pdf<br />www.finlay-online.com/.../Introduction_to_IV_Therapy[1].pp<br />50%-70% of the average human is body fluids. <br />Distribution of fluid in the body is:<br />1/3 in extracellular fluid<br /><ul><li> Interstitial fluid                
  4. 4. Plasma                          
  5. 5. Transcellular fluid            </li></ul>2/3 in intracellular fluid<br /><ul><li> Red blood cells            
  6. 6. Other cells                      
  7. 7. Establish or maintain a fluid or electrolyte balance
  8. 8. Administer continuous or intermittent medication
  9. 9. Administer bolus medication
  10. 10. Administer fluid to keep vein open
  11. 11. Administer blood or blood components
  12. 12. Administer intravenous anesthetics
  13. 13. Maintain or correct a patient's nutritional state
  14. 14. Administer diagnostic reagents
  15. 15. Monitor hemodynamic functions</li></ul>IV fluids come in four different forms:<br />• Colloids<br />• Crystalloids<br />• Blood and blood products<br />• Oxygen-carrying solutions<br />
  16. 16. Crystalloids <br />Crystalloids are water with electrolytes, which form a true solution and are able to pass through a semipermeable membrane. Crystalloids are lost rapidly from intravascular space into interstitial space (depending on the osmolality), and they remain in extracellular compartment for about 45 minutes. Therefore they require larger volumes than colloids for fluid resuscitation. Eventually water from crystalloids diffuse through intracellular fluid as well (membrane pumps and metabolism alter crystalloid distribution and osmotic forces). These may be hypertonic, isotonic or hypotonic.<br />Nevada and gasparis<br /><ul><li>ISOTONIC
  17. 17. Because an isotonic solution stays in the intravascular space, it expands the intravascular compartment.</li></ul>HYPERTONIC<br /><ul><li>A hypertonic solution draws fluid into the intravascular compartment from the cells and the interstitial compartments.</li></ul>HYPOTONIC<br /><ul><li>A hypotonic solution shifts fluid out of the intravascular compartment, hydrating the cells and the interstitial compartments</li></ul>A solution type depends on whether you want to change or maintain a patients fluid status.<br />
  18. 18. Commonly Used Crystalloid IV Solutions<br />http://instructor.mstc.edu/instructor/randers/documents/IV%20fluids%20chart.pdf<br />
  19. 19. Colloids<br />Colloid solutions are IV fluids that contain solutes in the form of large proteins or other similarly sized molecules. The proteins and molecules are so large that they cannot pass through the walls of the capillaries and onto the cells. Accordingly, colloids remain in the blood vessels for long periods of time and can significantly increase the intravascular volume (volume of blood). The proteins also have the ability to attract water from the cells into the blood vessels. However, although the movement of water from the cells into the bloodstream may be beneficial in the short term, continual movement in this direction can cause the cells to lose too much water and become dehydrated.<br />http://www.pearsonhighered.com/samplechapter/0131186116.pdf<br />http://www.modernmedicine.com/modernmedicine/data/articlestandard/rnweb/412007/463604/i1.gif<br /><ul><li>blood
  20. 20. plasma / albumin
  21. 21. synthetics</li></li></ul><li>Blood Products<br />https://www.healthinfotranslations.org/pdfDocs/Receiving_Blood_Products_Som_FINAL.pdf<br />http://www.pearsonhighered.com/samplechapter/0131186116.pdf<br />• Plasma<br />This is the liquid part of the blood. It is often used to add volume to the blood system after a large loss of blood. Cryoprecipitate is a concentrated source of certain plasma proteins. It is used to treat some bleeding problems. <br />• Red blood cells <br />These carry oxygen from the lungs to other parts of the body and then they carry carbon dioxide back to the lungs. A low red blood cell count is called anemia. A red blood cell transfusion may be needed to treat anemia. <br />• White blood cells <br />These help fight infection, bacteria and other substances that enter the body. When the white blood cell count becomes too low, it is called Neutropenia. A white blood cell transfusion may be needed to treat Neutropenia. <br />• Platelets <br />These help blood to clot. Platelet transfusions are given when the platelet count is too low. <br />Oxygen-carrying Solutions<br /><ul><li> Oxygen-carrying solutions are synthetic fluids that carry and deliver oxygen to the cells. These fluids, which remain experimental, show promise for the prehospital care of patients who have experienced severe blood loss or are otherwise suffering from hypovolemia. It is hoped that oxygen-carrying solutions will be similar to crystalloid solutions in cost, storage capability, and ease of administration, and be capable of carrying oxygen, which presently can only be accomplished by blood or blood products.</li></li></ul><li>Daily Recommended Electrolyte Levels<br />Leavitt Leavitt<br />Leavitt<br />Leavitt<br />V Leavitt<br />Leavitt<br />Leavitt<br />Leavitt<br />Leavitt<br />Leavitt<br />Leavitt<br />Leavitt<br />Leavitt<br />Leavitt<br />www.medscape.com<br />
  22. 22. Fluid Imbalances<br />
  23. 23. Electrolyte Imbalances<br />http://www.modernmedicine.com/modernmedicine/data/articlestandard/rnweb/182005/158213/electrolyte_balance_may05_i2.gif<br />
  24. 24. Positive Trousseau’s SignCarpopedal attitude of the hand when blood pressure cuff is placed on the arm and inflated above systolic pressure for 3 minutes. Positive reaction is the development of carpal spasm.<br />Positive Chvostek’s Sign<br />Occurs after tapping the facial nerve approximately 2 cm anterior to the earlobe.<br />-- ---<br />
  25. 25.
  26. 26. Electrolyte Composition of Body Fluids<br />http://www.fastbleep.com/medical-notes/other/15/31/205<br />
  27. 27. Electrolyte Composition of IV Fluids<br />
  28. 28. Common IV Formulas and Conversions<br />
  29. 29. Comparing Needle and Catheter Gauges<br />http://emprocedures.com/peripheraliv/equipment.htm<br />
  30. 30. Complications of IV Therapy<br />Bohony, J. (1993). 9 common IV complications and what to do about them. American Journal of Nursing, 93(10), 45-49. Retrieved from EBSCOhost.<br />
  31. 31. Common Terms and Abbreviations<br />http://www.iv-infiltration-injuries.com/Practice-Areas/IV-Terms-and-Definitions.shtml<br />
  32. 32. 9. Infusion-related complications 60<br />9.1 Phlebitis 60<br />9.2 Infiltration 60<br />9.3 Extravasation 61<br />9.4 Haematoma 61<br />9.5 Haemorrhage 62<br />9.6 Pneumothorax and haemothorax 62<br />9.7 Cardiac tamponade 63<br />9.8 Air embolism 63<br />9.9 Speedshock/fluid overload 64<br />9.10 Infusion-related bloodstream infections 64<br />9.11 Thrombosis 65<br />http://www.rcn.org.uk/__data/assets/pdf_file/0005/78593/002179.pdf<br />
  33. 33. References<br />Lenox, A. C. (1990). IV THERAPY: REDUCING THE RISK OF INFECTION. Nursing, 20(3), 60-61. Retrieved from EBSCOhost<br />Southern Nevada Regional Professional Development Program. (n.d.). Effects of Solutions on a Red Blood Cell. Retrieved http://www.rpdp.net/sciencetips_v3/L8B2.htm<br />Gasparis, L., Murray, E., & Ursomanno, P. (1989). I.V. solutions: which one's right for your patient?. Nursing, 19(4), 62-64. Retrieved from EBSCOhost.<br />