Important ppt for medical students

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Chapter 15
Introduction to IV Therapy

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Primary Line
• Typically connected to maintenance IV
fluids
• Includes spike, drip chamber, and roller
clamps for adjusting drip rate and ports for
IV medications

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Primary Line Set-Up: Step 1
• Assumes IV fluid bag is ready
• Open package containing tubing
• Close all roller clamps on IV tubing to
prevent air bubbles

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Primary Line Set-Up: Step 2
• Use sterile technique
• Pull cover off port on bag
• Pull cover off IV tubing spike
• Spike IV bag

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Primary Line Set-Up: Step 3
• Squeeze drip chamber
• Fill approximately half full with IV fluids
– Or to mark provided by tubing manufacturer

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Primary Line Set-Up: Step 4
• Prime tubing with IV fluids to remove air
• Open roller clamp closest to drip chamber
• Air must be displaced to prevent client from
experiencing air embolism

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Primary Line Set-Up: Step 5
• Close roller clamp

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Primary Line Set-Up: Step 6
• Label tubing with the following
information:
– Date
– Time
– Initials

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Remember
• With gravity drip IV lines, pressure in line
is created when fluid drop falls in drip
chamber
• With electronic volumetric IV pump, pump
maintains constant pressure in line to
maintain patency of IV access

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Secondary Line
• Shorter tubing used to infuse small-volume
medications
• Also referred to as IV piggybacks (IVPB) or
minibags (IVMB)

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ADD-Vantage® Bags
• Have powdered medication in vial in top of
small-volume bag with IV fluid in it
• Vial opened within IV bag
• Medication mixes with fluid for infusion
• Used to package medications with short
shelf life in solution

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Volume-Controlled Burettes
• For greater accuracy in measurement of
small-volume IV medications or fluids, use
calibrated burette chamber
• Used most often in intensive care unit (ICU)
for frequent small-volume fluid replacement

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Indwelling Infusion Ports
• Used for intermittent IV medication
administration, either IVMB or IV bolus
• Most often referred to as:
– Saline locks
– Heparin locks
– Medlocks

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IV Bolus/IV Push
• Medications administered directly through
lock or into IV tubing port if IV fluids
infusing

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Flush with IV Bolus
• When administering IV bolus medications,
must flush before and after medication with
5 to 10 mL of compatible flush fluid

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Volumetric Pumps
• Electronic devices
• Force fluids into vein under pressure
• Maintain patency of IV
• Control infusion rates

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Volumetric Pumps
• Hospital or clinical in-service education
required for use of all infusion pumps
• Programming of pumps must be double-
checked
• IVs still should be checked every hour

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Syringe Pump
• Variations on electronic volumetric pumps
• Used to infuse drugs that cannot be mixed
with other solutions or medications
• Used with very small volumes
– e.g., infants, ICU clients

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Patient-Controlled Analgesia
(PCA) Devices
• Allow client to self-administer medication
to control pain
• Pre-filled syringe or medication bag
containing analgesics (opioids) inserted into
device

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PCA Pumps
• Items programmed into device include the
following:
– Dosage
– Frequency
– Lock-out time
– Amount

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Introduction to IV Fluids
• Manufactured and packaged under sterile
conditions
• Most prepared in plastic bags
• Volumes range from 25 to 1000 mL

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IV Fluids
• Abbreviations
– Dextrose (D)
– Water (W)
– Saline (S)
– Normal saline (NS)
• Numbers identify percentage strengths

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Fluid Strengths
• Percentages mean grams of drug per 100
mL of fluid
– e.g., 5% dextrose, 0.9% normal saline, 0.45% normal
saline, 3% saline

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Parenteral Nutrition
• Administer nutrition solution via central
vein through central venous access device
(CVAD)
• Usually infused slowly
• Solutions usually changed every 24 hours to
prevent spoilage and bacterial growth

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Types of Parenteral Nutrition
• Total parenteral nutrition (TPN)
• Partial parenteral nutrition (PPN)
• Hyperalimentation