Iv fluids

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Iv fluids

  1. 1. IV FLUIDS MONITORING & FLUID BALANCE
  2. 2. IV THERAPY <ul><li>The goal to fluid administration: </li></ul><ul><li>To correct or prevent Fluid & Electrolyte Imbalances. </li></ul>
  3. 3. IV THERAPY <ul><li>Nurses need to know: </li></ul><ul><li>Correct solution </li></ul><ul><li>Correct equipment </li></ul><ul><li>Correct infusion rate EN (check) </li></ul><ul><li>System initiation </li></ul><ul><li>System maintenance </li></ul><ul><li>System monitoring EN (monitor) </li></ul><ul><li>Problem identification EN (report) </li></ul>
  4. 4. IV THERAPY <ul><li>Problem correction </li></ul><ul><li>Discontinuation of infusion </li></ul><ul><li>REMEMBER: </li></ul><ul><li>IV Fluids are Medications. </li></ul>
  5. 5. INTRAVENOUS THERAPY <ul><li>Intravenous – within a vein </li></ul><ul><li>Infusion - administration of fluids into a vein via a plastic catheter (cannula) </li></ul>
  6. 6. INTRAVENOUS THERAPY <ul><li>Purpose : </li></ul><ul><li>Fluid replacement </li></ul><ul><li>To correct fluid volume deficits </li></ul><ul><li>To maintain fluid & electrolyte balance </li></ul><ul><li>To administer intravenous medications e.g:IV antibiotics </li></ul><ul><li>To prolong nutritional support e.g:parental nutrition </li></ul>
  7. 7. INTRAVENOUS THERAPY <ul><li>Components : </li></ul><ul><li>IV cannula </li></ul><ul><li>IV giving (administration) set </li></ul><ul><li>IV fluids ( as per orders/different fluids for different situations) </li></ul><ul><li>An intravenous pump </li></ul><ul><li>IV fluid documentation (Medical Officers order & fluid balance chart) </li></ul>
  8. 8. INTRAVENOUS THERAPY <ul><li>Fluid Rate : </li></ul><ul><li>This is determined by the Medical Officer in accordance with the patients condition. </li></ul><ul><li>Orders must be documented & signed. </li></ul><ul><li>The flow rate should be checked every 15 minutes initially. Then as per policy. </li></ul><ul><li>If not monitored, the patient could become under hydrated or over hydrated. </li></ul>
  9. 9. TYPES OF IV SOLUTIONS <ul><li>Hypotonic : these solutions promote osmosis of extracellular fluid into the cells. </li></ul><ul><li>Hypertonic : these solutions promote osmosis of fluid out of the cells. </li></ul><ul><li>Isotonic : these solutions do not promote osmosis, but increase extracellular fluid volume. </li></ul>
  10. 10. CONTROL OF IV RATE <ul><li>Equipment used : </li></ul><ul><li>An infusion pump </li></ul><ul><li>A microdrip IV giving set </li></ul><ul><li>A burette </li></ul>
  11. 11. THE RN’S RESPONSIBILITY <ul><li>To add any drugs (ordered) to the infusion </li></ul><ul><li>To adjust the rate </li></ul><ul><li>To label and sign for any additives (drugs) to the IV fluid </li></ul><ul><li>To review and initiate any action in response to the EN’s concerns regarding the IV infusion or patient wellbeing. </li></ul>
  12. 12. GUIDELINES FOR OBSERVATIONS <ul><li>Know the patients normal range of vital signs to be able to identify the abnormal . </li></ul><ul><li>Note: </li></ul><ul><li>Dehydration : hypotension / tachycardia </li></ul><ul><li>Fluid overload : hypertension / bounding </li></ul><ul><li>pulse </li></ul>
  13. 13. OBSERVATIONS <ul><li>Observe, record & report : </li></ul><ul><li>Unusual changes in the patient e.g: pallor / flushes / pain / temperature </li></ul><ul><li>Any concerns verbalised by the patient </li></ul><ul><li>If IV therapy has stopped </li></ul><ul><li>If blood is noticed in the IV line </li></ul><ul><li>Check IV line for kinks / or air in the line </li></ul><ul><li>Check drip rate </li></ul><ul><li>Note fluid remaining in bag. </li></ul>
  14. 14. OBSERVATIONS <ul><li>Inspect the IV site : </li></ul><ul><li>For redness </li></ul><ul><li>Any tissue swelling </li></ul><ul><li>Ask the patient about pain or burning at IV site </li></ul><ul><li>Note any moisture leakage </li></ul><ul><li>Note if IV line is intact or has become disconnected </li></ul><ul><li>Note positioning of IV & any effect on drip rate </li></ul><ul><li>Note any coolness around IV site </li></ul>
  15. 15. COMPLICATIONS <ul><li>Infiltration : </li></ul><ul><li>Needle / cannula displacement </li></ul><ul><li>Blood leak from IV site </li></ul><ul><li>Air Embolism : </li></ul><ul><li>Air in IV tubing (IV bag has emptied) </li></ul><ul><li>Infection : </li></ul><ul><li>Note any signs of redness / pain / swelling/ hot to touch </li></ul>
  16. 16. COMPLICATIONS <ul><li>Circulatory (fluid) overload : </li></ul><ul><li>The cardiovascular system is unable to cope with the IV rate & volume. </li></ul><ul><li>The patient becomes pale / sweaty / short of breath. </li></ul><ul><li>Allergic reaction : </li></ul><ul><li>Note any known allergies & document </li></ul><ul><li>Observe for any reaction to IV additives e.g:IV antibiotics / blood products </li></ul>
  17. 17. COMPLICATIONS <ul><li>Signs & Symptoms </li></ul><ul><li>Infiltration : pain/redness/swelling/diminished flow rate. </li></ul><ul><li>Air embolism : decreased BP/weak, rapid pulse/cyanosis </li></ul><ul><li>Infected site :redness/pain/swelling/hot to touch/+/- yellow discharge </li></ul><ul><li>Circulatory overload :headache/dysponea/raised BP/flushed skin/fluid imbalance(volume infused vs volume excreted) </li></ul>
  18. 18. DO NOT… <ul><li>Use marking pens to write on IV fluid bags. Use appropriate stick on labels. </li></ul><ul><li>Adjust the flow rate, unnecessaraliy </li></ul><ul><li>Insert an IV cannula </li></ul><ul><li>Remove an IV cannula (without clarifying with RN) </li></ul>
  19. 19. DO…. <ul><li>Turn the IV fluid line off if it has ‘run through’ </li></ul><ul><li>Turn the IV fluid line off if it has dislodged at the IV site. </li></ul><ul><li>Check the IV insertion site every shift for localised reaction & document this in the patient progress notes. </li></ul>
  20. 20. <ul><li>Thank-you. </li></ul>

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