This document provides information on administering medication through the intravenous route. It discusses the purposes of intravenous administration, types including bolus and continuous infusion, common sites for venipuncture, and procedures for intravenous bolus administration and starting an intravenous line. Complications from intravenous therapy like infiltration, thrombophlebitis, and air embolism are also covered. The document aims to outline best practices for safe and effective intravenous medication administration.

1. Administration of Medication through
Intravenous Route
Presented by: Ganga Tiwari
Bsc. Nsg 4th year, Teaching Learning
TU, IOM, MNC, Kathmandu, Nepal

2. Contents
 Introduction of intravenous injection
 Purposes
 Types of intravenous administration
 Articles required
 Procedure for intravenous bolus
administration.

3. Contents…
 Different types of intravenous solution
 Venepuncture
 Common sites
 Articles required
 Procedure
 Intravenous infusion care

4. Introduction
 It is the administration of medication
directly into the bloodstream.
 It can be continuous or intermittent.
Continuous administration is called an
intravenous drip.
 Compared to the other route of
administration, the intravenous route
is the fastest way to deliver fluid and
medication throughout the body.

5. Types of Iv methods
 Adding medicine in intravenous
solution bottle.
 Existing intravenous line for
continuous infusion.
 Bolus- direct intravenous push for
immediate or fast action.

6. Articles required
 Medication tray containing
 Medicine ( from vial or ampule)
 Medicine cutter or opener
 Dilutant ( distilled water or NS) when
medicine is available in powdered form.
 Syringe and needle
 Sprit swab
 Tourniquet
 Disposable gloves
 Kidney tray.

7. Procedure
 Check the physician instructions and
identify the patient.
 Explain the procedure to the patient the
purpose of medication ,site of injection,
expected effect and how to cooperate
 Wash hands.
 Prepare the medication and assemble all
articles at the patient’s bed site.
 Maintain privacy
 Wear gloves.

8. Procedure...
 Place the patient relaxed and
comfortable position suitable for
intravenous injection.
 Select a site suitable for the route of
administration, quantity of medication
given and characteristics of
medication.
 Apply the tourniquet in the upper arm
(about 5- 6 inches above the site.)
 Ask the patient to open and close the

9. Procedure..
 Clean the site with spirit swab and
allow it to dry.
 Pull the skin taut and place the needle
in the line with vein at a 15 to 45
degree angle.
 Insert the needle a bit below the point
of needle insertion.
 When the backflow of the blood
occurs into the syringe, release the
tourniquet and inject the medication
slowly.

10. Procedure..
 As you remove the needle. Press the
vein slowly with dry cotton swab at the
puncture site to prevent bleeding.
 Assist the patient to a comfortable
position.
 Document the administration of drug.
 Observe patient for any allergic
reaction.

11. Introducing medicine through
heparin lock/ saline lock
 Withdraw 2 ml of sterile normal saline
in one syringe and draw medicine in
another syringe.
 Remove the cap from the port.
 Insert the syringe with normal saline
into the port and flush with 1 ml
normal saline.

12. Contd..
 Remove the syringe. Insert the syringe
containing medicine and inject the
medicine.
 Do not force if the resistance is felt.
 Remove the syringe when
administration is completed.
 Insert the syringe containing saline
and flush the site with 1 ml of normal
saline.

13. Contd..
 Remove the syringe and put on hep
lock/ IV lock.
 Dispose syringe and the needle in
puncture proof container.
 Remove gloves and dispose properly.
 Wash hands.
 Document the medication
administration.
 Observe patient for adverse reaction

14. Contd..
 Intravenous infusion refers to the
administration of fluids, nutrients,
electrolytes, vitamins, blood and
minerals, medications directly in to the
vein.
 IV administration is done to establish
/maintain the state of fluid and
electrolyte balance in a patient. It can
be continuous or intermittent.

15. Types of IV solution
-Crystalloid
Crystalloids are the solution of sterile
water and added electrolytes to
approximate the mineral content of
human plasma.
They are further classified as:

16. 1. Isotonic solution
 A solution is isotonic when the
concentration of dissolved particles is
similar to that of plasma. Isotonic
solution have osmolality 250 to 375
mOsm/L.
 E.g. Normal Saline (0.9%) , 5%
dextrose in water (D5W), Ringer
lactate(RL) solution.

17. 2.Hypotonic solution
 A solution is said to be hypotonic
when the concentration of the
dissolved particles is less than the
plasma in the body. Hypotonic IV
solution have osmolality less than 250
mOsm/L.
 E.g. 0.45 % NS and 2.5% dextrose.

18. 3.Hypertonic solution
 Hypertonic crystalloids have a tonicity
that is greater than the plasma in the
body causing unequal pressure
gradient between the inside and the
outside the cell.
 Hypertonic solutions are used as
volume expanders. e.g. 10 %
dextrose, 25% dextrose,50 %
dextrose,3% NS and 5 % NS(DNS)

19. Colloid
 Colloids solutions are the IV solutions
that contain solutes in the form of
large proteins or other similarly sized
molecules.
 E.g. albumin, gelatin, starches,
dextrans, gelofusine etc.

20. Venepuncture

21. Definition
 Puncturing vein for the purpose of
drawing blood sample or administering
medication is called venipuncture.

22. Common sites
 Basilic vein and cephalic veins ( fore
arm)
 Median cubital vein
 Radial vein
 Dorsal metacarpal vein
 Great saphenous veins, dorsal flexus
( vein in the foot)
 Femoral and saphenous vein ( thigh)
 Vein in the scalp( for infants)

24. Sites preferred
 Mostly superficial veins are suitable so
forearm is preferred. Which are more
visible and can be stabilized easily.
 As forearm acts as a natural splint,
immobilization with an arm board is
rarely necessary.
 Veins of the ankle and foot are best
avoided.

25. Sites preferred..
 Use distal vein of the arm first.
 Use the non- dominant hand
 Select the vein that is easily palpated,
feel soft and naturally splinted by
bone
 Avoid using veins that are in the area
of joint or flexion.

26. Articles
 Medication tray containing:
 -Cardex
 -Medicine/ IV drip
 -Medicine cutter / opener
 -IV cannula of appropriate gauge
 -IV drip infusion set
 -IV stand
 -Tourniquet
 -Spirit swab

27. Contd..
 Syringe containing normal saline/ flush
 Kidney tray

28. Parts of IV cannula

29. Different sizes of IV cannula

30. Beuroset( volumetric IV set)

31. Procedure for starting a new IV
line.
 Check physician’s instructions, identify
the patient.
 Explain procedure to the patient.
 Wash hands.
 Assemble all the necessary articles at
patient’s bed site.
 Maintain privacy.
 Maintain aseptic technique while opening
IV solution and IV set.
 Clamp IV set.

32. Contd..
 Uncap the spike and insert on the IV
solution
 Hang the container on the IV stand.
 Squeeze the drip chamber and allow it to
fill at least 1/3rdof the chamber.
 Release the clamp and allow the fluid to
flow until air has escaped the tube.
 Close the clamp.
 Apply label containing date, time, and
amount of medicine added if any
medicine is added.

33. Perform venepuncture
 Position the patient in supine position
or comfortable position.
 Place protective pad under the patient
arm.
 Select the appropriate size and
palpate the accessible veins.
 Apply tourniquet 5 -6 inches above the
venipuncture site to obstruct venous
blood flow and distend the vein.

34. Contd..
 Ask the patient to open and close the
fist.
 Observe and palpate for suitable vein.
 If the vein is not visible tab the vein
gently or apply the hot compress over
the area for 10 to 15 minutes.
 Wear gloves

35. Contd..
 Cleanse the entry site with spirit swab
using circular motion from center to
outwards.
 Hold the hand about 1-2 inches below
the entry site with non -dominant
hand.
 Pierce the vein gently at an angle of
15 to 30 degrees holding the dominant
hand with the bevel site up.

36. Contd..
 When the blood is seen withdraw the
needle a little and advance the
cannula until the hub is at the
venipuncture site.
 Remove the needle.
 Release the tourniquet.
 Quickly remove the protective cap
from IV tubing and attach the tube to
the cannula.

37. Contd..
 Release the clamp on the tube.
 Examine the flow rate and the site for
any signs of IV infiltration.
 Secure the cannula with the tape and
label the date and time of
venepuncture.

38. Intravenous infusion care
 Administration IV fluid with clearly
written prescription.
 Follow strict aseptic technique during
the procedure.
 Maintain the specified rate of flow to
prevent circulatory overload.
 Maintain the height of the bottle at
about 18 to 24 inches (about 45 cm)

39. Contd..
 Instruct patient not to move hand with
iv infusion unnecessarily.
 Observe for any swelling, redness and
pain at the IV site.
 Never allow bottle to empty completely
to prevent the entry of air.
 While disconnecting bottle first clamp
the tube.

40. Contd..
 Calculate the flow rate.
 Do not use if the site is tender, red,
edematous and inflamed.
 If fluids are discolored, cloudy in
appearance they should not be used
for infusion.
 If more than one bottle is to be
administered, keep the second bottle
ready before the first bottle is empty.

41. Contd..
 Monitor vital signs
 if there is no swelling, tenderness or
pain change IV cannula after 72

42. Complications
 Infiltration
 Thrombophlebitis
 Air embolism
 Pyrogenic reaction
 Hematoma formation

43. IV Infiltration.

44. Thrombophlebitis

45. Air embolism

46. Hematoma

47. References
 Health learning material center. Institute of
medicine of medicine ,Tribhuwan
University.Fundamentals of nursing (
second edition reprint ,2010).
Kathmandu:Heidal Press ,Dillibazar.
 Basvanthappa,B.T.(2004). Fundamentals of
Nursing. New Delhi :Jaypee Brothers.
 Perry, A.G. and Potter, P.A. (2007).Basic
Nursing Essentials For Practice .(sixth
edition): Mosby
 Giri, M. and Sharma,P. (2013). Essential
Fundamental Of Nursing.(first
edition).Kathmandu: Medhavi Publication.

48. References..
 Pathak ,S.and Devkota ,R.(2011).A
Textbook of Fundamentals of
Nursing.(second
edition).Kathmandu:Vidyarthi
Prakashan.
 Taylor,C.R. and Lillis,C.(2008).
Fundamental of
Nursing.(Volume1):Lippincott William
and Willikins
 Skidmere ,L . Nursing Drug
Reference(2009): Mosby

49. THANK YOU !!