The document outlines the objectives and procedures for intravenous (IV) fluid therapy, including definitions, indications, types of IV fluids, and complications. It details the steps for IV cannulation, the necessary equipment, and nursing responsibilities during therapy. Emphasis is placed on making safe and effective decisions to manage fluid therapy responsibly while recognizing potential complications.

1. IV FLUID THERAPY
FARWANIYA HEALTH REGION
STAFF DEVELOPMENT UNIT

2. Objective
At the end of this session the staff nurse will be able to
• Define IV therapy.
• Describe the indication and Places to avoid of IV therapy.
• Mention the type of IV fluids.
• Identify Sites for venous puncture For adult & pediatric.
• Explain the formula for medication administration.
• List out the steps of IV cannulation.
• Discuss the Nursing responsibilities during IV therapy
• Enumerate the complication of IV therapy.

3. INTRODUCTION

4. INTRODUCTION
 Total body fluid- for approximately 60% of total body weight
 TBW can be divided into
• 2/3 of the TBW
• Found inside the plasma
membrane of the body's cells
Intracellular
• Interstitial compartment
• Intravascular compartment
• 3rd space
Extracellular

5. DEFINITION
Intravenous therapy (abbreviated as IV therapy) is a
treatment technique that infuses intravenous solution,
medications, nutrients, blood and blood products
directly into the vein

6.  Fluid and Electrolyte Replacement.
 Emergency Care
 Administration of Medication.
 Blood or Blood Products Administration.
 Administration of Total Parental Nutrition.
 Chemotherapy Administration.
 Administration of Contrast agent for CT,MRI and Nuclear Imaging.
 Surgery
Indications

7. Places to avoid
 Veins of the fractured limbs
 Same arm as an AV fistula
 An area that is affected by burns, oedema or infection
 Bony prominences/ flexion area
 A limb affected by stroke
 A limb that has a deep venous thrombosis
 Same arm of post mastectomy or lymph node dissection.
 Avoid inserting a cannula into the lower limb if possible

8. Types of IV Fluids
Fluids can be classified into
a. Colloids,
b. Crystalloids
c. Blood products

9. 1. Colloid
• Contain large molecules which remain in the
intravascular compartment to expand the
intravascular volume
• Used to increase the blood volume following
severe loss of blood or loss of plasma.
+ Examples: Albumin
Gelatine
Dextran

10. 2. Crystalloid
+ Contain small molecules that flow easily across the cell
membranes
+ This will increase fluid volume in both the interstitial and
intravascular spaces (Extracellular)
+ Used as maintenance fluids to correct body fluids and
electrolyte deficit .
+ It is subdivided into:
* Isotonic * Hypotonic * Hypertonic

11. Isotonic fluids
 Same osmolarity as blood serum
 No change at the cellular level
 Example
• Dextrose 5% in water
• Sodium chloride 0.9%
• Lactate ringer
-
Cells are stable

12. Hypotonic fluids
+ Decrease osmotic pressure causing fluid into
invade cells
+ Danger of water intoxication
+ Example
• 0.45% NaCl
• 0.2%NaCl
-
• Water moves
into cells

13. Hypertonic fluids
+ This fluid can cause venous irritation
+ The osmotic pressure drawing fluid from
cell
+ Danger of cellular dehydration
+ Examples - 3% sodium chloride (3% NaCl):
10,20,50,70 % Dextrose
: TPN
-
• Water moves out of
cells

14. Sites for venous puncture For adult

15. Sites for
venous
puncture
for
pediatric

16. Layers of the Vein

17. Parts of cannula

19. IV Calculation
Formula
 Calculating Rate in Drops per Minute
Volume x drop factor = drop/min
No of hours x 60
 Rate in mL per Hour

20. IV Calculation example
Calculating Rate in Drops per Minute
Start 2pints of ½ strength Normal Saline in Dextrose 5% to be given over
10 hours. If the IV set used is a micro drip set, how many drops per
minute shall the IVF be regulated?
Volume x drop factor 2 pints = 1000 ml
No of hours x 60 micro drop = 60
1000ml x 60 = 1000 = 100 drops/mt
10 x 60 10

21. IV Calculation example
Calculating ML Per hour
How many ml per hour will be set in an infusion pump to deliver 1 litter
over 8 hours?
Total volume 1000 = 125 ml / hour
No of hours 8

22. IV Cannulation procedure
EQUIPMENTS
1-Trolly containing
• Prescribed infusion fluid
• IV infusion set
• IV needle /cannulas of different sizes
• Alcohol 70%

23. Equipment (Cont.)
• Cotton balls
• Sterile gauze
• Bed protector
• Gloves
• Tourniquet
• IV label
• Kidney basin
• Adhesive plaster
• Pairs of scissors
• Flush - 10mL 0.9% NaCl
in a syringe

24. Equipment (Cont.)
2- Infusion stand
3- Container for waste
4- Sharp disposable box
Optional
1- Splint and bandage.
2- Shaving set

25. Steps of IV Cannulation
+ Confirm doctor’s instructions
+ Wash and dry hand
+ Assemble equipment
+ Identify the patient and explain the procedure
+ Provide privacy
+ Prime the IV set with prescribed solution
• Open the IV set and Iv solution aseptically
• Clamp the tubing
• Hang the IV solution on the IV stand
• Open the clamp , expel the air

26. Steps of IV Cannulation (Cont.)
+ Place the patient in comfortable position
+ Apply tourniquet, the tourniquet should be applied at a
pressure which is high enough to impede venous distension
but not to restrict arterial flow
+ Identify vein
+ Clean the site over the vein with alcohol wipe, allow to dry
+ Hold the cannula in your dominant hand, stretch the skin over
the vein to anchor the vein with your non-dominant hand.

27. + Insert the needle (bevel side up) at an angle of 10-30o
to
the skin (this will depend on vein depth.)
+ Observe the back flow of the blood and advance the
needle into the vein
+ Release the tourniquet
+ Flush the cannula using 10mL of 0.9%NaCl.
+ Connect iv tubing with needle ,release the clamp and
observe for swelling
Steps of IV Cannulation (Cont.)

28. Steps of IV Cannulation (Cont.)
+ Fix the needle with adhesive plaster and label with date
and time of insertion
+ Regulate the IV flow
+ Attach the infusion label with require information
+ Discard waste
+ Clean and replace reusable equipment
+ Wash and dry hands
+ Document the date, site, the cannula gauge and the number of attempts

29. Removing the Cannula
+ Wash your hands and don gloves.
+ Remove the dressing and any tape
surrounding the cannula.
+ Remove the cannula in a steady, fluid motion.
+ Apply pressure to the area using sterile gauze.
+ Place a small dressing (such as a cotton ball) to the area with tape.

30. Assess , Observe, record & report for the following :
1- The line for.
 IV line is intact or become disconnected
 IV therapy has stopped
 Back flow of blood into the IV line
 Any changes in the drip rate.
 kinks or air in the line
Nursing responsibilities during IV therapy

31. 2- The site of injection for :
 Proper positioning of IV
 Redness, any tissue swelling
 Pain or burning at IV site
 Any leakage, any coolness around IV site
 Any concerns verbalised by the patient
 Unusual changes in the patient e.g.: pallor / flushes / pain /
temperature
Nursing responsibilities during IV therapy(Cont.)

32. COMPLICATIONS
+ Infection: Redness, swelling and drainage at site;
chills, fever, malaise, headache
+ Tissue damage: Skin color change, sloughing of
skin, discomfort at site
+ Phlebitis: Heat, redness, tenderness, swollen
+ Thrombophlebitis:
Heat, redness, tenderness, hard
and cordlike vein

33. COMPLICATIONS (Cont.)
+ Air embolism: Tachycardia, dyspnea, hypotension,
cyanosis, decreased level of consciousness
+ Catheter embolism: Pain along vein, weak, rapid
pulse,
+ Hematoma: leakage of blood at the site, and hard painful
lumps at the site
+ Infiltration: Edema, pain, coolness at the site
+ Circulatory overload: Increased BP, distended
jugular veins, moist cough and crackles

34. Conclusion
Iv fluid therapy is very important for many medical conditions .
Fluid management for any particular medical condition has always been
an interesting but challenging field. Where, IV fluids can save the life of
an individual at the same time inappropriate administration can be a life
threatening.

35. Thanky
ou!
Any questions?