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IV Therapy Complications How to hang an IV 1 Fluid Balance Fluid intake Normal Fluids ingested Oral 1100-1400 mL Foods 800-1000 mL Metabolism 300 mL Total 2200-2700 Fluid output Skin (sweat) 500-600 mL Insensible (lungs) 400 mL GI 100-200 mL Urine 1200-1500 Ml Total 2200-2700 2 Intravenous Therapy •The goal of IV fluid administration is to •Correct or prevent fluid and electrolyte disturbances •Provide direct access to the vascular system 3 Types of Solutions • Isotonic: • • • • Most common A fluid with the same concentration of normal blood Ex. 0.9% Sodium Chloride (NS), 5% Dextrose in Water (D5W) Used for volume replacement (eg. after prolonged vomiting); • Hypotonic • A fluid that is more dilute than blood • Used to rehydrate the cells; eg. 0.45% NaCl, D5 0.45% NaCl • Hypertonic • A fluid that is more concentrated than normal blood • Used to increase vascular volume, use with caution due to risk for fluid overload; eg. D10 W, D5 LR, 3% normal saline 4 Intravenous Therapy: Additives • Potassium chloride (KCl): common • 1000 ml D5 ½ NS with 20 mEq KCl at 125 mL/hr • Potassium must be given carefully, since hyperkalemia can cause fatal cardiac dysrhythmias • NEVER give KCl IV push • KCl must be given slowly • KCl is irritating to the veins and patients will complain of pain 5 Intravenous Therapy: Orders Should contain: • specific solution • Volume to be infused • Rate • Frequency • additives • time schedule • Example: D5½ NS with 20 meq KCL Follow 7 rights of medication administration, same as with all medications 6 Vascular Access Devices (VADs) • Peripheral catheters: short term use (after surgery or a procedure) 7 Vascular Access Devices (VADs) • Central Catheters: long-term use (chemo therapy, PN) • More effective than peripheral catheters for administering large volumes of fluid, PN and medications 8 IV Therapy: Central Line 9 IV Therapy: Implanted Ports 10 Vascular Access Devices (VADs) • Central Catheters: long-term use (chemo therapy, PN) • PICC: Peripherally inserted central catheters 11 IV Therapy: Peripheral Sites Feet not recommended for adults 12 IV Therapy: Starting an IV • Review order • Get supplies • Explain to patient • Find best vein • Start distally • Perform venipuncture, secure, start fluids • Document • Dressing should be transparent 13 IV Therapy: Equipment 14 Nexvia 15 Nexiva 16 Nexiva With your power point in full screen, click on movie icon for youtube. 17 IV Therapy: Dressing 18 Complications of Intravenous Therapy 19 Circulatory overload NI: Reduce IV flow rate and Notify HCP Raise head of bed Monitor VS and labs Watch for new IV order 20 Infiltration or Extravastion 21 Phlebitis 22 Local infection 23 Bleeding at IV Site 24 Alaris® Pump module Preparing an Infusion 25 Alaris® Pump module Preparing an Infusion 26 Alaris® Pump module Preparing an Infusion 27 Alaris® Pump module Preparing an Infusion 28 Alaris® Pump module Preparing an Infusion 29 Alaris Pumps 30 31 Alaris Pumps 32 Secondary Tubing 33 34 35