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Transcript
Carolyn McCune, RN, MSN, CRNP
Teresa Peck RN, BSN
 Review
syllabus and course requirements
 Answers any questions related to class
 www.emprocedures.com/index.htm
 Then go to Peripheral IV access
4723.171 Intravenous therapy procedures.
(A) A licensed practical nurse may perform on any person any of the intravenous
therapy procedures specified in division (B) of this section without receiving
authorization to perform intravenous therapy from the board of nursing under section
4723.17 of the Revised Code, if both of the following apply:
(1) The licensed practical nurse acts at the direction of a registered nurse or a licensed
physician, dentist, optometrist, or podiatrist and the registered nurse, physician,
dentist, optometrist, or podiatrist is on the premises where the procedure is to be
performed or accessible by some form of telecommunication.
(2) The licensed practical nurse can demonstrate the knowledge, skills, and ability to
perform the procedure safely.
(B) The intravenous therapy procedures that a licensed practical nurse may perform
pursuant to division (A) of this section are limited to the following:
(1) Verification of the type of peripheral intravenous solution being administered;
(2) Examination of a peripheral infusion site and the extremity for possible infiltration;
(3) Regulation of a peripheral intravenous infusion according to the prescribed flow
rate;
(4) Discontinuation of a peripheral intravenous device at the appropriate time;
(5) Performance of routine dressing changes at the insertion site of a peripheral
venous or arterial infusion, peripherally inserted central catheter infusion, or central
venous pressure subclavian infusion.
Effective Date: 04-10-2001
 First
began in the 17th century
 19th century-infection control procedures
 mid 1950’s-used for surgery and
hydration(20%)
 Today approximately 90 % of pts in hospital
receive IV’s
 Skilled nursing homes, doctors office and
home
 Fluid
and electrolyte maintenance,
restoration and replacement
 Administer medications and nutritional
feedings
 Give blood and blood products
 Chemotherapy
 Patient controlled analgesics
 KVO for quick access
 Oral
medications-absorbed in the digestive
tract
 IV- faster acting and distributed throughout
the bloodstream immediately after giving
 Unconscious
pt:
 Unable to swallow:
 Vomiting:
 Nutrition:
 Others?
 Slides
3-6-material from Fulcher and
Frazier(2007)
 Pre-existing
vascular compromise
 Regional infection
 Adult:
 Antibiotic:
 Arterial
Line:
 Aspirate:
 Central Line:
 Central Venous Access Device: (CVAD’S)
 Continuous
Infusions:
 Controlled Analgesic:
 Drip Factor:
 Electronic Pumps and Controllers:
 Flow Rate:ml/hr or gtts/min
 Infiltration:
 Infusion Devices:
 Thru
peripheral IV sites-depend on gravity
for administration- must be 24-36 inches
above IV sites
 If patient changes positions volume
decreases-back pressure greater, rate slows
or stops
 Simplest controllers-roller or slide clamp
 Use to speed up or slow, counts gtts in drip
chamber
 Apply
external pressure to administration set
tubing to run at specified rate
 Specific volume/time
 More accurate
 Alarm systems-kinks, air, occlusion
 Disadvantage-Cost of equipment,
maintenance, more serious infiltration.
SYRINGE
 Holds
PUMPS
prefilled syringe
 Positive pressure to plunger delivers specific
volume
 Used for small volume
 Insulin pumps, PCA pumps
 Safer, preprogramming to prevent calculator
errors
 Initiate:
 Intermittent
Infusion: (Piggyback)
 Intravenous: (IV)
 IV Bolus:
 IV Push:
 Maintain
 Nurse
Practice Act: (Ohio)
 Palpation:
 Peripheral:
 Peripherally Inserted Central Catheters:
(PICC’s)
 Phlebitis:
 Piggyback:
 Roller
clamp:
 Tourniquet:
 TPN:
 Transparent Dressing:
 Venipuncture:
 Other Terms:
 Questions????????
 Apparatus
that connects large volume
parenteral solution with IV access device into
patient veins
 Insertion spikes
 Clip chamber
 Plastic tubing with rate control clamp
 Rubber injection port
 Needle adapter and protective cap on needle
adapter
 Over
needle cath left in for medical
administration
 Flush every 8 hours
 Flush before/after meds
 See
Handout from OBN website
 Chapter 4723-17
 Try
to access sites