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1. IV Therapy IP-NUR-39

2. Objectives of IV therapy Achieve & maintain normal fluid & electrolyte balance Achieve optimal nutritional status Maintain homeostasis through blood blood products administration Medication administration

3. Composition Distribution body fluids Component Water electrolytes Distribution Intracellular- Extracellular Interstitial- Lymph Intravascular-plasma Transcellular-CSF, pleural, peritoneal & synovial

4. OsinolariN greater than OsmolariW equal to @ fluid body fluid SF .‹ fluid into blood Keeps fluid in the intravascular volume plasma by moving fluid from tissue cells Uses: Hypovolemia hyponatremia Watch for: Increase in BP Fluid overload Uses: dehydration, KVO, intravascular compartment expansion Fluid overload Low Hb/Hct levels Osmolari is less than body fluid Shifts fluid from intravascular to the tissue cells Uses: Expand and hydrate cells in cellular dehydration Monitor Na levels Hypotension

5. Examples of IVF

6. Common IV sites 1-cephaIic 2- basiIic median cubital medial cutaneous nerve of forearm medial antebrachial cutaneous n. lateral cutaneous nerve of forearm lateral antebrachial cutaneous n.

7. Standard intravenous catheter Used for continuous fluid administration Not considered for long term therapy Flow rate regulated manually by clamp or regulated by an automatic pump

8. Heparin Lock Intermittent infusion lock Used when fluid therapy is no longer required Used to administer intermittent medication Used to maintain venous access Needs flushing to maintain patency

9. Medication Administration Preparation- Always practice strict hand washing Preparation for additives Vial or ampule- measure appropriate amount Powder- mix with diluents

10. Intravenous Therapy & Piggyback

11. Medication Administration Preparation- s Always practice strict hand washing Preparation for additives Vial or ampule- measure appropriate amount Powder- mix with diluents

12. Complication IV-Site Infection : Does not produce much (if any) pus or inflammation at the IV site.  This is the most common cannula-related infection, may be the most difficult to identify 12

13. Complication Cellulites :  Warm, red and often tender skin surrounding the site of cannula insertion; pus is rarely detectable. 13

14. Complication Infiltration or tissuing occurs when the infusion (fluid) leaks into the surrounding tissue. It is important to detect early as tissue necrosis could occur – re-site cannula immediately 14

15. Complication Thrombolism / thrombophlebitis occur when a small clot becomes detached from the sheath of the cannula or the vessel wall – prevention is the greatest form of defence. Flush cannula regularly and consider re-siting the cannula if in prolonged use. 15

16. Complication Bruising commonly results from failed IV placement - particularly in the elderly and those on anticoagulant therapy. 16

17. Cannulation Extravasation is the accidental administration of IV drugs into the surrounding tissue, because the needle has punctured the vein and the infusion goes directly into the arm tissue. The leakage of high osmolarity solutions or chemotherapy agents can result in significant tissue destruction, and significant complications 17

18. Vascuiar Access Devices Short Peripheral catheters Midline Catheters PICC- peripherally inserted central catheters Nontunneled Percutaneous Central Catheters Implanted ports Dialysis catheters

19. Cat h e ter care & Maintenance Educate client Assessment Securing& dressing the catheter Changing administration sets Controlling infusion pressure Obtaining blood samples from catheter Keeping catheter patent Discontinuing catheter