ANUR 603 Nursing Theory and Practice 5 .

In this presentation the student is given the opportunity to observe how to perform insertion of the Nasogastric tube

1. INTRAVENOUS INFUSION
PREPARED BY
MrsSilpaJose T
Assistant Professor
STCON,KATTANAM

2. DefinitionofIVFluids
Theword"intravenous"asanounreferstoanintravenous
fluid drip, a solution (usually a balanced electrolyte solution)
administered directly into the venous circulation.
Intravenous(iv)therapyistheinsertionofa
needle or catheter/cannula into a vein, based
on the physician’s written prescription. The
needle or catheter / cannulaisattachedtoa
steriletubinganda fluid container to provide
medication and fluids.

3. IndicationsofIVTherapy
providefluidandelectrolytemaintenance,restoration,
andreplacement
•Administermedicationandnutritionalreplacement
•Administerbloodandbloodproducts
•Administerchemotherapytocancerpatients
•Administer key-controlledanalgesics
•Keepaveinopenforquickaccess

4. TYPESOFIVFLUIDS
1/colloid:
Solutionsthatcontainlargemoleculesthat
don’t pass the cellmembranes.
Wheninfused,theyremainintheintravascular
compartment and expand the intravascular
volumeandtheydrawfluidfrom
extravascularspacesviatheirhigheroncotic
pressure.

5. TYPESOFIVFLUIDS
Volume expanders(Colloid)
–Areusedtoincreasethebloodvolume
following
severelossofblood(haemorrhage)orlossof
plasma ( severeburns).
–Expanderspresentindextran,plasma,and
albumin.

6. TYPESOFIVFLUIDS
2/Crystalloid:
Solutionsthatcontainsmallmoleculesthatfloweasily
acrossthecellmembranes,allowingfortransfer
fromthebloodstreamintothecellsandbody
tissues.
Thiswillincreasefluidvolumeinboththeinterstitial
and intravascular spaces ( Extravascular).
Itis subdivided into:
Isotonic•
Hypotonic•
hypertonic•

7. TYPESOFIVFLUIDS
Electrolyte solutions(Crystalloid)
–Fluidsthatconsistofwateranddissolved
crystals, such as salts andsugar.
–Usedasmaintenancefluidstocorrectbody
fluidsandelectrolytedeficit.
–Divided todifferent types.

8. SolutionsTypes
1/ Hypotonic -solutions
that have a lower
osmolality than body
fluids
2/ Hypertonic -solutions
that have ahigher
osmolality thanbody
fluids
3/ Isotonic -solutions that
have thesame
osmolality as bodyfluids

9. INTRAVENOUS INFUSION
DEVICES
Cannula
IV Tubing set &Solution bag
IV Pole and/orPump
Tape

10. IV AdministrationSet

12. orDripContinuousIV
Infusion –IVfluidsor
medications such as
aminophyllineandheparinare
addedtoIVfluidcontainerand
hungatthepatient’sbedsideand
allowtodripslowlyintoaveinby
gravityfloworthroughtheuseof
electricalbattery- operated
volumetricinfusionpumps.Thisis
slow,primarylineinfusionofanIV
preparationto maintaina
therapeuticdruglevelorprovide
fluidandelectrolytereplacement.

14. IntermittentIVInfusion–Thisallowsdrug
administeredatspecificintervals.
Threedifferenttechniquesmaybe
used:

15. Heparin lock or heparin
well system –Heparin
lock is a device
consisting of an IV
needle attached to a
short plastic tube which
terminates in a rubber
seal through which
medication is injected or
infused at designated
times.

17. IVPiggyback
IV Piggyback –Medication is
added to a small volumecontainer
and connected as a secondary
infusion to a primary IVline.

19. Additive Set Infusion
–Use of volume
control device
designed to administer
small amounts of fluids
over a specified time
period. Usually 30 to
60 minutes, by
attaching its fluid
chamber to an
independent fluid
supply or placed
directly under the
established primary IV
line.

21. How to calculate IV flowrates !
Intravenous fluid must be given at a specific rate,neithertoofastnortooslow.
Thespecific rate may be measured as ml/hour, L/hour or drops/min. To control or
adjust the flow rate onlydropsperminuteareused.

22. How to calculate IV flowrates !
What is a dropfactor?
Dropfactoristhenumberofdropsinonemilliliter
used in IV fluid administration (also called drip
factor). A number of different drop factors are
available but theCommonest are:
110 drops/ml (bloodset)
215 drops / ml (regularset)
360drops/ml(microdrop,burette)

24. How to calculate IV flow rates?

25. IV INFUSION PUMP

26. NursingcareduringIVF
administrations
ChecktheIVsolutionforthetypeamount,percentofsolutionandrateof
flow
•Assess thehealthstatusandmedicaldisorders
•Washhandsthoroughlyandusesteriletechnique
•Primethetubingtoremoveairfromthesystem
•ChangetheIVsiteevery48–72hrs
•ChangetheIVdressingevery72hrsespeciallywhenwetand
contaminated
•ChangetheIVtubingevery24to72hrs
•Labelthetubing,dressingandsolutionbagsindicatingthedateandtime
whenchanged
•Beforeaddingmedorsolutions,swabaccessportswith70%alcohol
•InpreparingtoAdministerIntravenousTherapythenurseselectsthe
mostappropriateinsertionsiteandtypeofcannulaforaparticular
patient
•Documentation

27. COMPLICATIONS
Infection –redness,
swelling and
drainage at site;
chills, fever,
malaise,
headache
•Tissuedamage–
skincolorchange,
sloughingofskin,
discomfortatsite

28. COMPLICATIONS
Phlebitis –heat,
redness,tenderness,
not
hard andswollen
Thrombophlebitis –
heat,redness,
tenderness, hardand
cordlikevein

29. COMPLICATIONS
Infiltration–Edema,
pain,andcoolnessat
thesite
Catheter embolism –
decrease BP, pain
along vein, weak,rapid
pulse, cyanosisof
nail beds, lossof
consciousness

30. COMPLICATIONS
Circulatory overload –
increased BP,
distended jugularveins,
rapid breathing,
dyspnea, moist cough
andcrackles
Electrolyte overload –signs
depend onthe
specificelectrolyte
imbalance

31. COMPLICATIONS
Hematoma –ecchymosis,
immediate
swelling and leakageof
blood at thesite,
and hard painfullumps
at thesite
Air embolism –
tachycardia, dyspnea,
hypotension,cyanosis,
decreased level of
consciousness