Intravenous Infusion Procedure for Demonstration

Intravenous

1. SKILLS ENHANCEMENT Nursing Procedures

2. PARENTERAL MEDICATION

3. Is giving of fairly large amount of fluids into the vein ACTION SYSTEMIC EFFECT INTRAVENOUS INJECTION

4. Purposes: To supply the body with fluids when the patient is unable to take adequate amounts by mouth

5. Purposes: To supply the body with salts or tissue fluids and thus maintain the fluid and electrolytes balance of the body

6. Purposes: To supply the body with nutrients To reduce body temperature To dilute amounts of bacteria and toxins

7. Action: Systemic effect More rapid than IM and SQ route

8. Site: Accessible peripheral veins are preferred: Cephalic vein of the arm Dorsal vein of the hand

9. Site: When possible ask the clients of his or her preference. Avoid needless restrictions. In newborns, the veins of the feet, lower legs and head may also be used after the previous sites have been exhausted.

10. Equipment: Needle: Adults – 20 – 21 gauge; 1-1.5 inches Infants – 24 gauge; 1 inch Children – 22 gauge; 1 inch Use larger bore for viscous drug. Whole blood or fractions; large volume for rapid absorption

11. Equipment: Electronic IV delivery device – an infusion controller or pump

12. Precautions: Maintain aseptic technique throughout the procedure Be sure that the needle/cannula are sharp and in good condition Do not allow solution to be completely empty before removing the needle

13. Precautions: Watch patient closely throughout the procedure If s ome drugs have been administered to the solution, indicate by proper labeling.

14. Precautions: Observe patient for swelling around the site of injection which indicates that the needle is out of vein

15. Factors to Consider in Selecting a vein: Purpose of the infusion To correct fluid and electrolyte imbalance Drug therapy To administer blood and blood products

16. Factors to Consider in Selecting a vein 2. Duration of therapy 3. Condition of veins Suitable for the particular style of needle selected.

17. Factors to Consider for the choice of cannula Purpose of infusion Type of infusion Size and condition of patient’s vein Duration of treatment Condition of patient

18. Palpating veins It is extremely important to develop sensitivity for palpating veins, merely inserting a needle and hoping for the best is not a sound approach.

19. Palpating veins If you are a right-handed person, continual use of the left forefinger for palpation will increase your sensitivity

20. Palpating veins Never use the thumb for palpating. It is not as sensitive and you may feel your own pulse, mistaking it for the patient’s.

21. Measure aiding distention of Veins Pause a few minutes after tourniquet is applied to allow the vein to fill. Ask patient to open and close hand a few times

22. Measure aiding distention of Veins 3. Lightly patting the vein 4. Allow arm to hang down over the side of the bed. 5. Application of heat to the arm.

23. Complications of IV Therapy Infiltration Thrombophlebitis Circulatory Overload Air Embolism Infection of venipuncture site Systemic infection Speed shock

24. Complications of IV Therapy 8. Allergic reaction 9. Pulmonary Congestion 10. Nerve Damage 11. Drug Overload

25. Procedural problems associated with IV therapy Fluctuating flow rate Runaway and Sluggish IV Tubing disconnection Blood back – up in tubing IV line obstruction/kinking of IV tubing

26. Procedural problems associated with IV therapy 6. Clogged filter 7. Break in aseptic technique 8. Leaks due to inappropriate device 9. Infectious organism exposure 10. Needle stick injury 11. Chemical exposure

27. Change IV tubing every 72 hours to prevent contamination Change or alter IV needle inserting site every 72 hours to prevent thrombophlebitis Reminder!

28. Stranger Anxiety (infant) Maintain a non-threatening approach and move slowly Developmental Needs of Pediatric Clients

29. Hospitalization, illness or injury may be viewed as punishment Allow control where appropriate; Obtain child’s view of situation Encourage positive relationship and expression of feelings in acceptable manner and activities. Developmental Needs of Pediatric Clients

30. Include the family or a support person if appropriate. Developmental Needs of Pediatric Clients

31. Fear of Mutilation (3 – 6 years old) Explain the procedure carefully Use less intrusive routes whenever possible, such as the oral route Allow children to give “play injections” to a doll or stuffed toy. Developmental Needs of Pediatric Clients

32. Observe general principles of giving medicines Report immediately any untoward effect of the drug GENERAL CONSIDERATION

33. SKILLS

34. THANK YOU!