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 the giving of liquid substances directly into a

vein. It is useful in safely delivering vitamins


and medications that can be quickly and
efficiently absorbed into the body.
Why the veins?
Veins are highly distensible, thin walled vessels. They
act as a volume reservoir for circulatory systems. At
any given time, the veins carry about fifty percent of
the body’s blood volume. The veins transport blood
back to the lungs and heart.
reasons why IV therapy can be more effective than
administering vitamins and medications orally

• First, absorption into the blood stream is complete and


bioavailability of the substances is immediate.
• Second, there is no "first pass" effect in the liver, thus the
procedure lessens the workload on the liver.
• Another thing to consider is that the absorptive capacity of the
bowel may be decreased with age, and this along with a
decrease in the natural production of hydrochloric acid and
pancreatic enzymes can result in nutritional deficiencies because
the body is no longer properly breaking down and absorbing
nutrients from the foods we eat.
• IV repletion leads to a rapid increase in nutrient levels in the
blood, meaning that the nutrients are able to get into the cells as
needed and increase cell metabolism.
Intravenous Fluid Solutions

Hydrating Solutions
• primary use is to provide
• contain water and either carbohydrate or sodium
solution

Ex.
a. NS .9%
b. 1/2 NS .45%NaCl
c. 1/4 NS .22%
d. Dextrose in water (D5W) 5% Dextrose
e. Dextrose in saline' D5NS, D51/2, D51/4
Maintenance Solutions
• isotonic, usually contain water, a carbohydrate for basic
caloric needs, and basic electrolytes
Ex:
a. LR
Na, K, Ca, Cl, and lactate in roughly same concentration
as plasma
b. D5LR

Replacement Solutions
• used to replace concurrent losses of water and
electrolytes in normal amounts
Ex:
a. IV fluid and electrolytes
b. TPN
c. blood
Monitoring IV Fluid Therapy
Assessment
• monitor labs and keep doctor informed
• correct solution and additives
• correct equipment
• correct infusion rate
• start IV
• maintain system
• identify problems
• monitor hourly IV line and patient
• DC IV
Complications of IV therapy
site
1. Phlebitis – inflammation
2. pain, warmth, redness traveling along vein
3. Infiltration – no longer in vein
4. Swelling, pallor, cool
5. Elevate extremity, apply warmth
6. Infection
7. Pain, erythema (redness), purulent drainage
8. Bleeding
Infection Control of IV Therapy

IV bags
change every 24 hours, 4hours for blood
Tubing
change every 48 hours
Dressing changes
per hospital policy
Site
peripheral, central venous, PICC (peripherally
inserted central catheter)
Blood and Blood Products

increases circulating volume, maintain


hemoglobin levels, and provide clotting factors

Products
• whole blood
• packed blood
• platelets
• human serum albumin
• plasma
• plasma protein fraction
• clotting factors
Potential complications
•pyogenic reaction
•first reaction, fever, chills
•hemolytic reaction
•STOP IMMEDIATELY
•ABO incompatibility
•severe flank – back pain
•chest pain
•blood in urine
•increased HR and BP
•fullness in head within minutes
•allergic - rare
•itching
•hives
•STOP INFUSION
•potassium excess
•circulatory overload (particularly with frail
elderly and people with cardiac and lung
problems)
•serum hepatitis/HIV
IVF COLOR CODING
COLOR IVF SOLUTION
PINK D5 IN LACTATED RINGER’S

RED D5 WATER

ORANGE D5 NM

GREEN PLAIN NORMAL SALINE SOLUTION

DARK BLUE PLAIN LACTATED RNGER’S

LIGHT BLUE D5 0.3% NaCl

YELLOW D5 NSS

YELLOW GREEN D5 NR

VIOLET D5 IMB
IV CANNULA
Size COLOR CATHETER CATHETER Water Flow
(gauge) I.D O.D. LENGTH Rate
mm mm (mm) (ml./min.)

14 ORANGE 1.7 2.1 45 270


16 GREY 1.3 1.7 45 180
17 WHITE 1.1 1.5 45 125
18 GREEN 0.9 1.3 45 80
20 PINK 0.8 1.1 32 54
22 BLUE 0.6 0.9 25 33
24 YELLOW 0.5 0.7 19 20
I. V. Cannula with Wings and
without Injection Port

I. V. Cannula with Wings and


Injection Port
IV Cannula without port and
without wings

IV Cannula with Small Wings


and without Injection Port
3-Way Stop Cock

Blood Transfusion Set


Low Pressure Extension
Tube

3-Way Stop Cock with


Extension Tube
IV INSERTION

step 1. Finding a vein

First you must select an area for venous cannulation. Apply


a constricting band to the patients forearm proximal to the
annicupital space (the crux of the elbow). This should cause
the veins to engorge with blood and swell.
step 2. Select a catheter
You must now prepare the equipment to cannulate the vein.

You will need:

1-IV catheter
1-.9% NS flush
1-Saline lock or 1 bag of LR, .9% NS, or D5W/D25W
1-alcohol prep
1-2x2 bandage
1-sharps container
tape to secure the IV to the skin
step 3. Clean the site and prepare the vein
palpate the vein looking for any valves or pulsations (which
would indicated that it is an artery). Run your finger along
the length of the vein to determine how it runs, its length,
etc. Open the alcohol prep and clean the area very well.

step 4. Insert the IV catheter


Pull the skin taunt behind the vein and insert the
catheter slowly just under the skin MAKE SURE THE
BEVEL OF THE NEEDLE IS UP. Also please
remember that you must run the needle TOWARD the
heart.
step 5. Advance the needle
advance the needle under the skin so that you just pierce
the wall of the vein. When you are in, you should get a
"flashback" of blood in the back of the IV. It may or may
not run up the plastic tube. The speed and amount will
vary based on the size of the catheter

step 6. Thread the catheter and remove the needle


Advance the needle VERY VERY slightly then push the
catheter over the needle to that it slides into the vein. If
you encounter resistance, stop and remove the catheter.
As you pull the needle out make sure to occlude the vein
by pressing firmly down just distal to the end of the
catheter. This will stop blood from flowing out of the vein.
IMMEDIATLY and CAREFULLY waste the needle in an
approved sharps container.
step 7. Check the line
evaluate the line for patency. If the patient complains of
burning pain or if tissue edema/swelling/redness etc is
noted at the injection site, the IV has infiltrated and must
be removed immediately.

step 8. Secure the line and monitor


Secure the line by tearing a piece of medical tape in half.
Slide the half under the catheter and fold it in toward itself.
This is called a "butterfly". Tape two or three more pieces of
tape to secure the heplock etc to the arm PRN. ALWAYS
check the line for patency as often as possible and before
using it to give medications/fluid challenge.