FOREWORD Praise and thanksgiving we pray the Presence of God Almighty, for His blessings and grace I can

finish this paper with no lack of anything better. In this paper the authors review the use of osmosis in medical midwife in this case is the infusion. The author also includes various types of infusions and complications that occur when there is an error in intravenous fluids. Authors recognize the limitations have been trying to concoct from various sources that exist and have taken the flowers belonged to someone else who has been there and pick some flowers of life experiences that have been planted since birth. The author would like to thank all those who have supported the writing of this paper, especially to Mrs. Lolita A. M. Parera who had come to share knowledge and friends who always motivate and support and all the parties involved in the writing of this paper. However, the authors realize that writing is far from perfect and there are still many shortcomings. Therefore, the authors welcome any suggestions and constructive criticism from readers. Kupang, September 2011

Table of contents
Approval Sheet .................................................................................................................. Preface ................................................................................................................................ Table of Contents .............................................................................................................

Chapter I: Introduction ............................................................

Background ..................................................................................................................... The formulation of Problem ......................................................................................... Goal ................................................................................................................................. Benefits of a .....................................................................................................................

Chapter II: Foundations Theory .................................. Chapter III: Discussion ................................................. Chapter IV: Conclusions and suggestions ...................
Conclusion ....................................................................................................................... Suggestions ...................................................................................................................... Bibliography ....................................................................................................................... .............................................................................................................................................

Background Nowaday, almost everyone would have been sick and hospitalized and in pairs infusion. The use of infusion itself is the use of osmotic events in the field of medical science. Given intravenous fluids certainly different, given intravenous fluids, adjust the patient's condition. Most patients are given intravenously because of lack of body fluids. Fluid infusion was adjusted from the liquid density up to discharge discharge from the bottle towards infusion into patients. Problem formulation How can infusion of fluids into our bodies? Why IV fluids are made differently? Why IV fluids should be tailored to the patient in terms of density of liquid? Are there any problems that would arise if an error occurs in intravenous fluids? Destination The objective of this paper to find out: Causes of intravenous fluids are made differently. Causes of intravenous fluids and patient adjustment. Problems that arise in fault intravenous fluids. Benefit For the Readers The benefits for the reader itself is actually as an addition to the insight and open horizons of knowledge about the use of osmosis in the field of medicine in this case the use of infusion.

For the author Benefits for the writer himself is an improvement value, but through the work of this task, the author may be an addition to new insights for writers who had previously not really know about the use of this infusion.

Theory grounding Osmosis is a special case of passive transport, where the water molecules diffuse through the membrane which is selectively permeable. In osmosis system, known as hypertonic solutions (solutions that have a high solute concentration), a hypotonic solution (a solution with low solute concentration), and isotonic solutions (two solutions have equal solute concentration). Osmosis process also occurs in many cells in nature. Changes in cell shape occurs when there is on a different solution. Cell located in an isotonic solution, then the volume will be constant. In this case, the cell will receive the same and lose water. If a cell contained in a hypotonic solution, then the cell will get a lot of water, so that can cause lysis (in animal cells), or high turgiditas (in plant cells). Conversely, if the cell is in a hypertonic solution, the cells lose a lot of water molecules, so that the cells become smaller and can cause death. In animals, to survive in an environment that hypo-or hypertonic, the water balance adjustment is necessary, namely in the process of osmoregulation.

Discussion Intravenous fluid infusion (intravenous infusion fluids) is the provision of a number of fluids into the body through a needle, into the veins (veins) to replace lost fluids or food substances from the body. Intravenous fluids to flow from the bottle, the body has adjusted to the pressure in the blood and the pressure in the liquid so it does not happen other things such as hemolysis and krenasi. If someone need the nutrients from the injection of intravenous fluids, the osmotic pressure of the fluid infusion should be in accordance with the osmotic pressure of the blood (isotonic / isosmotic). If the pressure in the red blood cells> pressure fluids (hypertonic), then the water in red blood cells will come out, so the cell will shrink. If the pressure in the red blood cells <pressure fluids (hypotonic), then the red blood cells will absorb water so that the cell walls will swell and burst.

In general, the circumstances may require intravenous fluids are: 1. Bleeding in large quantities (loss of body fluids and blood components) 2. Trauma to the abdomen (stomach) weight (loss of body fluids and blood components) 3. Fractures (broken bones), especially in the pelvis (hip) and femur (thigh) (loss of body fluids and blood components) 4. "Heat waves" (heat stroke) (loss of body fluids in dehydration) 5. Diarrhea and fever (causing dehydration) 6. Extensive burns (loss of body fluids) 7. All the trauma of the head, chest, and spine (loss of body fluids and blood components) Indications through the intravenous administration of drugs, among others: 1. In a person with severe disease, intravenous drug administration directly into the circulatory pathways. For example in the case of bacterial infection in the bloodstream (sepsis). Thus providing more profits than giving oral medication. Yet often the case, although the administration of intravenous antibiotics is indicated only in serious infections, hospitals give antibiotics of this type without looking at the degree of infection. Oral antibiotics (usually eaten by mouth) in most patients admitted to hospital with bacterial infection, is as effective as intravenous antibiotics, and more profitable hospitals in terms of ease of administration, maintenance costs, and duration of treatment. 2. The drug has an oral bioavailability (efficacy in the blood if it is inserted through the mouth) are limited. Or only available in intravenous preparations (as drug injection). For example the composition of the aminoglycoside antibiotic class of chemical "polications" and very polar, so it can not be absorbed through the gastrointestinal (gut up until entry into the blood). It must be inserted into a blood vessel directly. 3. Patients can not take medication because of vomiting, or indeed can not swallow medicine (there are blockages in the upper gastrointestinal tract). In these circumstances, to consider giving through other pathways such as rectal (anal), sublingual (under tongue), subcutaneous (under the skin), and intramuscular (injected in the muscle). 4. Decreased consciousness and at risk of aspiration (choking-drug gets into the breathing), thus giving through other channels considered. 5. Peak drug levels in the blood needs to be achieved, thus given by bolus injection (an injection directly into veins / venous). Rapid increase of drug concentration in blood is reached. For example in people who experience severe and life-threatening hypoglycemia, in people with diabetes mellitus. These reasons are also frequently used for intravenous antibiotics / injections, but keep in mind that many antibiotics have good oral bioavalaibilitas, and able to achieve adequate levels in the blood to kill bacteria. Indications Installation Path Vein Infusion through the veins (Peripheral Venous Cannulation) 1. Intravenous fluid administration (intravenous fluids). 2. Parenteral nutrition (direct entry into the blood) in limited quantities. 3. Giving blood bags and blood products. 4. Giving medication continuously (continuous). 5. Efforts prophylaxis (preventive measures) before the procedure (eg major surgery with risks of bleeding, an intravenous infusion line fitted to the preparation in the event of shock, as well as to facilitate the administration of drugs) 6. Efforts prophylaxis in patients who are unstable, such as the risk of dehydration (lack of fluids) and shock (life-threatening), before the collapse of blood vessels (not palpable), so it can not be placed intravenous lines. Contraindications and Warnings at Infusion Installation Path Through Blood Vessels Veins 1. Inflammation (swelling, pain, fever) and infections at the infusion site. 2. Area of the forearm in patients with renal failure, because this location will be used for the

installation of arterial-venous fistula (AV shunt) on the action hemodialysis (dialysis). 3. The drugs are potentially irritant to the small veins that blood flow is slow (eg veins in the legs and feet). Some of the complications that can occur in the installation of infusion: 1. Hematoma, blood collects in the tissue due to rupture of arteries, veins, or capillaries, occurs due to lack of proper emphasis when inserting the needle, or "stab" repeatedly on blood vessels. 2. Infiltration, namely the entry of fluids into surrounding tissues (not the blood vessels), occurs due to the IV needle tip through the blood vessels. 3. Thrombophlebitis, or swelling (inflammation) in the veins, occurs due to the infusion set is not strictly and properly monitored. 4. Air embolism, the entry of air into the blood circulation, occurs due to the inclusion of air in the fluid infusion into the blood vessels. Complications that can occur in the provision of intravenous fluids: Sense smarting / pain Allergic reactions Type of Fluid Infusion: 1. Hypotonic fluids: lower than serum osmolarity (concentration of Na + ions is lower than serum), so late in the serum, and lower serum osmolarity. Then the fluid "pulled" from the vessel out into surrounding tissues (principle of fluid moves from high osmolarity to lower osmolarity), until finally fill the target cells. Used on the state of the cell to "experience" dehydration, for example in dialysis patients (dialysis) in diuretic therapy, also in patients with hyperglycemia (high blood sugar levels) with diabetic ketoacidosis. Threatening complication is the sudden displacement of fluid from the blood vessels into cells, leading to cardiovascular collapse and increased intracranial pressure (the brain) in some people. An example is 45% NaCl and 2.5% Dextrose. 1. Isotonic fluids: osmolarity (density) near the liquid serum (the liquid part of blood components), that persist in the blood vessels. Beneficial in patients with hypovolemia (lack of body fluids, so blood pressure continues to decline). Has the risk of overload (excess fluid), especially in congestive heart failure and hypertension. Examples are liquid-Ringer's lactate (RL), and normal saline / saline solution (NaCl 0.9%). 1. Hypertonic fluids: higher than the serum osmolarity, so the "pull" the fluid and electrolytes from the tissues and cells into blood vessels. Able to stabilize blood pressure, increase urine production, and reduce edema (swelling). Its use is contradictory with hypotonic fluids. For example Dextrose 5%, 45% hypertonic saline, Dextrose 5% + Ringer-Lactate, Dextrose 5% + 0.9% NaCl, blood products (blood), and albumin. The division is based on the group's other fluids: 1. Crystalloids: is isotonic, it is effective in filling a volume of fluid (volume expanders) into the blood vessels in a short time, and is useful in patients who require immediate fluid. Eg RingerLactate and physiological saline. 1. Colloids: molecular size (usually proteins) is large enough so it will not come out of the capillary membrane, and remain in the blood vessels, then the hypertonic nature, and can draw out fluid from blood vessels. Examples are albumin and steroids. TYPES OF LIQUID INFUS ASERING

Indications: Dehydration (hypovolemic shock and acidosis) on the conditions: acute gastroenteritis, dengue hemorrhagic fever (DHF), burns, hemorrhagic shock, severe dehydration, trauma. Composition: Each liter asering contain: Na 130 mEq K 4 mEq Cl 109 mEq 3 mEq Ca Acetate (salt) 28 mEq Advantages: 1. Acetate is metabolized in the muscle, and can still be tolerated in patients with hepatic impairment 2. On giving prior caesarean section, lactic acidosis RA cope better than RL in neonates 3. In surgical cases, acetate can maintain body temperature at the central anesthesia with isoflurane 4. Have the effect of vasodilator 5. In cases of acute stroke, the addition of MgSO4 20% as much as 10 ml to 1000 ml of RA, can increase the tonicity of the infusion solution to minimize the risk of worsening cerebral edema KA-EN 1B Indications: 1. As an initial solution when the patient's electrolyte status is unknown, eg in case of emergency (dehydration due to inadequate oral intake, fever) 2. <24 hours post-surgery 3. The usual dose of 500-1000 ml for all IV. The speed should be 300-500 ml / h (adults) and 50-100 ml / hour in children 4. Premature infants or newborn babies, should not be given more than 100 ml / hour KA-EN-EN KA 3A & 3B Indications: 1. National maintenance solution to meet the daily needs of water and electrolytes with potassium content enough to replace the daily excretion, on the state of oral intake is limited 2. Maintenance for postoperative cases (> 24-48 hours) 3. Supply of potassium at 10 mEq / L for the KA-EN 3A 4. Supply of potassium at 20 mEq / L to KA-3B EN KA-EN MG3 Indications: 1. National maintenance solution to meet the daily needs of water and electrolytes with potassium content enough to replace the daily excretion, on the state of oral intake is limited 2. Maintenance for postoperative cases (> 24-48 hours) 3. Supply of potassium 20 mEq / L 4. Maintenance for cases where the NPC supplements required 400 kcal / L KA-EN 4A Indications: 1. Is a maintenance infusion solutions for infants and children 2. Without the content of potassium, so it can be administered to patients with various levels of normal serum potassium concentrations 3. Appropriately used for hypertonic dehydration Composition (per 1000 ml):

 Na 30 mEq / L K 0 mEq / L Cl 20 mEq / L Lactate 10 mEq / L Glucose 40 g / L KA-EN 4B Indications: 1. Is a maintenance infusion solutions for infants and children younger than 3 years 2. Supplying 8 mEq / L potassium in patients so as to minimize the risk of hypokalemia 3. Appropriately used for hypertonic dehydration Composition: 1. o Na 30 mEq / L o K 8 mEq / L o Cl 28 mEq / L o Lactate 10 mEq / L o Glucose 37.5 g / L Otsu-NS Indications: 1. For resuscitation 2. Loss of Na> Cl, eg diarrhea 3. Syndrome associated with loss of sodium (diabetic acidosis, adrenocortical insufficiency, burns) Otsu-RL Indications: 1. Resuscitation 2. Supply of bicarbonate ions 3. Metabolic acidosis MARTOS-10 Indications: 1. Supply of water and carbohydrates parenterally in patients with diabetic 2. Another critical condition requiring exogenous nutrients such as tumors, severe infections, severe stress and protein deficiency 3. Dosage: 0.3 g / kg BW / hour 4. Containing 400 kcal / L AMIPAREN Indications: 1. Severe metabolic stress 2. Burn 3. Severe infections 4. Kwasiokor 5. Postoperative 6. Total Parenteral Nutrition 7. Adult dose of 100 ml for 60 minutes AMINOVEL-600 Indications: 1. Additional nutrients in the GI tract disorders 2. Patients fasted GI 3. Increased metabolic needs (eg burns, trauma and post-surgery) 4. Metabolic stress is

5. Adult dose of 500 ml for 4-6 hours (20-30 TPM) PAN-AMIN G Indications: 1. Amino acid supply on hyponatremia and mild metabolic stress 2. Nitrisi early postoperative 3. Typhoid

Conclusions and Suggestions Conclusion Can be concluded that Intravenous fluids to flow from the bottle, the body has adjusted to the pressure in the blood and the pressure in the liquid so it does not happen other things such as hemolysis and krenasi. If someone need the nutrients from the injection of intravenous fluids, the osmotic pressure of the fluid infusion should be in accordance with the osmotic pressure of the blood (isotonic / isosmotic). If the pressure in the red blood cells> pressure fluids (hypertonic), then the water in red blood cells will come out, so the cell will shrink. If the pressure in the red blood cells <pressure fluids (hypotonic), then the red blood cells will absorb water so that the cell walls will swell and burst. Some of the complications that can occur in the installation of infusion: 5. Hematoma, blood collects in the tissue due to rupture of arteries, veins, or capillaries, occurs due to lack of proper emphasis when inserting the needle, or "stab" repeatedly on blood vessels. 6. Infiltration, namely the entry of fluids into surrounding tissues (not the blood vessels), occurs due to the IV needle tip through the blood vessels. 7. Thrombophlebitis, or swelling (inflammation) in the veins, occurs due to the infusion set is not strictly and properly monitored. 8. Air embolism, the entry of air into the blood circulation, occurs due to the inclusion of air in the fluid infusion into the blood vessels. Complications that can occur in the provision of intravenous fluids: Sense smarting / pain Allergic reactions Advice Advice from the author, so that intravenous injection should be done by people who really know and really carefully so that no errors occur and cause some of the above.

Bibliography id.wikipedia.org (2 November 2011) http://www.gudangmateri.or.id/ (1 November 2011) http://cikalcikal.blogspot.com (2 November 2011) http://dokteryudabedah.com (2 November 2011)