INTRAVENOUS

INFUSION
 STARTING AN INTRAVENOUS
INFUSION

INTRAVENOUS (IV)
THERAPY
is the aseptic instillation
of fluid, electrolytes,
nutrients or medications
through a needle into a
vein.
 PURPOSES:

• Toadminister fluids and chemical substances

when circumstances prevent the patient from
consuming a normal diet and oral liquids
• To replace fluids and chemical substances when the
patient has experienced loss through vomiting, diarrhea,
bleeding, etc.
• To provide access to the circulatory system if it
becomes necessary to administer emergency
medications
• To maintain an access to the circulatory system for
the intermittent administration of scheduled medications
 POSSIBLE NURSING DIAGNOSIS:

1. Fluid Volume Excess

2. Fluid Volume Deficit
3. Altered Nutrition: Less than Body Requirements
4. Altered Oral Mucous Membrane
5. Self Care Deficit
6. High Risk for Infection
7. High Risk for Injury
FACTORS AFFECTING FLOW RATE:
Age
Condition of the patient
Solution used
Manufacturer’s drop factor
Patency of the needle
Position of the site
Height of the IV pole
Kinking of the tube
 2 TYPES OF I.V. THERAPY

Peripheral IV Therapy__________________
• given through an arm, or
a hand vein and
sometimes through a leg
or foot vein.
 PERIPHERAL VEINS USED IN IV
THERAPY
• Basilic Vein
• Cephalic Vein
• Radial Vein
• Metacarpal Veins
 2 TYPES OF I.V. THERAPY

Central Venous Therapy_____________

• a catheter inserted into a
central vein, commonly the
right or left subclavian vein or
the internal or ext. jugular veins.
• For Long term therapy or a
large volume of fluid; may be
used for an emergency when
the pt.has inaccessible
peripheral veins or in long term
therapy at home.
 Subclavian Vein

Internal Jugular Vein Basilic Vein

Equipment_____ IV stand

_ An IV tray containing the

following:
IV solution as ordered
IV tubing
Needle (IV catheter/ cannula)
Tourniquet
Alcohol swabs or CB with ROH
Plaster
Armboard (splint), if needed
Scissors
Medicine ticket
IVF label
EQUIPMENT

DROP
FACTO
IV CATHETER GAUGE

• Grey - 16 G
• Green - 18 G
• Pink - 20 G
• Blue - 22 G
• Yellow - 24 G
TYPES OF IV SET
PARTS OF IV SET
VOLUME- CONTROL SET
VOLUME-CONTROL SET
 IV bottle
IV bag
STARTING IV INFUSION
PROCEDURE
1. Check the IV solution and medication
2. additives with the physician’s order.

3. Wash hands

4. Gather all equipment and prepare the

IV solution and tubing

4. Maintain aseptic technique when

opening sterile packages and
IV solution
5. Close the regulator, uncap the spike and insert it
into the entry site on the bag or bottle as the
manufacturer directs. If an additive is ordered,
incorporate it before inserting spike into the entry site
6. Suspend the IV solution on a hook in the preparation
area and press the drip chamber and allow it to fill at
least halfway
7. Remove the cap
at the end of the tubing ,
release the clamp and
allow the fluid to flow
through the tubing.
(This is termed
PRIMING). Allow the
fluid to flow until all air
bubbles have
disappeared. Close the
clamp and recap the
end of the tubing.
8. Notify the physician or the nurse who will insert the
IV. When he/she arrives , bring preparation to the
bedside
9. Identify the patient and explain the procedure.
10. Have the patient in a supine or low
Fowler’s position in bed.
11. Hang the bag or bottle
of solution on IV stand.
12. Hand the tourniquet to
the doctor/ nurse, followed
by a CB with alcohol and
the IV catheter/cannula.
Observe while the doctor/nurse
is inserting.
13.Release the tourniquet when he/she indicates
or when a return flow of blood to the adapter is
observed (optional- can be done by the doctor)

14.Connect the tubing to the needle

15. Start the flow of solution promptly by releasing
the clamp on the tubing. Examine
the site for signs of infiltration
16. Loop the tubing near the
site of entry and anchor it with
plaster to prevent pulling of the
needle.

17.Anchor the arm to an

armboard for support if
necessary.

18. Adjust the rate of flow

according to the doctor’s
order.
19.Complete the label and tape
it to the IV bag/bottle.

20. Do the aftercare of equipment

and wash hands.

21.Document the procedure and

the patient’s response. Chart the
time, site, device used, solution
and rate of flow and the
physician or nurse who inserted the needle.

22. Monitor patient periodically.

 NURSING ALERT:

If infusion is not flowing well, lower the

bottle/bag to check if the line is still patent
COMMON ACRONYMS USED IN
IV THERAPY

•C/D (consume and discontinue)

• KVO (keep vein open)

• D/C (discontinue)

• KSS (keep set sterile)

 COMPLICATIONS
ASSOCIATED WITH IV
THERAPY
SYSTEMIC COMPLICATIONS
C O M P L I C A T I O N S A S S O C I A T E D WI T H I V T H E R A P Y
SIGNS AND SYMPTOMS_________________________________
• Moist crackles upon lung auscultation
• Edema
• Weight gain
• Dyspnea
• Shallow respirations and increase rate
INTERVENTION_________________________________________
• Decreasing the IV rate
• Monitoring vital signs frequently
• Assessing breath sounds
• High Fowler’s position.
• Contact physician stat
MANIFESTATION___________
• dyspnea and cyanosis
• hypotension
• weak, rapid pulse
• Loss of consciousness
• chest, shoulder, and low back pain.

INTERVENTIONS______________________________________
• Clamping the cannula
• Placing the patient on the left side in the
Trendelenburg position
• Assessing vital signs and breath sounds,
• and administering oxygen.
 SEPTICEMIA
& OTHER INFECTIONS
Signs and symptoms________________________________
• abrupt temperature elevation
• backache, headache
• Increased pulse and respiratory rate,
• Nausea and vomiting,
• diarrhea, chills and shaking,
• general malaise
Prevention__________________________________________
• Strict aseptic technique
• Examine IV bag for cracks, leaks
• Inspecting the IV site daily
• Replacing the peripheral IV cannula every 48 to 72 hours
• Removing the IV cannula at the first sign of local inflammation,
contamination, or complication
 LOCAL COMPLICATIONS
C O M P L I C A T I O N S A S S O C I A T E D WI T H I V T H E R A P Y
• Infiltration is the unintentional administration of a nonvesicant
solution or medication into surrounding tissue
• Occurs when the IV cannula dislodges or perforates the wall
of the vein.
• characterized by edema around the insertion site,
leakage of IV fluid from the insertion site, discomfort
and coolness in the area of infiltration, and a significant
decrease in the flow rate.

Intervention__________________________________________
• Remove IVF
• Apply cold compress (recent), warm compress (long period)
• Similar to infiltration, with an inadvertent administration of
vesicant or irritant solution or medication into the surrounding
tissue.
• Medications such as dopamine, calcium preparations, and
chemotherapeutic agents can cause pain, burning, and
redness at the site.
• Blistering, inflammation, and necrosis of tissues can occur.

Intervention_____________________________________________
• Notify physician
• Stop infusion immediately
• Apply warm or cold compress
• inflammation of a vein related to a chemical or
mechanical irritation, or both.
• It is characterized by a reddened, warm area around
the insertion site or along the path of the vein, pain or
tenderness at the site or along the vein, and swelling

Intervention__________________________________
• Discontinue IV
• Apply a warm, moist compress to the affected site.
IVF FOLLOW UP
PROCEDURE
 REGULATING IV INFUSION
Purpose:
• To comply with the prescribed rate ordered by the
physician

• To maintain an equal & constant rate of fluid

administration throughout the duration of the infusion.

• To assist in reassessing the progress of the fluid infusion.

• To prevent circulatory overload or insufficient correction

of hypovolemia.
 NURSING CONSIDERATIONS:

• Read the current written medical order for the

volume & number of hours of infusion.

• Determine the manufacturer’s drop factor & the

ratio of drops per millimeter.

• The hourly rate of infusion will not deviate by more

or less than 25% of the hourly calculated rate.
 EQUIPMENT

• Jot down notebook &

ballpen.
• Wrist watch with a second
hand.
• IV tag
• IV bottle
 IV TAG

Davao Doctors Hospital

IV TAG

Date:___________

Name:_______________RM #:___________
IVFluid:______________________________
Incorporation:________________________
Rate:________________________________
Time started:_________________________
Time ended:__________________________
Signature:____________________________
 PROCEDURE

1. Check the
physician’s order.

2. Wash hands and prepare

needed materials.
3. Countercheck the
available IV solution against
the doctor’s order.
4. FILL UP the necessary data
in the IV tag.
5. Calculate the flow rate using standard formula

Standard Formula:
Rate = Volume (cc) x gtt factor (gtts/cc)
Duration (hrs) x 60 min/hr

Duration = Volume (cc) x gtt factor

Rate (gtt/min) x 60 min/hr

If ml/hr is known: ml/hr X drop factor

60 min
6. Explain the procedure to the patient.

7. Close the regulator and remove the

IVF bottle from the IV pole and pull the
spike from the empty IV container.
8. Maintain the sterility of the spike; open
the new IV solution and insert the spike.
9. Hang the IV
solution and press
the drip chamber
and fill it halfway
with the solution.

10. Open the

regulator and
regulate the desired
rate.
11. Put the IV tag.

12. Does after care of the

equipments and proper
disposal of needles
12. Document the ff:
type of IV
amount
flow rate
time started
patient’s response
DISCONTINUING IV
INFUSION
PROCEDURE
 DISCONTINUING IV INFUSION

• The pt’s oral fluid intake & hydration status are

satisfactory.
• IV lines are obstructed, dislodged & site is inflamed.
• The medications administered by IV route are no
longer required.
 EQUIPMENT

An IV tray containing the following:

• Dry CB & plaster to cover the site temporarily.
• CB soaked in 70% alcohol
• Working gloves
• Waste Receptacle
1. Check the physician’s order for discontinuing IVF
2. Wash hands and assemble equipment
3. Identify and explain the procedure.
4. Close the regulator and Release anchorage of
arm, tubing & needle. Loosen the tape @ the
venipuncture site while holding the counteraction
to the skin.
5. Hold a swab above the venipuncture site,
withdraw the needle quickly by pulling it out along
the line of the vein.

6. Immediately apply firm pressure to the site,

using the dry CB for 2-3 minutes.
7. Hold the client’s arm or leg above the body if any
bleeding persists.

8. Check the needle or catheter to make sure it is

intact. Report a broken needle or catheter to the
nurse in-charge immediately. If the broken needle
piece can be palpated, apply a tourniquet
above the insertion site .
9. Apply the sterile dry CB/ Band aid to cover the IV
site.
10.Discard the IV solution container & used
supplies appropriately.

11.Record the amount of fluid infused on the I & O

record sheet & on the chart. Include the type of
solution used, time, & reason for discontinuing the
infusion & the pt’s response.
-END-