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13 Cards in this Set

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IV Therapy
-Identify purpose of IV therapy
-Identify the different types of IV fluids
-Identify basic IV orders
-Calculate IV drip rate problems
-Identify what to check for IV assessment during clinical rounds
-Complete and IV time tape
-Complete an intake and output form
-Hang and change an IV bag/tubing
-Regulate an IV according to IV orders
-Convert a main line IV to an intermittent venous access device and convert an intermittent venous access device to a main line IV
-Instill additives into an IV bag
Intravenous (IV) Therapy
Purpose
-Maintain daily fluid and electrolyte needs
-Replace fluid and electrolyte losses
-Correct fluid and electrolyte imbalance
-Provide entry into circulation system for medication administration
Type of solution: Hypotonic
[Osmolarity - <240 mOsm/L]
Definition
-Lower than serum osmolarity and causes fluid to shift out of blood vessels and into cells and interstitial spaces - hydrate the cells while depleting the circulatory system
Example
-1/4 Normal saline
-1/2 Normal saline
-2.5% Dextrose
*Caution - cellular swelling exacerbates hypotension
Type of solution: Isotonic
[Osmolarity - 240 to 320 mOsm/L]
Definition
-Prevent shifting of fluid and electrolytes from intracellular and interstitial compartments and are used to expand the intravascular compartment. Treatment of hypotension
Example
-Normal saline
-Lactated Ringers
-5% Dextrose & Water
*Caution - circulatory overload, may dilute and lower concentration of Hgb and Hct
Type of solution: Hypertonic
[Osmolarity - >340 mOsm/L]
Definition
-Used to replace electrolytes and shift fluid from interstitial and cellular spaces to plasma to expand the intravascular compartment
Example
-5% Dextrose in 0.45% sodium chloride
-5% Dextrose in 0.9% sodium chloride
-5% Dextrose in LR
-20% Dextrose in Water
-3% NaCl
-Hyperalimentation solutions with 10-70% Dextrose
Type of solution: Colloids
Definition
-Hypertonic solutions with proteins. Pulls fluid from interstitial and intracellular spaces by increasing intravascular colloid osmotic pressure (pressure of plasma proteins)
Example
-Blood and blood products
-Albumin
-Dextran
Hang & Change IV Bag/Tubing
1. Get IV Fluid
-Be sure to check for current order - orders must be written every day
2. Get tubing
-Is it going to run on a pump or by gravity? If pump, be sure it is functioning correctly. If by gravity, be sure to identify on tubing the drip factor in order to determine the gtts/min
3. Open tubing
-Close all clamps, maintain sterility of spike end
4. Open fluid
-Check for any leaks, or particles in fluid. Add any additives if they have been ordered
5. Pull tab off bag opening
6. Spike IV fluid bag
-Be sure to push it all the way
7. Squeeze and fill chamber halfway
8. Slowly prime tubing, using roller clamp
-Do this slowly to avoid getting air, and invert side ports
9. Date and time tubing
-Check policy for when to change tubing
IV Orders
Components of an IV Order
-IV orders must be written by the physician or authorized prescriber on the order sheet or computerized ordering system. The order must be dated, timed and signed by the physician or authorized prescriber. The IV orders are good for 24 hours.
IV Orders
The order must include
-Type of solution
-Amount of solution to be given (#mL's) OR the rate of infusion (mL/hr)
Examples:
-1,000 mL of Normal Saline (NS) over 8 hours
-NS at 125 mL/hr
-D5W 1,000 mL every 8 hours x 24 hours
Methods of Administering IV Therapy
Pump
-This requires calculating the mL/hr and correctly setting the pump
Gravity
-This requires calculating the gtts/min in order to deliver the specified number of mL/hr
Calculations using Dimensional Analysis
Pump - mL/hr
-Order reads: D5W 1,000 mL every 8 hours by 24 hours
You must calculate how many mL/hr to set the pump
mL/hour = #mL's/#hour mL/hr = 1000 mL/8 hours = 125 mL/hr - set the pump at 125
Calculations using Dimensional Analysis
Gravity - gtts/min
-You need to know the following in order to calculate gtts/min
*Calibration of the IV tubing being used (drop factor) - this is not a constant value. Each manufacturer designates the calibration on the tubing package. Most commonly this value is 10, 15, 20, or 60 gtts/mL
*mL's to be infused
*Hours to be infused
Calculations using Dimensional Analysis
To calculate
gtts/min = gtts calibration/per mL x mL to be infused/hours to be infused x 1 hour/60 min
Examples
1,000 mL to run over 8 hrs calibration = 10
gtts/min = 10 gtts/1 mL x 1000 mL/8 hours x 1 hour/60 min = 10,000/480 = 20.8 or 21 gtts/min