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Chapter 7

Chapter 7. Nursing Care of Patients Receiving IV Therapy. Intravenous (IV) Therapy. The Administration of Fluids or Medication Via a Needle or Catheter (Cannula) Directly Into the Bloodstream. Indications for IV Therapy. Hydration Electrolyte Replacement Nutrition (PPN or TPN)

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Chapter 7

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  1. Chapter 7 Nursing Care of Patients Receiving IV Therapy

  2. Intravenous (IV) Therapy The Administration of Fluids or Medication Via a Needle or Catheter (Cannula) Directly Into the Bloodstream

  3. Indications for IV Therapy • Hydration • Electrolyte Replacement • Nutrition (PPN or TPN) • Medication Administration • Blood Product Transfusions

  4. Types of Infusions • Continuous • Intermittent • Piggy Back • Injection Caps • Direct Injection/IVP

  5. Methods of Infusion • Gravity Drip • Electronic Infusion Devices (EIDs) • Mechanical Controllers

  6. Factors Affecting Flow • Change in Catheter Position • Height of Solution • Patency of Catheter

  7. Calculation Practice You need to administer 1,000 mL of 0.9% sodium chloride over 6 hours. You have tubing with a drop factor of 10. How many drops per minute will you deliver?

  8. Calculate Drip Rate

  9. Types of Fluids • Dextrose Solutions • Sodium Chloride Solutions • Balanced Electrolyte Solutions

  10. Osmolarity of IV Solutions • Isotonic • e.g., 0.9% Sodium Chloride • Hypotonic • e.g., 0.45% Sodium Chloride • Hypertonic • e.g., Dextrose 5% in 0.9% Sodium Chloride

  11. Access • Peripheral • Central

  12. Starting a Peripheral Line

  13. Nursing Care Fear Impaired Physical Mobility Risk for Infection

  14. Gerontological Issues • Monitor for Fluid Overload • Elevated Blood Pressure • Increasing Weight • Bounding Pulse • Shallow, Rapid Respirations • Jugular Venous Distention (JVD) • Increased Urine Output • Crackles

  15. Local Complications • Hematoma • Thrombosis • Phlebitis • Infiltration/Extravasation • Local Infection • Venous Spasm

  16. Systemic Complications • Septicemia • Circulatory Overload • Venous Air Embolism • Speed

  17. Central Venous Catheters • Types • Non-tunneled Central Catheter • Tunneled Catheter • Picc • Ports • Rationale for Use

  18. Central Venous Catheters (cont’d)

  19. Nutritional Support • Rationale • For Patients Unable to Eat or Tolerate Tube Feedings • Contents • Carbohydrates (CHOs) • Amino acids • Electrolytes • Trace Elements • Vitamins • Lipids

  20. Nursing Care of Patients Receiving TPN • Initial and Ongoing Assessment • Monitor Blood Glucose • Monitor Signs and Symptoms of Infection • Initiate and Discontinue Slowly

  21. Home IV Therapy • Fluid Replacement • Treatment of Infection • Nutritional Support

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