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Type and Indications of IV Therapy . Done by : Salwa Maghrabi Teacher Assistant Nursing Department . Outline . Definition of IV therapy Indication of IV therapy Type of IV solution . Isotonic solution Hypertonic solution Hypotonic solution

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type and indications of iv therapy

Type and Indications of IV Therapy

Done by :

Salwa Maghrabi

Teacher Assistant

Nursing Department

outline
Outline
  • Definition of IV therapy
  • Indication of IV therapy
  • Type of IV solution .
      • Isotonicsolution
      • Hypertonic solution
      • Hypotonic solution
  • Categories of intravenous solutions according to their purpose.
      • Nutrient solutions
      • Electrolyte solutions (Crystalloid)
      • Volume expanders (Colloid)
  • Parenteral Nutrition (PN)
slide3
cont’
  • Clinical indications of parenteral nutrition.
  • IV Infusion Method .
  • Equipment of I.V. therapy.
  • Nursing role in managing patient receiving IV therapy
    • Nursing assessment .
    • Nursing diagnosis.
    • Implementation
      • Initiation phase
      • Maintenance phase
      • Discontinuing IV infusion .
    • Recoding and reporting .
    • Evaluation .
objective
Objective
  • Define intravenous therapy .
  • List the indications of IV therapy .
  • Differentiate between the types of IV solutions.
  • Discuss the categories of IV solution according to their purpose .
  • List the IV infusion methods.
  • Discuss the nursing process for the patient who receiving IV therapy .
definition of iv therapy
Definition of IV therapy

It is an effective and efficient method of supplying fluid directly into intravenous fluid compartment producing rapid effect with availability of injecting large volume

of fluid more than other method of administration.

indication of iv therapy
Indication of IV therapy
  • Maintain or replace body store .
  • Restore acid abase balance
  • Restore the volume of blood component
  • Administer of medication
  • Provide Nutrition
  • Monitor CVP
isotonic solution
Isotonicsolution
  • A solution that has the same salt concentration as the normal cells of the body and the blood.
  • Ex:

1- 0.9% NaCl .

2- Ringer Lactate .

3- Blood Component .

4- D5W.

hypertonic solution
Hypertonic solution:
  • A solution with a higher salts concentration than in normal cells of the body and the blood.
  • Ex:

1- D5W in normal

Saline solution .

2-D5W in half normal

Saline .

3- D10W.

hypotonic solution
Hypotonic solution
  • A solution with a lower salts concentration than in normal cells of the body and the blood.
  • EX:

1-0.45% NaCl .

2- 0.33% NaCl .

categories of intravenous solutions according to their purpose
Categories of intravenous solutions according to their purpose:
  • Nutrient solutions.
  • Electrolyte solutions.
  • Volume expanders.
nutrient solutions
Nutrient solutions.
  • It contain some form of carbohydrate and water.
  • Water is supplied for fluid requirements and carbohydrate for calories and energy.
  • They are useful in preventing dehydration and ketosis but do not provide sufficient calories to promote wound healing, weight gain, or normal growth of children.
  • Common nutrient solutions are D5W and dextrose in half-strength saline.
electrolyte solutions crystalloid
Electrolyte solutions (Crystalloid)
  • fluids that consist of water and dissolved crystals, such as salts and sugar.
  • Used as maintenance fluids to correct body fluids and electrolyte deficit .
  • Commonly used solutions are:

-Normal saline

(0.9% sodium chloride solution).

-Ringer’s solutions

(which contain sodium, chloride, potassium, and calcium.

-Lactated Ringer’s solutions

(which contain sodium, chloride, potassium ,calcium and lactate) .

volume expanders colloid
Volume expanders (Colloid)
  • Are used to increase the blood volume following severe loss of blood (haemorrhage) or loss of plasma ( severe burns).
  • Expanders present in dextran, plasma, and albumin.
parenteral nutrition pn
Parenteral Nutrition (PN)
  • Parenteral nutrition is a form of nutritional support that supplies protein, carbohydrate, fat, electrolytes , vitamins, minerals, and fluids via the IV route to meet the metabolic functioning of the body.
clinical indications of parenteral nutrition
Clinical indications of parenteral nutrition
  • Client cannot tolerate internal nutrition as in case of paralytic ileus, intestinal obstruction, persistent vomiting.
  • Client with hyper metabolic status as in case of burns and cancer.
  • Client at risk of malnutrition because of recent weight loss of > 10%, NPO for > 5 days, and preoperative for severely depleted clients.
equipment of i v therapy
Equipment of I.V. therapy
  • I. Solution containers.

II. I.V. administration sets.

nursing assessment
Nursing assessment

1- assess the solution:

2- Reading the label on the solution.

3- Determine the compatibility of all fluid and additives.

4- observe I.V sets

slide20

Also, the nurse should assess the patient for :

1- Any allergies and arm placement preference.

2- Any planned surgeries.

3- Patient’s activities of daily living.

4- Type and duration of I.V therapy, amount, and rate.

nursing diagnosis
Nursing diagnosis:
  • Anxiety (mild, moderate, severe) related to threat regarding therapy.
  • Fluid volume excess.
  • Fluid volume deficit.
  • Risk for infection.
  • Risk for sleep pattern disturbance.
  • Knowledge deficit related to

I.V therapy.

planning
Planning
  • Identify expected outcomes which focus on:
  • preventing complications from I.V therapy.
  • minimal discomfort to the patient.
  • restoration of normal fluid and electrolyte balance .
  • patient’s ability to verbalize complications.
implementation
Implementation
  • I. Implementation during initiation phase
  • A) Solution preparation: the nurse should be:
  • Label the I.V container.
  • Avoid the use of felt-tip pens or permanent markers on plastic bag.
  • Hang I.V bag or bottle .
slide24

B) Site preparation:

1- Cleanse infusion site.

2- Excessive hair at selected site should be clipped with scissor .

3- Cleanse I.V site with effective topical antiseptic.

4- Made Venipuncture at a 10 to 30 degree angle.

slide25

C) Regulating flow rate:

  • The nurse calculate the infusion rate by using the following formula :
slide26

II. Implementation during maintenance phase

  • A) Monitoring I.V infusion therapy: the nurse should :
  • inspect the tubing.
  • inspect the I.V set at routine

intervals at least daily.

  • Monitor vital signs .
  • recount the flow rate after 5 and

15 minutes after initiation

slide27

B) Intermittent flushing of I.V lines

  • Peripheral intermittent are usually flushed with saline (2-3 ml 0.9% NS.)
  • C) Replacing equipments (I.V container, I.V set, I.V dressing):
  • I.V container should be changed when it is empty.
  • I.V set should be changed every 24 hours.
  • The site should be inspected and palpated for tenderness every shift or daily/cannula should be changed every 72hours and if needs.
  • I.V dressing should be changed daily and when needed
slide28

III. Implementation during phase of discontinuing an I.V infusion

  • The nurse never use scissors to remove the tape or dressing.
  • Apply pressure to the site for 2 to 3 minutes using a dry, sterile gauze pad.
  • Inspect the catheter for intactness.
  • The arm or hand may be flexed

or extended several times.

recording and reporting
Recording and reporting:
  • Type of fluid, amount, flow rate, and any drug added.
  • Insertion site.
  • Size and type of I.V catheter or needle.
  • The use of pump.
  • When infusion was begun and discontinuing.
  • Expected time to change I.V bag or bottle, tubing, cannula, and dressing.
slide30

Any side effect.

  • Type and amount of flush solution.
  • Intake and output every shift, daily weight.
  • Temperature every 4 hours.
  • Blood glucose monitoring every 6 hours, and rate of infusion.
evaluation
Evaluation
  • Produce therapeutic response to medication, fluid and electrolyte balance.
  • Observe functioning and patency of I.V system.
  • Absence of complications.
reference
reference
  • http://www.medterms.com/script/main/art.asp?articlekey=3870
  • -Carol.T.taylor and carol lillis.R, (2001): Fundamentals of Nursing, 4th ed ,Lippincott, company,Pheladelphia ,pp:180-249.