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INTRAVENOUS FLUID ADMINISTRATION IN THE NEWBORN May Baldemor, RN Senior Nurse, NICU Jordan Hospital, Amman PowerPoint Presentation
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INTRAVENOUS FLUID ADMINISTRATION IN THE NEWBORN May Baldemor, RN Senior Nurse, NICU Jordan Hospital, Amman. PERIPHERAL INTRAVENOUS LINE . Purpose and Uses ?.

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INTRAVENOUS FLUID ADMINISTRATION IN THE NEWBORNMay Baldemor, RNSenior Nurse, NICUJordan Hospital, Amman
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Purpose and Uses ?

* Used to sustain clients who are unable to take substances orally. * Provides immediate access to the vascular system for the rapid delivery of specific solutions without the time required for gastrointestinal tract absorption. * Provide a vascular route for the administration of medications or blood components.

intravenous devices

Intravenous devices:

IV cannula:

a)Steel needles or butterfly needles.

b)Plastic cannula- after vein puncture, it is guided through the needle into the vein and the needle is removed from the catheter.

precautions

Precautions:

1- Wear gloves.

2- Avoid vessels across joints.

3- Take care to differentiate veins from arteries.

4- If limb requires warming prior to procedure, do not exceed 40 degrees.

5- Shave adequate area of head to permit stabilizationof IV.

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Precautions:6- Apply tourniquet correctly.7- Be alert for signs of phlebitis or infiltration.8- Write the date, time, signature on piece of tape secured to size.

complications

Complications:

1-Infection.

2-Tissue damage.

3-Phlebitis.

4- Infiltration.

5-Catheter embolism.

6- Air embolism.

umbilical arterial catheterization

Umbilical Arterial Catheterization

Indications:

a)Monitoring blood pressure.

b)Monitoring arterial blood gases when

infant is on supplemental oxygen.

c)May be considered as access and

infusion site in all neonates.

d)May be used as an alternative site of

fluid administration when attempt at

venous access are unsuccessful.

umbilical venous catheterization

Umbilical Venous Catheterization

Indications:

a) Emergency vascular access for fluids and

medication infusion and for blood drawing.

b) Central venous pressure monitoring.

c) Exchange transfusion.

d) Long term central venous access in low

birth weight infants.

equipments

Equipments:

1-Cut-down set.

2-IV fluids.

3-Tape measure.

4-Alcohol.

5-Povidine solution.

6-Suture.

7- Umbilical catheter.

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Equipments8- Normal saline.9-  Syringes.10- Three-way stopcock.11-  Umbilical tie tape.12-  Sterile gown, caps, gloves and mask.13- Graphs to determine appropriate depth of Insertion.

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Length of UAC InsertionShoulder-umbilicus UAC UVC 9cm 10cm 5.2cm 10cm 10.5cm 6cm 11cm 12cm 6.5cm 12cm 13cm 7cm 13cm 15cm 8cm 14cm 16cm 8.5cm 15cm 17cm 9cm 16cm 18.5cm 9.8cm 17cm 19cm 10.5cm 18cm 20cm 11cm

procedure

Procedure:

1- Set up the cut-down set on a sterile

mayo table using aseptic technique and

add to the sterile field- syringes, sutures,

blade, stopcock, umbilical catheter, then

assist the physician in drawing normal

saline.

procedure18

Procedure:

2-Prepare IV fluids- heparinized

D.W5% (1IU/1cc) for the arterial line

and plain D.W10% for the venous

line.

3- IV rate is regulated according to

the doctor’s order.

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Procedure:

3- Obtain x-ray film to check catheter position (by the physician).

4- If desired secure catheter with tape bridge.

5- Continue routine cord care using sterile gauze and povidine.

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Nursing Care:-Keep catheter free of blood to prevent clot formation.- Flush catheter with normal saline solution slowly each time blood sample is drown.- Infuse IV solution continuously to catheter between sample to prevent retrograde flow.- Note amount of blood removed and IV/ flush solution infused and add to fluid-balance record.

nursing care
Nursing Care:

2-Watch for indication of clot formation

difficulty withdrawing blood sample.

3-   Take appropriate action if clot formation

do not attempt to flush clots forcibly.

4- Note for any discoloration of lower extremities

complications22

Complications:

1-Infection.

2-Thrombo embolic.

3- Catheter mal-positioned in heart and great vessels.

4- Catheter mal-positioned in portal system.

5- Bleeding.

6-Ischaemia/ infarction of lower extremities.

7- Arrhythmia if the catheter is in the heart

fluid administration

FLUID ADMINISTRATION

Fluid requirements (per day)

First day of life 60-70ml/kg

Second day 75-85ml/kg

Third day 85-100ml/kg

Fourth day 100-125ml/kg

Fifth – 30 days 125-150ml/kg

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FLUID ADMINISTRATIONFluid needs may be increased or decreased depending on the clinical situation of the patient, daily weight, urine and serum urea nitrogen with electrolytes should be monitored carefully to determine water balance and fluid needs.