INTRAVENOUS THERAPY

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INTRAVENOUS THERAPY:

INTRAVENOUS THERAPY

DEFINITION:

DEFINITION Is the insertion of a needle or catheter/cannula into a vein, based on physician’s written prescription. The needle or catheter/cannula is attached to a sterile tubing and a fluid container to provide medication and fluids

Basis of Practice:

Basis of Practice Legal therapeutic prescription of a licensed physician Thorough knowledge of the vascular system, interrelatedness of the body system with proficiency in the skill of the IV therapy. Recognition of holistic approach to patient care. Collaboration with members of the healthcare team. Networking and linkages with the external environment. Individual professional accountability.

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Clinical Skills - The IV therapist shall be proficient and competent in all clinical aspects of the IV therapy

Indications for IV Therapy:

Indications for IV Therapy Establish or maintain a fluid or electrolyte balance Administer continuous or intermittent medication Administer bolus medication Administer fluid to keep vein open (KVO) Administer blood or blood components Administer intravenous anesthetics Maintain or correct a patient's nutritional state Administer diagnostic reagents

Types of IV Needles:

Types of IV Needles Steel needles: Butterfly catheters, named for the plastic tabs that look like wings. Used for small quantities of medicine, infants, and to draw blood although the small size of the catheter can damage blood cells. Usually small gauge needles.

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Over-the-needle catheters: Peripheral-IV catheters are usually made of various types of Teflon or silicone materials which determines how long the catheter can remain in your vein. These typically need to be replaced about every 1 to 3 days. Inside-the-needle catheters: Larger than Over-the-needle catheters, typically used for central lines.

Gauges:

Gauges Needles & Catheters are sized by diameters which are called gauges. Smaller diameter = larger gauge IE: 22-gauge catheter is smaller than a 14-gauge Larger diameter = more fluid able to be delivered If you need to deliver a large amount of fluid, typically 14- or 16-gauge catheters are used.

Types of IV Fluids:

Types of IV Fluids Three main types of IVF: Isotonic fluids Hypotonic fluids Hypertonic Fluids

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What are isotonic solutions for IV Therapy? Most IV therapy solutions are isotonic. Isotonic solutions are designed to match the makeup of your intracellular fluid and are equal in osmotic pressure inside and outside your cells. This prevents any fluid shifting in and out of your cells. Three primary examples of isotonic solutions are dextrose 5% in water (D 5 W), Lactated Ringer's solution, and normal saline

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Examples of hypotonic solutions: (1) Sports drinks that contain salts / electrolytes (2) physiologically: a. 0.45% NaCl (half-normal saline solution); since normal saline is 0.9% NaCl , any solution less than 9% is hypotonic b. dextrose 2.5% in water c. dextrose 2% in water

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D5 NaCl hypertonic D5 in Lactated Ringer's hypertonic D5 0.45% NaCl hypertonic

PROCEDURES::

PROCEDURES: The IV therapist shall be proficient and competent in all clinical aspects of the IV therapy. Carry out the p hysician’s prescription for IV therapy Perform peripheral venipuncture (all types of needles and cannulas excluding the insertion of subclavian and cut-down catheter.

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3. Based on physician’s written prescription prepare, initiate, monitor, terminate IV therapy. 4. Administer blood and blood components as prescribed by the physician. 5.Determine solution and medication incompatibilities. 6.Change IV site tubing and dressings. 7.Establish flow rates of solutions, medications, blood and blood components as prescribed by the physicians.

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8. Proficient technical ability in the use, care, maintenance and evaluation of IV equipment. 9. Management of patient receiving IV therapy and peripheral/ parenteral nutrition in various set-up(hospital, home,and others) 10. Adherence to established infection control practices.

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11. Observation and assessment of all adverse reactions related to IV therapy and initiation of appropriate nursing interventions 12. Appropriate documentation relevant to the preparation, administration and termination of all forms of IV therapy.

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INDICATIONS OF IV THERAPY 1. For maintenance of dehydration and or correction of dehydration in patients unable to tolerate sufficient volumes of oral fluids medication. 2. Parenteral nutrition 3. Administration of drugs. 4. Transfusion of blood or blood components.

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Contraindication Administration of irritant fluids or drugs through peripheral access e.g. sodium chloride potassium chloride