the giving of liquid substances directly into a vein. It is useful in safely delivering vitamins and medications that can be quickly and efficiently absorbed into the body.

Why the veins?Veins are highly distensible, thin walled vessels. They act as a volume reservoir for circulatory systems. At any given time, the veins carry about fifty percent of the body’s blood volume. The veins transport blood back to the lungs and heart.

reasons why IV therapy can be more effective than administering vitamins and medications orally

• First, absorption into the blood stream is complete and bioavailability of the substances is immediate.

• Second, there is no "first pass" effect in the liver, thus the procedure lessens the workload on the liver.

• Another thing to consider is that the absorptive capacity of the bowel may be decreased with age, and this along with a decrease in the natural production of hydrochloric acid and pancreatic enzymes can result in nutritional deficiencies because the body is no longer properly breaking down and absorbing nutrients from the foods we eat.

• IV repletion leads to a rapid increase in nutrient levels in the blood, meaning that the nutrients are able to get into the cells as needed and increase cell metabolism. 

Intravenous Fluid Solutions

Hydrating Solutions• primary use is to provide • contain water and either carbohydrate or sodium

solution

Ex.a. NS .9%b. 1/2 NS .45%NaClc. 1/4 NS .22%d. Dextrose in water (D5W) 5% Dextrose e. Dextrose in saline' D5NS, D51/2, D51/4

Maintenance Solutions• isotonic, usually contain water, a carbohydrate for basic

caloric needs, and basic electrolytes

Ex: a. LRNa, K, Ca, Cl, and lactate in roughly same concentration

as plasmab. D5LR

Replacement Solutions• used to replace concurrent losses of water and

electrolytes in normal amounts

Ex:a. IV fluid and electrolytes b. TPN c. blood

Monitoring IV Fluid Therapy

Assessment• monitor labs and keep doctor informed • correct solution and additives • correct equipment • correct infusion rate • start IV • maintain system • identify problems • monitor hourly IV line and patient • DC IV

Complications of IV therapy

site 1.Phlebitis – inflammation 2.pain, warmth, redness traveling along vein 3. Infiltration – no longer in vein 4.Swelling, pallor, cool 5.Elevate extremity, apply warmth 6. Infection 7.Pain, erythema (redness), purulent drainage 8.Bleeding

IV bagschange every 24 hours, 4hours for blood

Tubingchange every 48 hours

Dressing changesper hospital policy

Siteperipheral, central venous, PICC (peripherally inserted central catheter)

Infection Control of IV Therapy

Products

• whole blood• packed blood• platelets• human serum albumin• plasma• plasma protein fraction• clotting factors

Blood and Blood Products

increases circulating volume, maintain hemoglobin levels, and provide clotting factors

Potential complications

•pyogenic reaction •first reaction, fever, chills•hemolytic reaction•STOP IMMEDIATELY•ABO incompatibility •severe flank – back pain •chest pain •blood in urine •increased HR and BP •fullness in head within minutes

•allergic - rare •itching •hives •STOP INFUSION•potassium excess •circulatory overload (particularly with frail elderly and people with cardiac and lung problems) •serum hepatitis/HIV

IVF COLOR CODING

COLOR IVF SOLUTION

PINK D5 IN LACTATED RINGER’S

RED D5 WATER

ORANGE D5 NM

GREEN PLAIN NORMAL SALINE SOLUTION

DARK BLUE PLAIN LACTATED RNGER’S

LIGHT BLUE D5 0.3% NaCl

YELLOW D5 NSS

YELLOW GREEN D5 NR

VIOLET D5 IMB

IV CANNULA

Size (gauge)

COLOR

CATHETERCATHETER

LENGTH(mm)

Water Flow Rate

(ml./min.)

I.D mm

O.D. mm

14 ORANGE 1.7 2.1 45 270

16 GREY 1.3 1.7 45 180

17 WHITE 1.1 1.5 45 125

18 GREEN 0.9 1.3 45 80

20 PINK 0.8 1.1 32 54

22 BLUE 0.6 0.9 25 33

24 YELLOW 0.5 0.7 19 20

I. V. Cannula with Wings and without Injection Port

I. V. Cannula with Wings and Injection Port

IV Cannula without port and without wings

IV Cannula with Small Wings and without Injection Port

3-Way Stop Cock

Blood Transfusion Set

Low Pressure Extension Tube

3-Way Stop Cock with Extension Tube

IV INSERTION

step 1. Finding a vein

First you must select an area for venous cannulation. Apply a constricting band to the patients forearm proximal to the annicupital space (the crux of the elbow). This should cause the veins to engorge with blood and swell.

step 2. Select a catheter

You must now prepare the equipment to cannulate the vein.

You will need:

1-IV catheter1-.9% NS flush1-Saline lock or 1 bag of LR, .9% NS, or D5W/D25W1-alcohol prep1-2x2 bandage1-sharps containertape to secure the IV to the skin

step 3. Clean the site and prepare the vein

palpate the vein looking for any valves or pulsations (which would indicated that it is an artery). Run your finger along the length of the vein to determine how it runs, its length, etc. Open the alcohol prep and clean the area very well.

step 4. Insert the IV catheter

Pull the skin taunt behind the vein and insert the catheter slowly just under the skin MAKE SURE THE BEVEL OF THE NEEDLE IS UP. Also please remember that you must run the needle TOWARD the heart.

step 5. Advance the needle

advance the needle under the skin so that you just pierce the wall of the vein. When you are in, you should get a "flashback" of blood in the back of the IV. It may or may not run up the plastic tube. The speed and amount will vary based on the size of the catheter

step 6. Thread the catheter and remove the needle

Advance the needle VERY VERY slightly then push the catheter over the needle to that it slides into the vein. If you encounter resistance, stop and remove the catheter. As you pull the needle out make sure to occlude the vein by pressing firmly down just distal to the end of the catheter. This will stop blood from flowing out of the vein. IMMEDIATLY and CAREFULLY waste the needle in an approved sharps container.

step 7. Check the line

evaluate the line for patency. If the patient complains of burning pain or if tissue edema/swelling/redness etc is noted at the injection site, the IV has infiltrated and must be removed immediately.

step 8. Secure the line and monitor

Secure the line by tearing a piece of medical tape in half. Slide the half under the catheter and fold it in toward itself. This is called a "butterfly". Tape two or three more pieces of tape to secure the heplock etc to the arm PRN. ALWAYS check the line for patency as often as possible and before using it to give medications/fluid challenge.