IV Therapy Indications, Complications

IV Therapy is used for:fluid volume maintenance, fluid volume replacement, med administration, blood administration, TPN, emergency line,
Advantages of IV Therapyfaster absorption, rapid distribution, emergency access, unconscious patient
IV and Dressing changesPICC-every 6 weeks, IV inserted by paramedic w/in 24 hours, Peripheral site every 72 hours, Blood and TPN every 24 hours, CVC every 48-72 hours or 3xper week.



Nursing responsibilities for IV sitesassess site whenever in room, document at least every 8 hours, site CDI (clean, dry, intact), sterile technique, changine tubing and solution, awareness of complications, awareness of fluid types, 5 rights
Complications of IV therapyPain and irritation, infiltration and exravasion, occlusion, loss of patency, phlebitis, fluid overload
Infliltrationseepage of IV fluids into tissue when IV cath penetrates vein
Extravasion and Infiltration Assessmentswelling, pain, cool to touch, decreased flow, wet dressing, no back flow.
Causes of Infiltration and Extravasioncatheter permeates vein, poor taping of site, over manipulation
Intervention for Infiltration and ExtravasionRemove IV, cool compress
Occlusion causeskinked tubing, patient lying on tubing, infusion too slow
Occlusion assessmentIV stops dripping
Occlusion interventionmilk IV, aspirate, irrigate (if no resistance OK, if resistance may be clot>
Occlusion Preventiondon't let IV run dry, flush periodically with 1-5 cc of NSS and before and after any intermittent IV therapy.
Phlebitis Causesbacterial, chemical, mechanical
Phelebitis Interventionremove IV, cool compress
Phlebitis Assessmenterythemia, pain or burning, warmth, edema, cordlike vein.
Phlebitis possible causes:IV left in too long, irritating fluids, clot at tip of cannula, cath too large for vein
Crystalloidsclear fluids, dextrose or saline, can be Iso, Hypo or Hyper tonic
Colloidscloudy, yellowish, used to raise osmotic pressure, Dextran is clearish
Isotonic IVsame tonicity as body 0.9% NSS
Reasons to give an Isotonic IVHypotension (increases BP), Hypovolemia
Complications of Isotonic IVfluid overload
Examples of Isotonic Solutions0,9% NSS, D5W(isotonic in bottle, hypotonic in body), Lactated Ringers
Reasons to give a Hypotonic IVWill cause fluid to shift from intravascular to intracellular space.
Indications for Hypotonic IVdehydration
Hypotonic Solutions.45% sodium chloride, 5%dextrose water (becomes hypotonic in body)
Complications of hypotonic solutionMay cause edema
Reasons to give a hypertonic IVlow bp, slight edema but not w/CHF, pulls fluid from intracellular space to intravascular space
Hypertonic IV SolutionNot as strong as Albumin, 10% Dextrose in Water D10W, 5% normal saline, D5 Ringers Lactate
Complications of Hypertonic IVmore fluid in bloodstream can cause circulatory overload.
PCA stands for:Patient Controlled Analgesia
3 settings of PCAdrug dosage, lockout period, basal rate
Central Venous Therapy Indicationsinadequate vascular access, complex treatment regimes, hyperosmolar infustions ie parenteral nutrition, irritating or vesicant druges, (ie. dopamine cancause necrosis) rapid absorption, long term therapy.
Contraindications for Central venous therapyaltered skin integrity, anomalies of central vasculature, cancer in area, coagulopathies, fractured clavicle, septicemia, radiation to insertion site
Common insertion pathways for Central Venous Therapysubclavian, jugular, femoral vein, cephalic vein(is peripheral but the line runs to central area)
Risks and Complications of Central Venous TherapyAir embolism, pneumothorax, sepsis,chest pain, confusion, hypotension, dyspnea, pallor, tachycardia, tachypnea, unresponsiveness
Components of Intravenous Nutritional Supportamino acids, carbohydrates, electrolytes, minerals, vitamins, lipids, other (ie insulin)
Lipids in Intravenous Nutritional Supportlipids are administered via Piggy back. (white, thin liquid)
Cautions for IV nutritional supportnot refrigerated, observe for spoilage (fat on top, discoloration), expiration dateNo filter. , must be infused on IV pump, glucose monitored, gradual weaning. Daily weights,
Complications for IV nutritional supporthypoglycemia, hyperglycemia, dehydration, infection
Reasons to give IV Nutritional Supportbowel surgery, chronic weight loss, bowel rest, coma, excess nitrogen loss, hepatic or renal failure, malnutrition, low serum albumin, hypermetabolic states

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