chap. 35 - hydration & homeostasis

goals of IV therapy

• maintain or prevent fluid + electrolyte imbalances

• provide + maintain nutrition support

• administer meds

• replenish blood volume

• assist in pain management

equipment

IV fluid therapy:

• 1L, 500mL bags for fluids

• 50, 100, 250 mL bags or glass bottles for intermittent IV meds

IV tubing + administration sets:

• continuous (primary) + secondary IVPB

• specialize administration sets for blood, electronic infusion devices, syringe infusion

drip chambers:

• microdrop (60 drops/mL) + macrodrop (10, 15, 20 drops/mL)

• IV drip rate formula → volume to be infused / time (mins) x drop factor

filters:

• adhere policy fro TPN, lipids, blood products

• usual practice → change filters every 24-72 hrs to prevent bacterial growth; some filters in-line

peripheral venous catheters (PIV)

short (<3 in) over-the-needle plastics cannulas used for short term administration of fluids/electrolytes + meds

• higher gauge, smaller the catheter → 20 & 22 gauge common — access site w/ SMALLEST gauge needed

• infiltration + phlebitis common

• inserted into peripheral vein w/ final tip in location appropriate for pH + osmolarity of solution or med

peripheral venous catheter sites

hand, forearm, antecubital fossa (bending of arm area), scalp (common for neonates/infants)

• veins in lower extremities NOT suitable for adult clients b/c risk of thrombus formation

• veins in upper extremities contraindicated in …

  • patients w/ Hx of breast cancer w/ same side lymph node removal

  • patients w/ AV fistulas

  • patients w/ catheters for dialysis

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