MBECK.JML, SCHOOL OF PRACTICAL NURSING, IV Certification Class
Class Completion
Successfully initiate IV starts in a lab environment.
Completion of IV test with a passing grade of 80%.
Objectives
Recognize indications, contraindications, and complications of IV access in specific sites.
Review fluid and electrolyte distribution in the body and the physiological effect of alterations in fluids and electrolytes in the body.
Recognize indications, contraindications, and purposes of commercially prepared IV fluids.
Calculate IV flow rates and drip rates.
Identify commonly administered IV medications and the key nursing considerations for the administration of each.
Explain various aspects of infection control.
Initiate and maintain saline locks for adults.
Initiate and maintain continuous IV therapy for adults.
Identify documentation and guidelines in IV therapy.
Explain principles and techniques involved in blood transfusions.
Demonstrate ability to discontinue adult peripheral IVs.
Administer IV fluids and medications via saline locks.
Illinois LPN Scope
The Illinois Department of Financial and Professional Regulation has clarified the scope of the LPN providing IV care:
LPNs may initiate IV therapy (start the IV) when ordered by a provider.
Administer plain fluids, IV fluids with additives, and antibiotics.
The scope is limited; LPNs cannot administer blood, chemotherapy, or IV push medications.
Intravenous Therapy
Goal of IV fluid administration:
Correct or prevent fluid/electrolyte disturbances.
Allows direct access to the vascular system.
Must have a provider's order specifying type, amount, rate, and duration.
Requires knowledge of correctly ordered solution, reasons for ordering, equipment needed, procedures required to initiate infusion and maintain it, identify/correct issues, and how to discontinue infusion.
Cannot initiate infusions in Central lines or Critical medications.
Fluid Balance
Human body composition: Approximately 60% water.
Distribution:
Intracellular (2/3 stored inside cells).
Extracellular:
Interstitial fluid: Surrounds body cells and includes lymph.
Intravascular fluid: Blood/plasma found within blood vessels.
Transcellular fluid: Fluids in special compartments (e.g., cerebrospinal fluid).
Types of IV Fluids
Isotonic: Equal osmolarity in extracellular and intracellular fluids; no water movement.
Hypotonic: Extracellular fluid has fewer solutes, water moves into cells.
Hypertonic: Extracellular fluid has more solutes, water moves out of cells.
Intravenous Solutions
Types of Solutions:
Dextrose in Water Solutions
Saline Solutions
Dextrose in Saline Solutions
Balanced Electrolyte Solutions
Remarks:
Dextrose is another name for glucose; Saline is Sodium Chloride (Normal Saline).
Dextrose in Water Solutions
Solution/Concentration:
Dextrose 5% in Water (D5W): Isotonic and hypotonic.
Initially hypotonic; dilutes osmolarity after cellular absorption.
Should not be the sole treatment for fluid volume deficit.
Electrolyte deficits (especially potassium and phosphate) may occur with prolonged use.
Blood electrolyte monitoring necessary.
Essential vitamins and minerals should be provided as needed.
Dextrose 10% in Water (D10W): Hypertonic.
Dextrose in Saline Solutions
Solution/Concentration:
Dextrose 5% in 0.45% NaCl (D51/2NS; D5 0.45% NaCl): Hypertonic.