iv therapy RECORDING

Overview of Enteral Medication Routes

Enteral medications refer to those administered via the gastrointestinal (GI) tract. This includes various methods of delivery:

  • Oral Administration: This is the most common route, involving swallowing pills, liquids, or other substances that are absorbed through the digestive system.

  • Sublingual: Medication is placed under the tongue for quicker absorption through the rich blood vessels in that area. This route allows for almost immediate effects.

  • Rectal: Suppositories are inserted into the rectum, where they can be rapidly absorbed thanks to the vascular nature of the rectal wall. Medications that are less effective or suitable for oral administration can be given rectally.

Types of Non-Gastrointestinal Medication Routes

In addition to enteral routes, medications can be administered through non-GI pathways:

Topical Administration

  • This method involves applying medications in the form of creams, ointments, or patches directly onto the skin.

Inhalation

  • Medications can be administered directly to the lungs through inhalation, allowing for rapid absorption into the bloodstream.

Intravenous (IV) Therapy

  • IV therapy is one of the most common invasive procedures in healthcare. It allows for direct access to the bloodstream and can be crucial for:

    • Restoring fluid or electrolyte balance

    • Administering specific IV medications

    • Providing blood or blood products

    • Delivering Total Parenteral Nutrition (TPN).

Before administering IV therapy, lower risk routes should always be considered first.

Understanding IV Access

Anatomy of Blood Vessels

  • Arteries carry oxygenated blood away from the heart; Veins return deoxygenated blood back to the heart.

  • Familiarity with these terms is essential for understanding IV procedures.

Types of IV Cannulas

  • Peripheral IV Cannula (PIVC): This is the most common type, usually placed in the arm or hand. It has a limited duration of 5 to 10 days.

  • Central Venous Catheter (CVC): Inserted into larger veins that lead to the right side of the heart, such as the internal jugular or subclavian veins. These can remain in place longer (over six weeks).

  • Peripherally Inserted Central Catheter (PICC): A type of CVC inserted through a peripheral vein and placed centrally, allowing for long-term access.

Considerations for IV Placement

  • Assess the site carefully before insertion, determining the best type of cannula for the patient’s needs.

  • Certain irritant medications should be given via central lines rather than peripheral to prevent complications.

Selecting and Maintaining IV Equipment

Short Peripheral Catheters

  • These come in various sizes, with size inversely related to gauge number; smaller numbers indicate larger sizes.

  • Extension sets may be used to improve blood flow and reduce mechanical irritation, minimizing the risk of phlebitis (inflammation of veins).

Regular Maintenance

  • Regular flushing of IV lines (at least once per shift or daily) with saline is vital to maintain line patency and prevent thrombus formation.

  • Observe sterile techniques and hygiene to avoid infections during management and medication administration.

Key Terms and Practices in IV Administration

  • Key Parts and Sites: Understanding which parts require strict sterility (key parts) and which are less critical (non-key parts) is essential in IV management.

  • Always disinfect key parts before accessing them, and maintain hand hygiene before and during administering medications.

  • Use a 70% alcohol wipe and allow 15 seconds for disinfecting prior to injections.

Phlebitis Assessment

  • Phlebitis can occur as a complication of IV therapy. Assessment involves using a scoring system to rate the patient's symptoms, including:

    • 1: Possible phlebitis (mild pain or redness)

    • 2-5: Increasing severity from moderate phlebitis to fever and severe symptoms.

  • Identification and management of phlebitis involve terminating IV therapy at the affected site and documenting findings for care continuity.

Conclusion

Effective IV therapy requires thorough understanding of medication administration routes and diligent practice of assessment and hygiene protocols. Tomorrow's lab will include practical applications of these concepts.