MODULE # 3: INFUSION PROBLEM

PARENTERAL
Blood Transfusion
 Name of patient E. Blood Products
 Serial code Max.
 Expiration date Whole blood
4 hrs.
 Check cross matching PRBC
Platelets 30 mins.
A. Blood Types **Aparesis
A, B, AB, O  Plasma: Inc. volume
- For massive bleeding
B. Timeline: First 30 mins. (during)
 VS q15 F. Reaction
 Keep vein open: 1. Stop the BT line
- 10 gtts/min (PNLE) 2. Open the NSS line
- 20 gtts/min (NCLEX) 3. VS
 Stay with the patient 4. Report to physician

C. Gauge:
A. 18 to 20
B. Obese: 16
** the largest gauge the better G. Cross Matching Techniques

D. Solution:
O
C. Plasma
D. PNSS (Isotonic)
**Don’t use dextrose (R: hemolytic
reaction) A B
a. D5LR
b. D5W
c. D50 A
d. NSS B
 MODULE # 3: INFUSION PROBLEM

PARENTERAL
Total Parenteral Nutrition
aka IV hyper alimentation feeding D. Nursing Responsibilities
1. VS q4 (Temperature)
A. Purpose: 2. Blood glucose monitoring q6
- For severe malnutrition (Albumin (R: Hyperglycemia)
level dec. mg/dL) NV: 70-110
- GI tract must rest
3. Don’t stop TPN abruptly
B. Mixture (R: Rebound hypoglycemia)
4. TPN sol’n is good for 24 hrs.
5. Strict sterile technique
CHO: Glucose 60 to 70%
CHON: Amino acids 30 to 40%
FATS: Lipids 10 to 20%
Other Components:
 Vitamins and minerals
 Electrolytes
 Fluids

C. Complications
 Hyperglycemia – reg. insulin
 Sepsis – antibiotics
 MODULE # 3: INFUSION PROBLEM

3. X-ray (utilize once)

NASOGASTRIC Lumen – “openings” 6. Secure the tube Withdrawal Phase
TUBE (NGT) A. Principles a. Nasal bridge 1. Position: Fowlers
aka Naso-Intestinal Tube (NIT) Insertion Phase b. Cheeks
1. Position: High fowlers 2. Activity:
NGT NIT 7. Perform oral and nasal care a. Fold or coil the tube
2. Length: NEX technique around your hand
Stomach Duodenal
Feeding Phase b. Remove it slowly and
gastric Tip of the Nose
1. Position: Fowlers gently
Greenish Yellowish
(R: prevent aspiration)
Light brown Earlobe
3. Technique:
2. Ht. of Feeding Sol’n.: 12 in. I: Sterile
(3) Concepts: Xiphoid Process F: Clean
1. Lavage – “labas”
**For approximation of length: 3. Temperature: Room temp F: Clean
2. Gavage – “pasok”
Adult ~50cm ~30C
3. Decompression – “labas”
(R: prevent cramps)
3. Lubricant: KY Jelly (water
(5) Types:
base) 4. Check residual volume
Lumen
(R: prevent lipid pneumonia or 50% (80 to 100 cc)-
Levine Singe
NG aspiration pneumonia) withhold
Salem Double
T (R: prevent dumping
Sump
4. Instruction: syndrome)
Cantor Single
 Hyperextension
Miller- NIT Double
 Flexion 5. Before feeding:
Abbott
- Upon slight resistance  patency and placement
Sengstaken Triple
- Swallowing **soda if with blockage
-Blakemore
- for pt. w/
5. Check Placement 6. After feeding:
esophageal
1. pH level – Acidic (1 - 5) Flush the tube with 30 to 60 cc
varices
2. Introduction of air (10 - of clean water
Minnesota Quadrupl
15cc)
e
- Gurgling sound