D. E. Society’s Smt. Subhadra K.

Jindal
College of Nursing

PRACTICE
TEACHING
DEMONSTRATION
ON
INTRAVENOUS INFUSION

SUBMITTED TO SUBMITTED BY
Mrs. Shubhangi Malavade Meghavarsha Lakra
Lecturer First year M.Sc. Nursing

DATE OF SUBMISSION
11/03/2020
 INTRAVENOUS INFUSION

NAME OF THE STUDENT : MEGHAVARSHA LAKRA

NAME OF THE GUIDE : Mrs. SHUBHANGI MALAVADE

SUBJECT : MEDICAL-SURGICAL NURSING

UNIT : IX

DATE : 18/02/2020

TIME : 45 min

VENUE : CLASSROOM, FOUNDATION

LABORATORY

CLASS TAUGHT : 2nd YEAR B.Sc NURSING

METHOD OF TEACHING : LECTURE CUM DEMONSTRATION

AUDIO-VISUAL AIDS : CHARTS, FLASH CARDS, HANDOUT

PREVIOUS KNOWLEDGE : THE GROUP WILL HAVE PREVIOUS

KNOWLEDGE ABOUT
 INTRAVENOUS INFUSION

GENERAL OBJECTIVE :

At the end of the procedure demonstration, students will gain in depth knowledge
about intravenous injection, and will be able to apply this knowledge in clinical field.

SPECIFIC OBJECTIVE :

At the end of the procedure demonstration, students will be able to :

1. Define intravenous injection.

2. Explain the purposes for IV infusion.

3. Explain the types of intravenous fluids.

4. State the scientific principles of IV infusion.

5. Enlist the indications and contra-indications of IV infusion.

6. List down the articles required for IV infusion.

7. Demonstrate and explain procedure of IV infusion with rationale.

8. Calculate the flow rate for an infusion.

9. Enumerate the complications of IV infusion.

 INTRAVENOUS INFUSION

DEFINITION
Administration of fluid into the bloodstream through an intravenous catheter or a
butterfly catheter needle inserted into a peripheral vein to replace fluid losses, supply caloric
intake or as carrying solution for medications.

PURPOSES
1. To administer fluid and electrolytes to maintain the balance within the body
2. To provide glucose necessary for metabolism.
3. To provide water-soluble vitamins and minerals.
4. To establish a lifeline in case of emergency.
5. To administer medications.
6. To administer blood and blood products.

ADVANTAGES

 Immediate effect
 Control over the rate of administration
 Patient cannot tolerate drugs / fluids orally
 Some drugs cannot be absorbed by any other route
 Pain and irritation is avoided compared to some substances when given SC/IM

INDICATIONS
Patients receive intravenous fluids when they are unable to maintain an adequate fluid
balance and need fluid replacement. This may be due to the inability to take oral hydration or
as the result of excess losses, leading to dehydration if left untreated.
Despite getting plenty of fluids Intra-operatively, most patients are usually dehydrated after
an operation. There are several reasons for this:
 Poor oral intake prior to fasting for operation theatre
 Fluid and blood loss intra-operatively
 Direct blood loss
 Exposure of large internal surfaces to the heat and light of the theatre lights
 Fluid loss from respiration while incubated

Other possible causes of dehydration:

 Swallowing problems
 CVA / Maxfax problems
 GI problems eg perforation / obstruction
  Excessive vomiting / diarrhoea
 Haemorrhage

PHYSICAL SIGNS OF DEHYDRATION

 Hypotension
 Tachycardia
 Reduced Urine Output
 Increased Respiration
 Headache
 If a patient is dehydrated the blood results show an increase in sodium and urea

PARTS OF AN IV SET

CRYSTALLOID VS COLLOID SOLUTIONS

Crystalloid solutions –are solutions of ions (usually sodium and chloride) and or sugars
(glucose) contained in water.
It is subdivided into:
o Isotonic
o Hypotonic
o Hypertonic
Isotonic Fluids - When the concentration of the particles (solutes) is similar to that of
plasma. So it doesn't move into cells and remains within the extracellular compartment thus
increasing intravascular volume. Types of isotonic solutions include:
 0.9% sodium chloride (0.9% NaCl)
 lactated Ringer's solution
 5% dextrose in water (D5W)
 Ringer's solution

Colloid solutions –Gelatinous solutions containing large particles resulting in the fluid being
hypertonic. They exert an osmotic pull on fluids from the interstitial spaces into the
intravascular space increasing the circulatory volume:
 Albumin
 Dextrans
 Haemaccel
 Gelofusine

INFUSION CALCULATIONS:

A standard IV giving set delivers 20 drops /ml

Blood giving sets deliver 15 drops / ml

Microdrip/ burette set delivers 60 drops / ml

To calculate the infusion rate in ml / hr : Volume of solution (ml) = ml/hr

Number of hours

To calculate the drip rate in drops / min: Volume (ml) X drops per ml

Time (in minutes)

ARTICLES REQUIRED
1. A clean tray containing
1. Infusion set.
2. IV fluid.
3. Adhesive tape.
4. Clean gloves.
5. Tourniquet.
 6. Antiseptic swab.
7. Antiseptic ointment (optional).
8. IV cannula (angiocath/butterfly needle).
9. Sterile gauze dressing or transparent occlusive dressing
10. Arm splint (optional).
11. Towel/pad.
12. Mackintosh/waterproof pad.
13. Kidney tray.
Other Articles
1. IV pole.
2. Electronic infusion pump (optional).

PROCEDURE

Nursing action Rationale

1. Check physician's order indicating type Ensures that right procedure is done for right
of solution amount to be administered, patient.
rate of flow, etc.

2. Identify the patient. Assess vital signs, Obtains baseline data on patient condition.
Skill turgor, allergy to tape or
povidone-iodine, bleeding tendencies,
disease/injury to extremities and status
of vein.

3. Check for any contraindication for Prevents occurrence of any complications.

venipuncture like arterio-venous fistula,
arm on side of mastectomy, phlebitis,
infiltration sclerosis.

4. Prepare patient.
a. Explain procedure to the patient and Reduces anxiety and helps in obtaining
that the venipuncture will cause cooperation of patient.
discomfort for few seconds, but
once solution is initiated, there will
not be any discomfort. Explain to
patient how long the infusion will
take to complete.
b. Explain to the patient that Movement of the limb can cause needle to be
movement of the extremity should dislodged.
be minimal (In case of children
 apply splints).
c. Make sure that patient's clothing
can be removed over IV line if
needed or provide with a gown.
Prevents infection.
5. Wash hands and don gloves.

6. Open and prepare infusion set. Reduces risk of complication caused by

a. Check infusion container for solution.
sediments, turbidity, change in color
and expiry date.
b. Remove tubing from the packet and
straighten it out.
c. Slide the roller clamp along tubing
to just below the drip chamber.
Close the clamp.
d. Leave the ends of tubing covered This will maintain sterility of the ends of
with plastic caps until infusion is tubing.
started.

7. Spike the solution container.

a. Remove protective cover from entry
point of the IV bag/bottle.
b. Add any medications if required
using syringe and needle.
c. Remove cap from the insertion
spike.
d. Spike the solution container.

8. Paste a medication label on the solution

container if a medication was added. Applying label upside down will help in easy
Mix the solution. Apply label upside reading when container is hanging. Mixing
down. ensures uniform distribution of the medication.

9. Paste a timing label on the solution

container with the time when infusion Helps in confirming if flow rate is correct or
was started and flow rate. not.

10. Hang solution container on the pole.

The pole should be adjusted so that
solution container is 3 feet above This height is needed to enable gravity to
patients head. overcome venous pressure and facilitate flow of
solution into the vein,
11. Partially fill the drip chamber by
 squeezing it till half full. Prevents air from moving down the tubing.

12. Prime the tubing.

a. Release the clamp, and let solution
run through the tubing till all air Prevents introduction of air into the vein.
bubbles are removed. Tap tubing if
necessary with finger to remove air
bubbles sticking on sides of tubing.
b. Connect IV tubing to IV cannula
and set required drip rate.
c. If an infusion pump is used, set it
according to the rate prescribed. Maintains sterility.
Follow manufacturer’s instructions
for setting pump.

13. Label IV tubing with date and time of

attachment and signature. Labelling ensures that tubing is changed every
72 hours.
14. Ensure appropriate infusion flow
through pump or by adjusting roller
clamp and note patient's response.

15. Discard all disposable items, clean and

replace reusable items.

16. Wash hands.

17. Document relevant data like date and

time of starting IV fluid, amount and
type of solution used including
medication, flow-rate, type and gauge
of needle and patient's response.

18. Position patient comfortably.

19. Assess frequently for swelling, pain,

blanching, coolness of surrounding
skin, leaking or bleeding from site and
change in inflow-rate. etc.
 SUMMARY

Intravenous therapy (IV) is a therapy that delivers fluids directly into a vein. The
intravenous route of administration can be used both for injections, using a syringe at higher
pressures; as well as for infusions, typically using only the pressure supplied by gravity.
Intravenous infusions are commonly referred to as drips. The intravenous route is the fastest
way to deliver medications and fluid replacement throughout the body, because they are
introduced directly into the circulation. Intravenous therapy may be used for fluid volume
replacement, to correct electrolyte imbalances, to deliver medications, and for blood
transfusions.

CONCLUSION
The procedure demonstration on the topic Intravenous infusion was given to the second
year BSc nursing students. The students will be able to use it in the clinical field. The
objectives of the demonstration was covered during the presentation.
 REFERANCES
Book :
1. Annamma Jacob, “Clinical nursing procedures - The art of nursing practice”, 3rd
edition, Jaypee publication, Page no.- 246 to 248.
2. B.T. Basavanthappa, “Fundamentals of nursing”, 2nd edition, Jaypee publication, Page
no. – 491 to 495.
3. PR Ashalata, “Textbook of anatomy and physiology”, 4th edition, Jaypee publication,
page no. – 383 to 431
- 567 to 574

Online ;
1. www.opentextbc.ca/clinicalskills/chapter/10-2-intracath.insertion
2. www.intracath.insertion.com/The-Procedure
3. www.cincinnatichildrens.org/health/intracath.insertion