Intravenous Fluid Therapy

Sally A. Peralta RN MAN

Intravenous Fluid Therapy
Intracellular Fluid
Water
Extracellular Fluid
Extracellular Fluid
Water
Water
How much of you is water?
Fluid Therapy
Types of Fluid
Types of Fluid
Isotonic Fluids
Isotonic Fluids
Isotonic Fluids
0.9% Sodium Chloride (Normal
Saline
Isotonic Solution
Isotonic Solution
Isotonic Solution
Isotonic Solution
Isotonic Solution
Isotonic Solution
Isotonic Solution
Isotonic Solution
Isotonic Solution
Isotonic Solution
Isotonic Solution
Hypotonic Fluids
Hypotonic Fluids
Hypotonic Fluids
Hypotonic Fluids
Hypertonic Solutions
Hypertonic Solutions
Hypertonic Solutions
Colloid Solutions
Colloid Solutions
Colloid Solutions
Colloid Solutions
Colloid Solutions
Colloid Solutions
Colloid Solutions
Fluid Overload (Hypervolemia)
Fluid Overload (Hypervolemia)
How to calculate IV flow Rates
How to calculate IV flow Rates
How to calculate IV flow Rates
IV Lines Common Problems
 IV Lines Common Problems

Infiltration occurs when a non-vesicant solution (IV solution) is

inadvertently administered into surrounding tissue. Signs and
symptoms include pain, swelling, redness, skin surrounding
insertion site is cool to touch, change in quality or flow of IV, tight
skin around IV site, IV fluid leaking from IV site, and frequent
alarms on the IV pump.

Treatment: Stop infusion and remove cannula. Always secure

peripheral catheter with tape or IV stabilization device to avoid
accidental dislodgement. Avoid areas of flexion and always assess
IV site prior to giving IV fluids or IV medications.
 IV Lines Common Problems

Extravasation occurs when vesicant solution

(medication) is administered and inadvertently leaks into
surrounding tissue, causing damage to surrounding
tissue. Characterized by the same signs and symptoms as
infiltration but also includes burning, stinging, redness,
blistering, or necrosis of the tissue.

Treatment: Stop infusion and remove cannula. Follow

agency policy for extravasation for specific medications.
For example, toxic medications have a specific treatment
plan.
 IV Line Common Problems

Hemorrhage is defined as bleeding from the puncture site.

Treatment: Apply gauze to the site until the bleeding stops, then
apply a sterile transparent dressing.
 Systemic Complication of IV Therapy

Pulmonary edema, also known as fluid overload or circulatory

overload, is a condition caused by excess fluid accumulation in
the lungs, due to excessive fluid in the circulatory system. It is
characterized by decreased oxygen saturation, increased
respiratory rate, fine or coarse crackles at lung bases,
restlessness, breathlessness, dyspnea, and coughing up pinky
frothy sputum. Pulmonary edema requires prompt medical
attention and treatment.

If pulmonary edema is suspected, raise the head of the bed, apply

oxygen, take vital signs, complete a cardiovascular assessment,
and notify the physician.
 Systemic Complication of IV Therapy

Air embolism refers to the presence of air in the vascular system and occurs when
air is introduced into the venous system and travels to the right ventricle and/or
pulmonary circulation. An air embolism is reported to occur more frequently
during catheter removal than during insertion, and the administration of up to 10
ml of air has been proven to have serious and fatal effects
Signs and symptoms of an air embolism include sudden shortness of breath,
continued coughing, breathlessness, shoulder or neck pain, agitation, feeling of
impending doom, lightheadedness, hypotension, wheezing, increased heart rate,
altered mental status, and jugular venous distension.

Treatment: Occlude source of air entry. Place patient in a Trendelenburg position

on the left side (if not contraindicated), apply oxygen at 100%, obtain vital signs,
and notify physician promptly.
 Systemic Complication of IV Therapy

A catheter embolism occurs when a small part of the cannula breaks off and flows
into the vascular system.

When removing a peripheral IV cannula, inspect tip to ensure end is intact.

Remember
Starting an IV
How to Prime an IV Tubing Line
How to Start an IV
Removing Bubbles from an IV Line