NCM 109: CARE OF MOTHER AND CHILD AT RISKS OR WITH PROBLEM

(MATERNAL)
INTRAVENOUS THERAPY

CAMARINES SUR POLYTECHNIC COLLEGES

2nd SEMESTER A.Y. 2023 – 2024

INTRAVENOUS THERAPY INTRAVENOUS CATHETERS

➢ Administration of delivering nutrients and ➢ The larger the gauge, the smaller the diameter.
hydration directly into the bloodstream for Size Color Recommended
immediate absorption and use by the body. Use
➢ It is the administration of fluid that contains 14G ORANGE In massive
water, dextrose, minerals, electrolytes and trauma
drugs situations
16G GRAY Trauma,
PURPOSE OF IV THERAPY surgeries, or
➢ To supply fluid when clients are unable to take in mutiple large-
an adequate volume of fluids by mouth volume
➢ To provide salts and other electrolytes needed to infusions
maintain electrolyte balance 18G GREEN Blood
➢ To provide glucose (dextrose), the main fuel for transfusion or
metabolism large volume
➢ To provide water-soluble vitamins and infusions
medications 20G PINK Multi-purpose
➢ To establish a lifeline for rapidly needed IV; for
medications medications,
hydration, and
TYPES OF IV ADMINISTRATION routine
➢ Continuous IV administration: is a type of IV therapies
fluid administration that replaces fluid loss, 22G BLUE Most chemo
maintains fluid balance and is a vehicle for drug infusions;
administration patient with
▪ Maintenance fluid- are given to sustain small vein,
normal fluid and electrolytes balance. elderly or
▪ Replacement fluids- are being ordered pediatric
due to the fluid loss resulting from patients
hemorrhage, vomiting, diarrhea, and 24G YELLOW Very fragile
burn. veins; elderly
▪ KVO fluids- are ordered at a very low or pediatric
rate to keep the IV line accessible 26G PURPLE Pediatric or
should the patient require emergency neonate
fluid or IV medication
➢ Intermittent IV administration: a type of IV
administration which is primarily used for giving
or administering IV drugs.

TYPES OF IV NEEDLE
➢ Scalp Vein Needle (butterfly)
▪ Is a thin gauge needle approximately ¾
inch long with a plastic wings attached
to hold the needle in place during
venipuncture.
➢ Intra Catheter Needle
▪ Is a long plastic tube inserted through a
metal needle used if the duration of the
IV therapy is long, and if the patient is
restless.
➢ Plastic or Mini Catheter Needle
▪ Small plastic tube mounted on a metal
needle in which the needle is removed
from the vein leaving the plastic tube in
place.

ALLYSSA LEILA E. ORBE

BSN-2A
 NCM 109: CARE OF MOTHER AND CHILD AT RISKS OR WITH PROBLEM
(MATERNAL)
INTRAVENOUS THERAPY

CAMARINES SUR POLYTECHNIC COLLEGES

2nd SEMESTER A.Y. 2023 – 2024

CALCULATING IV FLOW RATES AND IV DRUGS

NURSING FUNCTIONS /RESPONSIBILITIES ➢ Hours of Infusion = Total volume of
DURING IV DRUG ADMINISTRATION infusion/Hours of infusion
1. Knowledge of IV sets and their drop factors ➢ Flow Rate = Total volume of infusion/Total time of
2. Calculating IV flow rates and IV drugs infusion in minutes×Drop Factor
3. Mixing and diluting drugs in IV fluids
4. Gathering equipment Drop Factor: The drop factor is the number of drops
5. Knowledge of the drug and the expected per mL and depends on the size of the opening in the
untoward reactions. drip chamber; IV tubing is not all alike. Tubing comes
in various drop factors. The drop factor is indicated on
KNOWLEDGE OF IV SETS AND THEIR DROP the IV tubing package and varies from one company
FACTORS to another
➢ TYPES OF ADMINISTRATION SET
▪ Micro drip set CALCULATIONS OF IV DRUGS
✓ Allow 60 drops per ml ➢ Common Conversions
✓ Good for medication ▪ 1 Liter = 1000 Milliliters
administration or pediatric fluid ▪ 1 Gram = 1000 Milligrams
delivery ▪ 1 Milligram = 1000 Micrograms
✓ Delivers smaller drops per ▪ 1 Kilogram = 2.2 pounds
milliliter ➢ Remember! Before doing the calculation, convert
▪ Macro drip set units of measurement to one system/unit.
✓ Allow 15 and 20 drops per ml
✓ Good for rapid fluid HOW TO CALCULATE DRUG
replacement and routine adult
fluid delivery Formula:
✓ Delivers larger drops per
milliliter D = dose ordered
or desired dose
H = dose on
container label or
dose on hand
V = vehicle or the
form and amount
in which drug
comes (tablet, capsule, liquid)
A = amount to give

ALLYSSA LEILA E. ORBE

BSN-2A
 NCM 109: CARE OF MOTHER AND CHILD AT RISKS OR WITH PROBLEM
(MATERNAL)
INTRAVENOUS THERAPY

CAMARINES SUR POLYTECHNIC COLLEGES

2nd SEMESTER A.Y. 2023 – 2024

CHOOSING THE SITE OF INSERTION

➢ Preferred
▪ Hand sites
▪ Larger veins
➢ Alternative
▪ Forearm Vein
VEIN SELECTION
➢ Use the client’s nondominant arm whenever
possible.
➢ Select a vein that is:
A. Easily palpated and feels soft and full
B. Naturally splinted by bone
C. Large enough to allow adequate circulation
around the catheter.
➢ Avoid using veins that are:
A. In areas of flexion (e.g., the antecubital fossa)
B. Highly visible, because they tend to roll away
from the needle
C. Damaged by previous use, phlebitis,
infiltration, or sclerosis
D. Continually distended with blood, or knotted or
tortuous
E. In a surgically compromised or injured
extremity (e.g., following a mastectomy), because
of possible impaired circulation and discomfort for
the client

10 GOLDEN RULES FOR ADMINISTERING DRUGS

SAFELY (10 R’s)
1. Right Drug
2. Right Patient
3. Right Dose
4. Right Route
5. Right Time & Frequency
6. Right Documentation
7. Right History & Assessment
8. Drug Approach & Right to refuse
9. Right Drug-Drug Interaction & Evaluation
10. Right Education & Information

COMPLICATIONS OF IV INFUSION
1. Infiltration- is when the needle is out of vein, and
fluids accumulate in the subcutaneous tissues.
Pain, swelling, skin is cold at needle site, pallor,
flow rate decreases or stops, absence of
➢ Last Resort backflow of blood.
▪ Leg, Foot & Ankle Assessment
▪ Pain, swelling, skin is cold at needle
site, pallor, flow rate decreases or stops,
absence of backflow of blood.
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.

2. Circulatory Overload – it results from

administration of excessive volume of IV fluids.

ALLYSSA LEILA E. ORBE

BSN-2A
 NCM 109: CARE OF MOTHER AND CHILD AT RISKS OR WITH PROBLEM
(MATERNAL)
INTRAVENOUS THERAPY
CAMARINES SUR POLYTECHNIC COLLEGES
2nd SEMESTER A.Y. 2023 – 2024
Assessment
▪ Headache, flushed skin, rapid pulse,
increased BP, weight gain, syncope or
faintness, pulmonary edema, coughing,
shortness of breath, tachypnea, shock.
3. Drug Overload- occurs when the patient receives
an excessive amount of fluid-containing drugs.
Assessment
▪ Dizziness, shock, fainting
4. Thrombophlebitis- is due to overuse of a vein,
irritating solutions/drugs, clot formation, large
bore catheters.
Assessment
▪ Pain, the vein may feel hard or cordlike,
edema and redness at the venipuncture site,
arm feels warmer than the other arm
5. Extravasation – occurs when vesicant solution is
administered and inadvertently leaks into surrounding
tissue, causing damage to surrounding tissue.
Assessment
▪ 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. For
example, toxic medications have a specific
treatment plan.
6. Local infection- is indicated by purulent drainage
from site, usually two to three days after an IV
site is started.
Treatment
▪ Remove cannula and clean site using sterile
technique. Monitor for signs and symptoms
of systemic infection.
7. 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.
8. Phlebitis – is the inflammation of the vein’s inner
lining, the tunica intima
Assessment
Localized redness, pain, heat, and swelling, which
can track up the vein leading to a palpable venous
cord.
Treatment
▪ Immediately remove cannula. May elevate
arm or apply a warm compress. Initiate a
new peripheral IV
9. 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. A
5 ml of air or more causes air embolism.
Assessment
▪ Chest, shoulder or back pain, hypotension,
dyspnea, cyanosis, tachycardia, increased
venous pressure, loss of consciousness.
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.
▪ To avoid air embolisms, ensure drip chamber
is one-third to one-half filled, ensure all IV
connections are tight, ensure clamps are
used when IV system is not in use, and
remove all air from IV tubing by priming prior
to attaching to patient.
10. Nerve Damage- may result from tying the arm too
tightly to the splint.
Assessment
▪ Numbness of fingers and hands
11. Speed Shock- a sudden adverse physiological
reaction to IV medication or drugs that are
administered too quickly.
Assessment
Flushed face, headache, a tight feeling in the chest,
irregular pulse, loss of consciousness, and cardiac
arrest.
12. 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
Assessment
▪ Swelling, pain, redness, discoloration, and
even cyanosis.
ALLYSSA LEILA E. ORBE
BSN-2A