IV Therapy

& IV
Incorporation
Lecturers:
Suzerrain Dame Soriano
Catherine Faith Gallemit
GENERAL OBJECTIVES:
At the end of 60 minutes of discussion, the students will
be able to gain knowledge and skills on how to perform
IV THERAPY AND IV INCORPORATION.
 SPECIFIC OBJECTIVES:
 Define Intravenous Fluid
 Enumerate the purpose of IV Therapy and IV
Incorporation
 Discuss the Basic IV set up of IV Therapy and IV
Incorporation
 Discuss it’s complications and Nursing Interventions
 Discuss the 14 rights of medications
DEFINITIO
N
IV THERAPY & IV INCORPORATION
 Intravenous therapy is a medical technique that
delivers fluids,medications and nutrition directly
into a person's vein. IV therapy uses a type of
tiny plastic tubing (cannula) that goes into the
vein,a needle, and plastic tubing that connects
the set-up to a bag of fluid.
PURPOSE
It is the fastest way to deliver blood products,
vitamins, medications, or other necessary fluids
directly into a person's circulatory system
It is dispensed through an intravenous catheter,
either through an injection with a syringe or infusion
(also referred to as a “drip”).
Provide fluid and electrolyte maintenance,
restoration, and replacement
Administer medication and nutritional feedings
Administer blood and blood products
Administer chemotherapy to cancer patients
Administer patient-controlled analgesics
Keep a vein open for quick access
 INTRAVENOUS ACCESS
DEVICES
1. Peripheral catheter
2. Peripherally inserted central catheter (PICC)
3. Central line
4. Subcutaneous injection port
PERIPHERAL
CATHETER
 PERIPHERAL CATHETER
 This is the most common intravenous access method in
both hospitals and pre-hospital services. A peripheral IV
line consists of a short catheter (a few centimeters long)
inserted through the skin into a peripheral vein (any vein
that is not inside the chest or abdomen). This is usually in
the form of a cannula-over-needle device, in which a
flexible plastic cannula comes mounted on a needle.
PERIPHERALL
Y INSERTED
CENTRAL
CATHETER
(PICC)
PERIPHERALLY INSERTED CENTRAL
CATHETER
• A PICC is a thin, flexible tube that is inserted into a
vein in the upper arm and guided (threaded) into a
large vein above the right side of the heart called the
superior vena cava. It is used to give intravenous
fluids, blood transfusions, chemotherapy, and other
drugs
CENTRAL
LINE
 CENTRAL LINE

• A central venous catheter, also known as a central

line, is a tube that doctors place in a large vein in the
neck, chest, groin, or arm to give fluids, blood, or
medications or to do medical tests quickly.
SUBCUTANEOU
S INJECTION
PORT
 SUBCUTANEOUS INJECTION
PORT
• A central venous catheter, also known as a central
line, is a tube that doctors place in a large vein in the
neck, chest, groin, or arm to give fluids, blood, or
medications or to do medical tests quickly.
 BASIC METHODS OF
DELIVERING IV THERAPY

1.CONTINUOUS INFUSION
2.INTERMITTENT INFUSION (piggyback)
3.DIRECT INJECTION
 CONTINUOUS INFUSION

 A continuous intravenous infusion is the

infusion of a parenteral drug over several
hours (continuous drip) to days. It
involves adding medication to sterile IV
solution and then hanging the IV solution
as a primary infusion.
 INTERMITTENT INFUSION
 Intravenous intermittent infusion is an
infusion of a volume of fluid / medication
over a set period of time at prescribed
intervals and then stopped until the next
dose is required. An intermittent IV
medication is also called a piggyback
medication, a secondary medication, or a
mini-bag medication.
 DIRECT INJECTION

 A direct IV injection, or IV push, involves

injecting a therapeutic dose of a
medication or another substance directly
into a vein. The benefit of a direct IV
injection is that it delivers the necessary
dose of a drug very quickly, which helps it
take effect as rapidly as possible.
 DOCUMENTATION
Proper documentation provides:
Accurate description of care that can serve as legal
protection
Mechanism for recording & retrieving information
Record for health care insurers of equipment &
supplies used
DOCUMENTING INITIATION OF IV THERAPY
 Size and type of the device
 Name of the person who inserted the device
 Date & time
 Site location
 Type of solution
 Any additives
 Flow rate
 Use of an electronic infusion device
 Complications, pt’s response, nursing interventions
 Number of attempts (both successful & unsuccessful)
 LABEL THE DRESSING!
 Date of insertion
 Gauge of venipuncture device
 Date and time of the dressing change
 Your initials
 DOCUMENTING IV MAINTENANCE
 Condition of the site
 Site care provided
 Dressing changes
 Site changes
 Tubing & solution changes
 Your teaching & evidence of patient
understanding
DOCUMENTING DISCONTINUATION OF IV
THERAPY

 All things come to an end..

 Time and date
 Reason for discontinuing therapy
 Assessment of venipuncture site
 Complications, pt reactions, & nsg interventions
 Follow-up actions
 IV therapy may be documented on:

1.A special IV therapy sheet or flow sheet

2.A NCP on the patient’s chart
3.An intake & output sheet
There are two types of fluids that are used
for intravenous drips:

1. CRYSTALLOIDS
2. COLLOIDS
CRYSTALLOIDS
- are aqueous solutions of mineral salts or other water-
soluble molecules. The most commonly used crystalloid
fluid is normal saline.
COLLOIDS
- contain larger insoluble molecules, such as
gelatin; blood itself is a colloid.
 KINDS OF IV SOLUTIONS
1. ISOTONIC SOLUTION
– Has the same osmolarity as serum and other body
fluids, hence, it stays where it is infused (intravascular
space).
Example: LR, NSS (0.9 NS)
Indication: blood loss or hypovolemia
2. HYPERTONIC SOLUTION
– Osmolarity is higher than the serum.
-Example: D50.5NS, D5LR, D5NS.

INDICATION:
- Regulate urine output; stabilize blood pressure; reduce
risk of edema; post-op patients
3. HYPOTONIC SOLUTION
– Osmolarity is lower than the serum.
Indications: dehydration; dka; hhnk
NS + insulin – in emergency situation
EQUIPMENTS
DIFFERENT VOLUMES OF
IV BAGS
Drip set
IV pole/stand
Drip set
IV pole/stand
PARTS OF IV SET
MACRODRIP & MICRODRIP
Six Rights of IV Fluid
Administration
Right Patient
Right Drug
Right Dose
Right Time
Right Route
Right Documentation
 14 RIGHTS OF
ADMINISTRATION
Right Client/Patient
Right Route
Right Dose
Right Frequency
Right Time
Right Assesment
Right Approach
Right Education
Right Evaluation
Right Documentation
Right to refuse
Right principle of care
Right prescription
Right nurse clinician
COMPLICATIONS
INFILTRATION
Assessment:
• little or no flow of IV infusion or bolus
• cool/hard to the touch
• swollen and pale infusion site
• fluid leakage from infusion site
• pain, tenderness, irritation and/or
burning sensation at infusion site
 Nursing Intervention:
• stop infusion immediately and remove
cannula
• elevate effected extremity
• apply warm compresses to encourage
absorption (apply ice to the swelling if
noticed within 30 minutes of infiltration
onset)
PHLEBITIS
Assessment:
• redness and/or
tenderness at insertion
site or along the vein
• bulge over the vein
Nursing Intervention:
• at first sign or symptom of phlebitis stop IV
infusion immediately
• apply warm compresses onto the area
• if further IV infusion is required, insert a
new catheter into a different vein and into
a different site, preferably choosing a
bigger vein and opposite arm
• document patient condition and
management
AIR EMBOLISM
Assessment:
• Abrupt drop in blood pressure
• Weak
• Rapid pulse
• Cyanosis
• Chest Pain
 Nursing Intervention:
• If air embolism is noted, infusion
administration should be stopped immediately
• Notify Supervisor and Physician immediately
Preventive Measures to avoid Air Embolism includes:
• Clear all air from tubing before attaching it to the patient
• Monitor solution levels carefully and change bag before it
becomes empty
• Frequently check to assure that all connections are secure
INFECTION
Assessment:
• redness
• swelling
• burning sensation
• discomfort
Nursing Intervention:
• when noted, infusion should be stopped
immediately
• remove cannula
• clean site of infection
• administer antibiotics as prescribed
• document patient condition and
management
EXTRAVASATION
Assessment:
• discomfort, blanching and/or
burning sensation at IV site
• cool sensation at IV site
• swelling at or right above IV site
• blistering
• skin sloughing
Nursing Intervention:
• stop IV therapy administration
immediately by disconnecting IV
tube from cannula
• administer antidote if available
• document patient condition and
management
HEMATOMA
Assessment:
• redness
• swelling
• pain
• disfiguring bruises
Nursing Intervention:
• during the first 24hrs from the formation of a
haematoma apply ice packs wrapped in cloth
for 20 minutes (you can repeat this multiple
times)
• after the first 24hrs from the formation of a
haematoma apply warm, moist compresses to
the affected site for 20 minutes (you can repeat
this multiple times in the second 24hrs post
haematoma formation)
• do not massage affected area
CLEARING AIR FROM
THE LINE
■ Tapping the tubing while holding it
■ Curling the tubing around the pen
■ Lower the IV solution bag below the level of the
patient’s heart
■ Using a needle and a syringe to remove the air at
the Y connector
■ Injecting solution into the Y connector
■ Flushing the IV line
IV SITE ASSESSMENT
• Site should be visually inspected and
palpated every 2hr.
• The IV site should be free of redness,
swelling, tenderness.
• The IV dressing should be clean and
secure.
• For adults, change catheter and rotate site
every 48 - 72 hours.