Ministry of higher education Second Semester/First Class

and scientific research Academic year 2023- 2024

Duhok Polytechnic University
College for Health and Medical
Techniques / Shekhan
Nursing Department

Lecture 1
Intravenous Injection and Infusion

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 Learning Outcomes:
After completing this chapter, you will be able to:
1. Discuss the function, distribution, composition, movement, and regulation of fluids
and electrolytes in the body.
2. Describe the regulation of acid–base balance in the body, including the roles of
buffers, the lungs, and the kidneys.
3. Identify factors affecting normal body fluid, electrolyte, and acid–base balance.
4. Discuss risk factors for, and causes and effects of, fluid, electrolyte, and acid
–base imbalances.
5. Collect assessment data related to clients’ fluid, electrolyte, and acid–base balances.
6. Identify examples of nursing diagnoses, outcomes, and interventions for clients with
altered fluid, electrolyte, or acid–base balance.
7. Teach clients measures to maintain fluid and electrolyte balance.
8. Implement measures to correct imbalances of fluids, electrolytes, acids, and
bases, such as enteral or parenteral replacements and blood transfusions

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 Intravenous Injection and Infusion
Intravenous Route(I.V.):
Because intravenous (IV) medication enter the client’s
bloodstream directly by way of a vein, they are appropriate
when a rapid effect is required. This route is also appropriate
when medications are too irritating to tissues to be given by other
routes. Intravenous therapy may be used for fluids volume
replacement, to correct electrolyte imbalances, to deliver
medications, and for blood transfusions. The intravenous (IV)
route includes peripheral and central veins. Medication
administered intravenously have an immediate effect, and
consequently it is the most dangerous route for drug
administration. Drugs administered in this manner cannot be
recalled once they have been given.

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 For this reason only selectively qualified nurses are permitted to
administer IV medications.
Despite its inherent risks, there are legitimate reasons for using IV
route . With all IV medication administration. it is very important
to observe client's closely for signs of adverse reactions. Because
the drugs enters the bloodstream directly and acts immediately,
there is no way it can be withdrawn or its action terminated,
therefore the nurse or doctors must take special care to avoid any
errors about the preparation of drug and the calculation of the
dose. Intravenous medication are administered either continuously
or intermittently. Intravenous administration is the route chosen
when :

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 1- A quick response is needed during an emergency.
2- Patients have disorders that affect absorption or metabolism of
drugs like burned patients.
3- Blood levels of drugs need to be maintained at a constant
therapeutic level.
4- It is in the patient’s best interests to avoid discomfort of
repeated intramuscular injection.

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 Vein puncture and Intravenous Infusion
Intravenous fluids are solutions that are infused through
a patient's vein. It is necessary to teach nursing personnel how
to perform vein puncture and start intravenous infusions. They
may be used for the following purposes:

1- To maintain or restore fluids balance when oral replacement

is inadequate or impossible .
2- To maintain or replace electrolytes.
3- To administer water – soluble vitamins.

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 4-
To administer drugs.
5-
To replace blood and blood products.
6-
When a very rapid effect is needed.
7-
In sever disturbance of fluids and electrolytes balance.
8-
When the patient is unable to take and retain oral
nourishment.
Fluids for such treatments consist of water with electrolytes,
sugar, or medications added in concentrations that depend on your
need. The rate and quantity of intravenous fluid given depends on
your medical condition, body size, and age

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 Types of Fluids

There are two types of I.V. Solutions:

1 – Crystalloid solutions:
Which consist of water and other uniformly dissolved
crystals such as salt and sugar, They are subdivided into:

A – Isotonic Solutions: Which is administer to maintain fluid

balance among patients who may
not be able to eat or drink for a short
period of time.

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 B - Hypotonic Solutions: Which are administer to patient who
have diarrhea or vomits.

C - Hypertonic Solutions: Which are not used very frequently

except for extreme cases in which it
is necessary to reduce cerebral edema

2 - Colloid Solutions:
Which consist of water and molecules of
suspended substances like blood cells and
blood products like albumin. It is used to replace
circulating blood volume (Blood, Blood products,
and solutions known as plasma.

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 Fluids used during I.V. infusion:
1- 9% Normal Saline ( also known as NS, 0.9NaCl, or NSS) .
2- Lactated Ringers (also known as LR, Ringers Lactate, or RL).
3- 5% Dextrose in Water (also known as D5 or D5W) .
4- 4.5% Normal Saline (also known as Half Normal Saline,
0.45NaCl).

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 Preparing Intravenous Solutions:
Intravenous solutions are most commonly stored in
plastic bags containing 1,000 , 500, 250 , 100,ML of
solutions. Before preparing the solutions the
nurse inspects the container and determine that:

1- The type of solution is same that prescribed by the physician.

2- The solution is clear and transparent.
3- The expiration dates has not elapsed.
4- No leaks are apparent.
5- A separate label is attached identifying the type and amount of
other drugs added to the commercial solutions.

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 Complications associated with Intravenous Infusion:

1 - Infection.
2 - Fluid infiltration.
3 - Phlebitis.
4 - Circulatory overload.
5 - Blockage of the infusion.
6 - A dislodged IV catheter

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 Nurses can avoid dislodging IV catheter by staying still or being
careful not to pull on the tubing during fluid administration. A
collapsed vein is more likely to occur if you need to have an IV
catheter in place for an extended period of time.
Complications related to the regulation of fluids include giving
too much fluid too rapidly, causing fluid overload. Alternatively,
not enough fluid may be given or it’s released too slowly.
Overload can cause symptoms such as a headache, high blood
pressure, anxiety, and trouble breathing. Some overload can be
tolerated if you’re fairly health. But if you have other health
problems, it can be dangerous.

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 Side Effects Of I.V. Infusion
1 - Flushing 2 - Headache 3- Dizziness 4 - Chills
5 - Muscle cramps 6 - Back/joint pain 7 - Fever
8 - Nausea, or vomiting may occur.
Tell doctor or other health care professional right away if any of
these effects occur, persist, or worsen. Pain, redness, and swelling
at the injection site may also occur.
Intravenous fluids (usually shortened to 'IV' fluids)
are liquids given to replace water, sugar and salt that you might
need if you are ill or having an operation, and can't eat or drink as
you would normally.

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 Intravenous cannula (l.V. cannula)

Is a flexible tube which when inserted into the

body is used either to withdraw fluid or insert
medication.

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 Factors Influencing The Rate of Flow:

1 - The size of the needle

2 - The height of the bottle
3 - The viscosity of the fluids
-----------------------------------------------
The site for infusion

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 Equipment
1-Infusion set consist of the following ( bottle of
solution, air vent drip champer, clamp, tubing,
needle adapter, needle used for adult 18, 19,20,
21, 22 gauge with short bevel (1- 2 ) inch length
2- Alcohol sponge
3- Tourniquet.
4- Adhesive tape and scissors.
5- I.V holder.
6- Arm splint.

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 Calculating infusion (drip) rates:

The rate of administration of a continuous or

intermittent infusion may be calculated from the
following equation:

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 ‫‪IV Cannula Sizes‬‬

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 Cannula Steps

• Apply the tourniquet

• Re-check the vein
• Clean the patients skin with the alcohol wipe
• Remove the cannula from its packaging and remove the
needle cover ensuring not to touch the needle.
• Insert the needle, bevel upwards at about 30 degrees.
• Advance the rest of the cannula into the vein
• Release the tourniquet
• Remove the needle
• Apply the plaster to the cannula
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 ‫‪Step 1‬‬

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 ‫‪Step 2‬‬ ‫‪Step 3‬‬

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 ‫‪Step 4‬‬ ‫‪Step 5‬‬

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 ‫‪Step 6‬‬ ‫‪Step 7‬‬

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 ‫‪Step 8‬‬ ‫‪Step 9‬‬

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