IV INFUSION IN ENGLISH

                                                

                                          IV INFUSION IN ENGLISH

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Ø IV INFUSION

Ø IV infusion is a process of administering large amount of fluid / medication into vein through infusion pump or gravity.

Ø IV FLUIDS

Ø Main fluids used for infusion are:

Ø Fluids used for IV infusion are classified into three categories

Ø Hypotonic fluids

Ø Isotonic fluids

Ø Hypertonic fluids

Ø Hypotonic fluids- A solution that contains fewer dissolved particles (such as salt and other electrolytes) than found in normal cells and blood. Means concentration is less than blood. Example - 0.33% NaCl and 0.33% NaCl solutions

 

Ø Isotonic fluids- Solutions that contain the same concentration of dissolved particles (such as salt and other electrolytes) than as found in normal cells and blood. Means concentration is same as blood. Example - 5% dextrose solution , 0.9% NaCl (normal saline) and RL (Ringer lactate solution) containing multiple electrolytes.

Ø Hypertonic fluids- Solutions having higher concentration of dissolved particles (such as salt and other electrolytes) than as found in normal cells and blood. Means more concentrated fluid than blood. Example - 5% dextrose solution+0.9% NaCl (DNS), 5% dextrose solution+0.45% NaCl  and 10% dextrose solution

Ø CALCULATION OF DROPS

Ø Drops per minute are calculated by following formula-

Ø

Ø Example 1000  ml fluid to be infused in 10 hours than how many drops per minutes flow rate you will set ( drop factor is 60)

Ø

Ø PREPARATION OF ARTICLES

Ø a tray containing-

Ø IV solution, as prescribed

Ø Nonallergenic tape

Ø IV administration set/ drip set

Ø Medication card

Ø Electronic infusion device (if appropriate

Ø Tourniquet

Ø label (for IV container)

Ø Sterile gloves

Ø IV canula  or butterfly needle

Ø Short extension tubing

Ø End cap for extension tubing

Ø Alcohol wipes

Ø sterile cotton swabs

Ø Kidney tray and paper bag

Ø Specimen tubes

Ø 2 and 5 ml syringes

Ø Mackintosh and towel

Ø Splint with bandages

Ø IV stand or pole (additional item)

Ø STEPS OF PROCEDURE-

Ø Always keep rights of drug administration in mind while starting IV infusion.

Ø Identify the client correctly (Right client)

Ø Explain the procedure to the client.

Ø Provide privacy with curtains and drapes.

Ø Wash hands and prepare fluid and IV tubings.

Ø place the iv stand at proper place and side.

Ø insert the iv set into bottle in sterile manner using twisting movement.

Ø Hang the IV container on the IV pole. Squeeze the drip chamber and fill at least halfway.

Ø Open the IV tubing clamp, and allow fluid to move through tubing. Allow fluid to flow until all air bubbles have disappeared and the entire length of the tubing is primed (filled) with IV solution. Maintain its sterility. After fluid has filled the tubing, close the clamp and recap the end of the tubing.

Ø Complete a time strip (label for time and date of starting infusion) for the infusion and apply to IV fluid container.

Ø Apply label to tubing reflecting the day/date for next set change, per facility guidelines.

Ø Place the patient in low Fowler’s or supine position in bed. 

Ø Place protective mackintosh and towel  under patient’s arm.

Ø Open the short extension tubing package. Attach end cap, Insert syringe with normal saline into extension tubing. Fill extension tubing with normal saline (priming of extension tubings) and apply slide clamp

Ø Palpate for appropriate vein and finalize the site for cannula insertion.

Ø Select appropriate cannula depending upon age and vein size.

Ø Apply a tourniquet 3 to 4 inches above the venipuncture site to obstruct venous blood flow and distend the vein

Ø Put on gloves

Ø Clean the skin with alcohol wipes.

Ø Take out cannula and hold in dominate hand.

Ø Use the nondominant hand to place  about 1 or 2 inches below the entry site and hold the skin taut against the vein. Avoid touching the prepared site. Ask the patient to remain still while performing the venipuncture.

Ø pierce the skin gently, holding the cannula by the hub in your dominant hand, bevel side up, at a 10- to 15-degree angle  Insert the catheter from directly over the vein or from the side of the vein.  advance the canula into the vein

Ø When blood returns through the lumen of the needle or the flashback chamber of the cannula, advance the device into the vein until the hub is at the venipuncture site while holding the needle slight back so that it may not pierce the vein again.

Ø Release the tourniquet. Quickly remove the protective cap from the extension tubing and attach it to the cannula while withdrawing the  needle and pressing the vein with thumb of the other hand to avoid leakage of blood.

Ø stabilize the catheter and flush gently with the saline, observing the site for infiltration and leaking. If it is ok than secure the cannula with plaster and attach iv tubings and start infusion.

Ø Label the IV cannula dressing with the date, time, site, and type and size of catheter or needle used for the infusion.

Ø Open the clamp on the administration set. Set the flow rate and begin the fluid infusion.

Ø Remove the articles to their proper place wash hands and record the  procedure in nurses notes.