Hypodermoclysis: Administering Fluids to Patients
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Questions and Answers

What is the primary advantage of this IV insertion method?

  • Rapid administration of fluids
  • Increased patient comfort and ease of insertion (correct)
  • Reduced risk of septicemia and thrombophlebitis
  • Ability to administer large volumes of fluid
  • Why is it essential to assess the IV solution and remove it from the outer bag?

  • To remove air bubbles from the line
  • To verify the solution, rate, and frequency (correct)
  • To prime the line with fluid
  • To attach the new IV solution bag
  • What is a significant disadvantage of this IV insertion method?

  • High risk of cellulitis and edema
  • Slow rate of infusion and limited fluids administration (correct)
  • Risk of septicemia and thrombophlebitis
  • Frequent need for site rotation
  • What is the purpose of massaging the infusion site?

    <p>To enhance edema absorption</p> Signup and view all the answers

    What is a contraindication for this IV insertion method?

    <p>All of the above</p> Signup and view all the answers

    What should be done to the infusion site during the post-procedure steps?

    <p>Date and initial dressing and tubing</p> Signup and view all the answers

    Why is it essential to check the patient and infusion site after one hour?

    <p>To monitor for edema, leakage, or disconnection</p> Signup and view all the answers

    What should be done if the patient exhibits signs of edema or other complications?

    <p>Remove the catheter and reassess the site</p> Signup and view all the answers

    What is the primary advantage of hypodermoclysis over IV therapy in patients who require hydration?

    <p>It avoids the need for venous access</p> Signup and view all the answers

    What is the maximum volume of fluid that can be administered in 24 hours using hypodermoclysis in 2 sites?

    <p>3000 ml/24 hours</p> Signup and view all the answers

    What is the recommended angle of insertion for the small gauge needle in hypodermoclysis?

    <p>45-60 degree angle</p> Signup and view all the answers

    What is the purpose of adding Hyaluronidase to the fluid in hypodermoclysis?

    <p>To enhance fluid absorption</p> Signup and view all the answers

    What is the recommended frequency for changing the tubing in hypodermoclysis?

    <p>Every 96 hours</p> Signup and view all the answers

    What is the recommended location for insertion of the small gauge needle in hypodermoclysis?

    <p>Outer upper arms, upper back between scapula, abdomen, and lateral aspects of thighs</p> Signup and view all the answers

    What is the purpose of massaging the site in hypodermoclysis?

    <p>To enhance edema absorption</p> Signup and view all the answers

    What is the alternative name for hypodermoclysis?

    <p>Clysis</p> Signup and view all the answers

    What is the primary indication for using hypodermoclysis in patients?

    <p>Mild to moderate dehydration</p> Signup and view all the answers

    What is the recommended frequency for changing the site of subcutaneous fluid administration in hypodermoclysis?

    <p>Every 48 hours</p> Signup and view all the answers

    What is the purpose of adding KCl to the fluid in hypodermoclysis?

    <p>To treat electrolyte imbalance</p> Signup and view all the answers

    What is the maximum volume of fluid that can be administered in 24 hours using hypodermoclysis in 2 sites?

    <p>3000 ml</p> Signup and view all the answers

    What is the recommended gauge of the needle used for hypodermoclysis?

    <p>22-25 gauge</p> Signup and view all the answers

    What is the purpose of using 0.9% NaCl or LR in hypodermoclysis?

    <p>To provide hydration</p> Signup and view all the answers

    What is the recommended location for insertion of the small gauge needle in hypodermoclysis?

    <p>Outer upper arms, upper back, abdomen, or lateral aspects of thighs</p> Signup and view all the answers

    What is the purpose of delivering the fluid with a pump in hypodermoclysis?

    <p>To provide a consistent flow rate</p> Signup and view all the answers

    What is the primary purpose of spiking the new bag with the dominant hand?

    <p>To enhance patient comfort and ease of insertion</p> Signup and view all the answers

    What should be done to the infusion site during the preparation step?

    <p>Cleanse the site with chlorhexidine</p> Signup and view all the answers

    What is the recommended rate of infusion for this IV insertion method?

    <p>No more than 1 ml/min</p> Signup and view all the answers

    What should be done if the patient exhibits signs of fluid overload during the post-procedure steps?

    <p>Remove the catheter</p> Signup and view all the answers

    What is the primary purpose of assembling the fluid and tubing during the procedure?

    <p>To prime the line</p> Signup and view all the answers

    What should be done to the infusion site after one hour during the post-procedure steps?

    <p>Check the patient and infusion site for signs of edema, leakage, or disconnection</p> Signup and view all the answers

    What is the primary purpose of donning gloves during the procedure?

    <p>To prevent infection</p> Signup and view all the answers

    What should be done to the dressing and tubing during the post-procedure steps?

    <p>Date and initial the dressing and tubing</p> Signup and view all the answers

    What is the primary purpose of adding Hyaluronidase to the fluid in hypodermoclysis?

    <p>To enhance fluid absorption</p> Signup and view all the answers

    What is the recommended frequency for changing the site of subcutaneous fluid administration in hypodermoclysis?

    <p>Every 24-48 hours</p> Signup and view all the answers

    What is the primary indication for using hypodermoclysis in patients?

    <p>Mild to moderate dehydration</p> Signup and view all the answers

    What is the recommended angle of insertion for the small gauge needle in hypodermoclysis?

    <p>45-60 degree angle</p> Signup and view all the answers

    What is the maximum volume of fluid that can be administered in 24 hours using hypodermoclysis in 2 sites?

    <p>3000 ml</p> Signup and view all the answers

    What is the recommended gauge of the needle used for hypodermoclysis?

    <p>22-25 gauge</p> Signup and view all the answers

    What is the primary purpose of delivering the fluid with a pump in hypodermoclysis?

    <p>To deliver the fluid at a controlled rate</p> Signup and view all the answers

    What is the alternative name for hypodermoclysis?

    <p>Clysis</p> Signup and view all the answers

    What is the primary reason for selecting the infusion site during the preparation step?

    <p>To minimize the risk of edema and cellulitis</p> Signup and view all the answers

    What is the recommended action if the patient exhibits signs of fluid collection distal to the site during the post-procedure steps?

    <p>Remove the catheter and assess the site for complications</p> Signup and view all the answers

    What is the primary purpose of cleansing the site with chlorhexidine during the procedure?

    <p>To reduce the risk of infection and septicemia</p> Signup and view all the answers

    What is the recommended frequency for changing the dressing and tubing during the post-procedure steps?

    <p>As necessary, based on the patient's condition</p> Signup and view all the answers

    What is the primary advantage of using a bio-occlusive dressing to secure the needle and tubing?

    <p>It protects the site from infection and septicemia</p> Signup and view all the answers

    What is the recommended action if the patient exhibits signs of bleeding or shock during the post-procedure steps?

    <p>Not applicable, as this is a contraindication for the procedure</p> Signup and view all the answers

    What is the primary purpose of priming the line during the procedure?

    <p>To remove any air from the tubing and fluid pathway</p> Signup and view all the answers

    What is the recommended angle of insertion for the small gauge needle during the procedure?

    <p>45-60 degrees</p> Signup and view all the answers

    Hypodermoclysis is a simple, safe and effective technique for subcutaneously administering ______ to a patient who requires hydration.

    <p>fluids</p> Signup and view all the answers

    The outer upper arms, upper back between the ______, abdomen, and lateral aspects of thighs are suitable locations for hypodermoclysis.

    <p>scapula</p> Signup and view all the answers

    Hypodermoclysis is also known as ______.

    <p>clysis</p> Signup and view all the answers

    The maximum volume of fluid that can be administered in 24 hours using hypodermoclysis in 2 sites is ______.

    <p>3000 mls</p> Signup and view all the answers

    Massage of the site can enhance ______ absorption.

    <p>edema</p> Signup and view all the answers

    The small gauge needle used for hypodermoclysis typically has a gauge of ______.

    <p>22-25</p> Signup and view all the answers

    Hypodermoclysis is an alternative to ______ therapy for mild to moderate dehydration.

    <p>IV</p> Signup and view all the answers

    Hyaluronidase may be added to the fluid to ______ fluid absorption.

    <p>enhance</p> Signup and view all the answers

    Before inserting the needle, the site should be cleansed with ______.

    <p>chlorhexidine</p> Signup and view all the answers

    The needle should be inserted at a ______ degree angle.

    <p>45-60</p> Signup and view all the answers

    The patient's infusion site should be checked for ______ after one hour.

    <p>edema</p> Signup and view all the answers

    The infusion site should be massaged to enhance ______ absorption.

    <p>edema</p> Signup and view all the answers

    The primary purpose of assembling the fluid and tubing is to ______.

    <p>prime</p> Signup and view all the answers

    The new IV solution bag should be spiked with the ______ hand.

    <p>dominant</p> Signup and view all the answers

    The dressing and tubing should be ______ and labeled with the medication name.

    <p>dated</p> Signup and view all the answers

    The patient should be assessed for ______ and tenderness during the post-procedure steps.

    <p>redness</p> Signup and view all the answers

    Study Notes

    Hypodermoclysis

    • Hypodermoclysis is a simple, safe, and effective technique for subcutaneously administering fluids to a patient who requires hydration.
    • It avoids the need for venous access in patients who often have poor veins at the end of life.
    • It can be carried out in home, hospice, or residential care facility settings without fully IV credentialed nursing staff.

    Indications and Contraindications

    • Indications for hypodermoclysis include mild to moderate dehydration, nausea, and vomiting, or medication administration.
    • Contraindications include rapid administration required, shock, bleeding disorder, major dehydration, and severe electrolyte disturbance.

    Insertion

    • A small gauge needle (22-25 gauge) or subcutaneous device (butterfly) is inserted into the subcutaneous space at a 45-60 degree angle.
    • The needle is inserted into subcutaneous tissue, and if blood returns, it is removed.
    • The site should be changed every 24-48 hours for fluid administration and every 7 days for medications.

    Location Choice

    • Suitable locations for insertion include outer upper arms, upper back between scapula, abdomen (at least 2 inches away from umbilicus), and lateral aspects of thighs.
    • Avoid areas that are scarred, bruised, infected, inflamed, near bony prominences, waistline, and sites that are highly vascular, damaged, or edematous.

    IV Fluids

    • Common fluids used include 0.9% NaCl, LR, D5NS, D51/2NS, 2/3 & 1/3, and 0.45% NaCl.
    • KCl or Hyaluronidase can be added to enhance fluid absorption.
    • The maximum volume is 3000 ml/24 hours in 2 sites, with a rate of 1 ml/min.

    Advantages and Disadvantages

    • Advantages include patient comfort, ease of insertion, and avoidance of thrombophlebitis, septicemia, and systemic infection.
    • Disadvantages include slow rate of infusion, limited fluids for administration, edema, cellulitis, pain, and discomfort.

    Preparation and Procedure

    • The patient should be explained the procedure and gather supplies.
    • The infusion site is selected and washed with chlorhexidine.
    • The needle is inserted, bevel up, into subcutaneous tissue at a 45-60 degree angle.
    • The fluid drip rate is adjusted as prescribed (no more than 1 ml/min).

    Post-Procedure

    • The date and initial dressing and tubing are documented, and the site is labeled with medication name if used.
    • The patient and infusion are checked after one hour for signs of edema, leakage, disconnection, or fluid collection distal to the site.
    • The infusion site can be massaged to enhance edema absorption if necessary.
    • The site is assessed for redness, tenderness, edema, bruising, bleeding, burning, leaking, blood in tubing, and cannula displacement.

    Hypodermoclysis

    • Hypodermoclysis is a simple, safe, and effective technique for subcutaneously administering fluids to a patient who requires hydration.
    • It avoids the need for venous access in patients who often have poor veins at the end of life.
    • It can be carried out in home, hospice, or residential care facility settings without fully IV credentialed nursing staff.

    Indications and Contraindications

    • Indications for hypodermoclysis include mild to moderate dehydration, nausea, and vomiting, or medication administration.
    • Contraindications include rapid administration required, shock, bleeding disorder, major dehydration, and severe electrolyte disturbance.

    Insertion

    • A small gauge needle (22-25 gauge) or subcutaneous device (butterfly) is inserted into the subcutaneous space at a 45-60 degree angle.
    • The needle is inserted into subcutaneous tissue, and if blood returns, it is removed.
    • The site should be changed every 24-48 hours for fluid administration and every 7 days for medications.

    Location Choice

    • Suitable locations for insertion include outer upper arms, upper back between scapula, abdomen (at least 2 inches away from umbilicus), and lateral aspects of thighs.
    • Avoid areas that are scarred, bruised, infected, inflamed, near bony prominences, waistline, and sites that are highly vascular, damaged, or edematous.

    IV Fluids

    • Common fluids used include 0.9% NaCl, LR, D5NS, D51/2NS, 2/3 & 1/3, and 0.45% NaCl.
    • KCl or Hyaluronidase can be added to enhance fluid absorption.
    • The maximum volume is 3000 ml/24 hours in 2 sites, with a rate of 1 ml/min.

    Advantages and Disadvantages

    • Advantages include patient comfort, ease of insertion, and avoidance of thrombophlebitis, septicemia, and systemic infection.
    • Disadvantages include slow rate of infusion, limited fluids for administration, edema, cellulitis, pain, and discomfort.

    Preparation and Procedure

    • The patient should be explained the procedure and gather supplies.
    • The infusion site is selected and washed with chlorhexidine.
    • The needle is inserted, bevel up, into subcutaneous tissue at a 45-60 degree angle.
    • The fluid drip rate is adjusted as prescribed (no more than 1 ml/min).

    Post-Procedure

    • The date and initial dressing and tubing are documented, and the site is labeled with medication name if used.
    • The patient and infusion are checked after one hour for signs of edema, leakage, disconnection, or fluid collection distal to the site.
    • The infusion site can be massaged to enhance edema absorption if necessary.
    • The site is assessed for redness, tenderness, edema, bruising, bleeding, burning, leaking, blood in tubing, and cannula displacement.

    Hypodermoclysis

    • Hypodermoclysis is a simple, safe, and effective technique for subcutaneously administering fluids to a patient who requires hydration.
    • It avoids the need for venous access in patients who often have poor veins at the end of life.
    • It can be carried out in home, hospice, or residential care facility settings without fully IV credentialed nursing staff.

    Indications and Contraindications

    • Indications for hypodermoclysis include mild to moderate dehydration, nausea, and vomiting, or medication administration.
    • Contraindications include rapid administration required, shock, bleeding disorder, major dehydration, and severe electrolyte disturbance.

    Insertion

    • A small gauge needle (22-25 gauge) or subcutaneous device (butterfly) is inserted into the subcutaneous space at a 45-60 degree angle.
    • The needle is inserted into subcutaneous tissue, and if blood returns, it is removed.
    • The site should be changed every 24-48 hours for fluid administration and every 7 days for medications.

    Location Choice

    • Suitable locations for insertion include outer upper arms, upper back between scapula, abdomen (at least 2 inches away from umbilicus), and lateral aspects of thighs.
    • Avoid areas that are scarred, bruised, infected, inflamed, near bony prominences, waistline, and sites that are highly vascular, damaged, or edematous.

    IV Fluids

    • Common fluids used include 0.9% NaCl, LR, D5NS, D51/2NS, 2/3 & 1/3, and 0.45% NaCl.
    • KCl or Hyaluronidase can be added to enhance fluid absorption.
    • The maximum volume is 3000 ml/24 hours in 2 sites, with a rate of 1 ml/min.

    Advantages and Disadvantages

    • Advantages include patient comfort, ease of insertion, and avoidance of thrombophlebitis, septicemia, and systemic infection.
    • Disadvantages include slow rate of infusion, limited fluids for administration, edema, cellulitis, pain, and discomfort.

    Preparation and Procedure

    • The patient should be explained the procedure and gather supplies.
    • The infusion site is selected and washed with chlorhexidine.
    • The needle is inserted, bevel up, into subcutaneous tissue at a 45-60 degree angle.
    • The fluid drip rate is adjusted as prescribed (no more than 1 ml/min).

    Post-Procedure

    • The date and initial dressing and tubing are documented, and the site is labeled with medication name if used.
    • The patient and infusion are checked after one hour for signs of edema, leakage, disconnection, or fluid collection distal to the site.
    • The infusion site can be massaged to enhance edema absorption if necessary.
    • The site is assessed for redness, tenderness, edema, bruising, bleeding, burning, leaking, blood in tubing, and cannula displacement.

    Hypodermoclysis

    • Hypodermoclysis is a simple, safe, and effective technique for subcutaneously administering fluids to a patient who requires hydration.
    • It avoids the need for venous access in patients who often have poor veins at the end of life.
    • It can be carried out in home, hospice, or residential care facility settings without fully IV credentialed nursing staff.

    Indications and Contraindications

    • Indications for hypodermoclysis include mild to moderate dehydration, nausea, and vomiting, or medication administration.
    • Contraindications include rapid administration required, shock, bleeding disorder, major dehydration, and severe electrolyte disturbance.

    Insertion

    • A small gauge needle (22-25 gauge) or subcutaneous device (butterfly) is inserted into the subcutaneous space at a 45-60 degree angle.
    • The needle is inserted into subcutaneous tissue, and if blood returns, it is removed.
    • The site should be changed every 24-48 hours for fluid administration and every 7 days for medications.

    Location Choice

    • Suitable locations for insertion include outer upper arms, upper back between scapula, abdomen (at least 2 inches away from umbilicus), and lateral aspects of thighs.
    • Avoid areas that are scarred, bruised, infected, inflamed, near bony prominences, waistline, and sites that are highly vascular, damaged, or edematous.

    IV Fluids

    • Common fluids used include 0.9% NaCl, LR, D5NS, D51/2NS, 2/3 & 1/3, and 0.45% NaCl.
    • KCl or Hyaluronidase can be added to enhance fluid absorption.
    • The maximum volume is 3000 ml/24 hours in 2 sites, with a rate of 1 ml/min.

    Advantages and Disadvantages

    • Advantages include patient comfort, ease of insertion, and avoidance of thrombophlebitis, septicemia, and systemic infection.
    • Disadvantages include slow rate of infusion, limited fluids for administration, edema, cellulitis, pain, and discomfort.

    Preparation and Procedure

    • The patient should be explained the procedure and gather supplies.
    • The infusion site is selected and washed with chlorhexidine.
    • The needle is inserted, bevel up, into subcutaneous tissue at a 45-60 degree angle.
    • The fluid drip rate is adjusted as prescribed (no more than 1 ml/min).

    Post-Procedure

    • The date and initial dressing and tubing are documented, and the site is labeled with medication name if used.
    • The patient and infusion are checked after one hour for signs of edema, leakage, disconnection, or fluid collection distal to the site.
    • The infusion site can be massaged to enhance edema absorption if necessary.
    • The site is assessed for redness, tenderness, edema, bruising, bleeding, burning, leaking, blood in tubing, and cannula displacement.

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