Intravenous Therapy Basics

Intravenous Therapy (IVT)

• IV therapy involves administering fluids and medications directly into the bloodstream through a vein for rapid action.
• Nurses are responsible for IVT administration and patient education, particularly for those unable to consume adequate food and fluids orally.

Purposes of IV Therapy

• Supplies fluids when oral intake is insufficient.
• Provides electrolytes to prevent imbalances.
• Supplies glucose for metabolism.
• Offers water-soluble vitamins and medications.
• Establishes access for urgently needed medications.

IV Fluid Solutions

• Crystalloids: Small molecules, categorized into hypertonic, isotonic, and hypotonic solutions.
• Colloids: Large molecules that remain longer in the intravascular space, such as fresh frozen plasma and albumin; can cause CHF in large amounts.

Crystalloid Solutions

• Hypertonic: Higher concentration than body fluids (e.g., 5% saline, D5NS), leads to cell dehydration and shrinkage; monitor for fluid overload.
• Hypotonic: Lower concentration than body fluids (e.g., 0.45% saline, D5W), causes cell swelling; monitor blood pressure.
• Isotonic: Same concentration as intracellular fluid (e.g., 0.9% saline), remains in intravascular space without fluid shifts.

IV Computation

• To calculate infusion rates: (# of volume in cc / # of hours) x (df gtts/ml) = gtts/min.

Common Complications of IV Therapy

• Air Embolism: Symptoms include tachycardia and chest pain; treat by clamping tubing and positioning the patient.
• Infiltration: Symptoms include pain and swelling; treat by removing the IV and applying warm compress.
• Infection: Symptoms include fever and redness; treat by removing IV and administering antibiotics.
• Circulatory Overload: Symptoms include high blood pressure and dyspnea; treat by decreasing flow rate and elevating the head.
• Phlebitis: Inflammation of the vein; treat with IV removal and notifying HCP.
• Hematoma: Blood collection in tissues; treat by elevating the extremity and applying pressure.
• Extravasation: Caused by vesicant drugs; treat by stopping the infusion and notifying HCP.

Blood Typing and Components

• Blood groups are determined by ABO antigens: Type A, B, AB, and O.
• Rh factor indicates if blood is Rh-positive or negative.
• Universal Donor: Type O; Universal Receiver: Type AB.

Blood Typing and Cross-Matching

• Blood typing determines blood group and Rh factor.
• Cross-matching identifies antigen-antibody interactions to avoid complications.

Catheter Guidelines

• For indwelling urinary catheters, using the smallest size possible minimizes risk for CAUTI.
• Proper positioning varies by gender; females are placed in dorsal recumbent or lithotomy positions, while males are supine.

Nutrition Support

• Gastronomy and Jejunostomy: Provide long-term nutritional support through a tube surgically placed in the stomach or jejunum.

Diet Examples

• Clear Liquid Diet: Includes clear liquids and broths.
• Full Liquid Diet: Adds dairy products and pureed foods.
• Soft Diet: Incorporates soft foods for digestibility.

Normal Lab Values

• Electrolytes:
  • Sodium: 136-145 mEq/L
  • Potassium: 3.5-5.0 mEq/L
  • Glucose: 70-99 mg/dL
• Hematology:
  • Hemoglobin: Females 12-16 g/dL; Males 14-18 g/dL
  • Platelets: 150,000-350,000/µL
• Lipids:
  • Total cholesterol: <200 mg/dL
  • HDL: Females <50 mg/dL; Males <40 mg/dL

Important Considerations

• Blood donation is voluntary and requires rigorous screening for diseases.
• Always assess patients for allergies before catheter insertion.

This quiz focuses on the principles and responsibilities associated with intravenous therapy (IVT). It covers the administration of IV medications and fluids, their rapid action in restoring fluid volume, and the importance of client education about IVT. Perfect for nursing students and healthcare professionals.