IV Fluids and Their Applications

Avoid inserting IVs in areas with infections, scarring, burns, surgeries, dialysis shunts, AV fistulas, or recent infiltrations/phlebitis. Choose a site distal to prior punctures and avoid the affected side of a CVA.

Follow strict aseptic technique using proper antiseptic solutions (e.g., alcohol or chlorhexidine), properly position the tourniquet, and possibly massage or clench the fist to improve vein visibility.

Isotonic fluids have the same concentration inside and outside the cell, so the cell's volume remains unchanged. They are used for hypovolemia and hypotension (too little fluid in circulation).

Cellulitis is an infection around the IV site, marked by redness, swelling, and outward spread from the insertion point in a circular pattern. It's caused by poor aseptic technique during insertion.

Monitor patients closely before, during, and after medication administration. Be prepared for adverse reactions like Red Man Syndrome (vancomycin) or Blue Man Syndrome (amiodarone) and know how to intervene safely.

Crucial steps in safe medication administration: the Right patient, drug, dose, route, time, documentation, assessment, education, and right to refuse.

Intravenous fluids are categorized as isotonic, hypotonic, and hypertonic, based on their concentration compared to blood.

Used for replacing fluids, electrolytes, and other nutrients needed to correct fluid and electrolyte imbalances (e.g. dehydration, vomiting, diarrhea).

Solutions with the same solute concentration as body fluids.

Solutions with a lower solute concentration than body fluids; water moves into cells.

Solutions with a higher solute concentration than body fluids; water moves out of cells.

Normal saline (0.9% NaCl) is a common example of an isotonic fluid.

0.45% NS is a common type of hypotonic fluid.

D5 0.9% NS is an example. Others include D5 LR, D10W

Avoid in increased intracranial pressure (ICP) because of potential brain swelling.

Not recommended for general use because of potential fluid overload side effects

Valacyclovir, a guanosine analog, stops viral DNA replication by inserting into viral DNA.

Headache, nausea, skin rash, and possible kidney problems (nephrotoxicity).

Neurological issues (agitation, confusion), hallucinations, seizures, blood clots, and kidney failure are possible.

A class of antiviral medications used to treat herpesviruses.

A group of DNA viruses including simplex, varicella-zoster, and cytomegalovirus.

Initial evaluation of herpes symptoms (location, pain, etc.) when starting antiviral medication.

Intravenous medications are given to replenish fluids, correct electrolyte imbalances, provide nutrition, deliver medications, transfuse blood products, and facilitate diagnostic testing.

Hypotonic fluids have a lower solute concentration than our cells causing water to move into the cells, making them swell.

Hypotonic fluids are used to treat dehydration, especially situations where fluid has been drawn out of the cells, like in hyperglycemic conditions like DKA or HHNS.

Commonly used hypotonic solutions include 0.45% NS (half-normal saline), 0.33% NS, and 0.2% NS.

Hypotonic solutions are contraindicated in patients with increased intracranial pressure (ICP) as they can worsen brain swelling, as well as in dehydration and trauma.

Cellulitis is an inflammation of the loose connective tissue around an IV insertion site, caused by poor aseptic technique during IV insertion.

Cellulitis is treated with antibiotics.

Antidotes are substances that counteract the effects of poisons or drugs.

Acyclovir, a guanosine analog, helps control herpes symptoms by inhibiting viral DNA replication, but it doesn't eliminate the infection or stop spreading.

Teach clients about safe practices like avoiding sexual activity with sores, consistently using condoms, and promptly reporting persistent side effects or worsening symptoms.

Common side effects include headaches, fatigue, nausea, and vomiting. More serious ones include kidney damage, blood clots, and a rare syndrome affecting blood cells.

Assess baseline health, monitor for side effects, and evaluate for the desired therapeutic effect (absence of lesions and herpes symptoms).

Never insert an IV in areas with infections, dialysis shunts, AV fistulas, scarring, burns, surgeries, paralysis from stroke, or recent IV problems.

Select veins for IV insertion that are free from infections, scarring, burns, surgeries, dialysis shunts, AV fistulas, and recent IV issues.

After inserting an IV, monitor for signs of complications like cellulitis (redness, swelling, pain), phlebitis (inflammation), or infiltration (fluid leakage).