Podcast
Questions and Answers
Which type of solution has the same osmotic pressure as blood?
Which type of solution has the same osmotic pressure as blood?
What is the recommended flow rate for the IV solution ordered for Mrs. Brown?
What is the recommended flow rate for the IV solution ordered for Mrs. Brown?
What is the main purpose of IV therapy in this case?
What is the main purpose of IV therapy in this case?
Which factor can influence the condition, size, and long-term use of veins for IV therapy?
Which factor can influence the condition, size, and long-term use of veins for IV therapy?
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Which term is used to describe devices that allow connection to IV catheters without using a needle?
Which term is used to describe devices that allow connection to IV catheters without using a needle?
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What is the current recommended terminology for devices that allow connection to IV catheters without using a needle?
What is the current recommended terminology for devices that allow connection to IV catheters without using a needle?
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How long should the hub be scrubbed before each access to prevent infection?
How long should the hub be scrubbed before each access to prevent infection?
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What is the recommended solution for flushing peripheral intermittent devices?
What is the recommended solution for flushing peripheral intermittent devices?
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Which organization is recognized as a global authority in infusion nursing and publishes standards of practice for infusion therapy?
Which organization is recognized as a global authority in infusion nursing and publishes standards of practice for infusion therapy?
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Which administration mode for IV medications involves a large-volume infusion of solution or medications administered over 2 to 24 hours?
Which administration mode for IV medications involves a large-volume infusion of solution or medications administered over 2 to 24 hours?
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What is the term used to refer to any medication route other than the digestive tract?
What is the term used to refer to any medication route other than the digestive tract?
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Why do patients receive IV therapy?
Why do patients receive IV therapy?
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Which of the following formulas is used to calculate drops per minute in intravenous therapy?
Which of the following formulas is used to calculate drops per minute in intravenous therapy?
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What is the ideal height for a solution in intravenous therapy?
What is the ideal height for a solution in intravenous therapy?
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Which of the following factors can affect the infusion flow rate in intravenous therapy?
Which of the following factors can affect the infusion flow rate in intravenous therapy?
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What type of pump uses positive pressure to deliver the solution in intravenous therapy?
What type of pump uses positive pressure to deliver the solution in intravenous therapy?
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Which type of filter is used for nonlipid solutions in IV fluids?
Which type of filter is used for nonlipid solutions in IV fluids?
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Which type of filter is used for blood infusions?
Which type of filter is used for blood infusions?
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Which type of IV solution is isotonic?
Which type of IV solution is isotonic?
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Which type of IV solution is more concentrated than body fluids?
Which type of IV solution is more concentrated than body fluids?
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Which technique is used to maintain positive pressure in the lumen of the cannula during the administration of the flush solution?
Which technique is used to maintain positive pressure in the lumen of the cannula during the administration of the flush solution?
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What is the purpose of Patient-Controlled Analgesia (PCA)?
What is the purpose of Patient-Controlled Analgesia (PCA)?
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Which method of infusion uses gravity to administer a solution into a vein?
Which method of infusion uses gravity to administer a solution into a vein?
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When using a gravity set, how can the nurse calculate the infusion rate and/or the drops required per minute to deliver fluid at the ordered rate?
When using a gravity set, how can the nurse calculate the infusion rate and/or the drops required per minute to deliver fluid at the ordered rate?
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Which type of solution has the same tonicity as body fluid?
Which type of solution has the same tonicity as body fluid?
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Which type of solution expands the extracellular fluid volume when administered to patients requiring water?
Which type of solution expands the extracellular fluid volume when administered to patients requiring water?
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Which type of solution is quickly metabolized, making it hypotonic when infused?
Which type of solution is quickly metabolized, making it hypotonic when infused?
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What are examples of isotonic solutions?
What are examples of isotonic solutions?
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Where can IV therapy be administered into the systemic circulation?
Where can IV therapy be administered into the systemic circulation?
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What are CVADs?
What are CVADs?
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Which type of solution is used for fluid replacement, treatment of shock, hyponatremia, and metabolic acidosis?
Which type of solution is used for fluid replacement, treatment of shock, hyponatremia, and metabolic acidosis?
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What is the recommended solution for priming blood component administration sets?
What is the recommended solution for priming blood component administration sets?
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Which factor can affect the infusion flow rate in intravenous therapy?
Which factor can affect the infusion flow rate in intravenous therapy?
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Which type of pump uses positive pressure to deliver the solution in intravenous therapy?
Which type of pump uses positive pressure to deliver the solution in intravenous therapy?
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Which term is used to describe devices that allow connection to IV catheters without using a needle?
Which term is used to describe devices that allow connection to IV catheters without using a needle?
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What is the recommended solution for flushing peripheral intermittent devices?
What is the recommended solution for flushing peripheral intermittent devices?
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What is the main purpose of IV therapy in this case?
What is the main purpose of IV therapy in this case?
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Which type of solution has the same osmotic pressure as blood?
Which type of solution has the same osmotic pressure as blood?
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Which of the following is a potential complication associated with IV therapy?
Which of the following is a potential complication associated with IV therapy?
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What is the recommended flow rate for the IV solution ordered for Mrs. Brown?
What is the recommended flow rate for the IV solution ordered for Mrs. Brown?
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Which of the following is a characteristic of hypertonic solutions?
Which of the following is a characteristic of hypertonic solutions?
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What is the purpose of IV therapy in the case of Mrs. Brown?
What is the purpose of IV therapy in the case of Mrs. Brown?
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Which type of filter is used for blood infusions?
Which type of filter is used for blood infusions?
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What is the purpose of Patient-Controlled Analgesia (PCA)?
What is the purpose of Patient-Controlled Analgesia (PCA)?
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Which type of solution is quickly metabolized, making it hypotonic when infused?
Which type of solution is quickly metabolized, making it hypotonic when infused?
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Where can IV therapy be administered into the systemic circulation?
Where can IV therapy be administered into the systemic circulation?
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Why do patients receive IV therapy?
Why do patients receive IV therapy?
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What is the purpose of Patient-Controlled Analgesia (PCA)?
What is the purpose of Patient-Controlled Analgesia (PCA)?
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Which type of solution is quickly metabolized, making it hypotonic when infused?
Which type of solution is quickly metabolized, making it hypotonic when infused?
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What is the recommended solution for flushing peripheral intermittent devices?
What is the recommended solution for flushing peripheral intermittent devices?
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What is the purpose of maintaining positive pressure in the lumen of the cannula during the administration of the flush solution?
What is the purpose of maintaining positive pressure in the lumen of the cannula during the administration of the flush solution?
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What is the technique to maintain positive pressure based on the type of needleless connector being used?
What is the technique to maintain positive pressure based on the type of needleless connector being used?
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Which type of IV solution is more concentrated than body fluids?
Which type of IV solution is more concentrated than body fluids?
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What is the formula used to calculate drops per minute in intravenous therapy?
What is the formula used to calculate drops per minute in intravenous therapy?
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Which type of solution expands the extracellular fluid volume when administered to patients requiring water?
Which type of solution expands the extracellular fluid volume when administered to patients requiring water?
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Which type of solution has the same tonicity as body fluid?
Which type of solution has the same tonicity as body fluid?
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Which type of solution is quickly metabolized, making it hypotonic when infused?
Which type of solution is quickly metabolized, making it hypotonic when infused?
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Which method of infusion uses gravity to administer a solution into a vein?
Which method of infusion uses gravity to administer a solution into a vein?
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What is the purpose of Patient-Controlled Analgesia (PCA)?
What is the purpose of Patient-Controlled Analgesia (PCA)?
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Where can IV therapy be administered into the systemic circulation?
Where can IV therapy be administered into the systemic circulation?
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What is the recommended flow rate for the IV solution ordered for Mrs. Brown?
What is the recommended flow rate for the IV solution ordered for Mrs. Brown?
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Which type of solution is used for fluid replacement, treatment of shock, hyponatremia, and metabolic acidosis?
Which type of solution is used for fluid replacement, treatment of shock, hyponatremia, and metabolic acidosis?
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What is the purpose of Patient-Controlled Analgesia (PCA)?
What is the purpose of Patient-Controlled Analgesia (PCA)?
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What are examples of isotonic solutions?
What are examples of isotonic solutions?
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Which type of solution is used for fluid replacement, treatment of shock, hyponatremia, and metabolic acidosis?
Which type of solution is used for fluid replacement, treatment of shock, hyponatremia, and metabolic acidosis?
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What is the purpose of Patient-Controlled Analgesia (PCA)?
What is the purpose of Patient-Controlled Analgesia (PCA)?
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Which type of filter is used for blood infusions?
Which type of filter is used for blood infusions?
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What is the recommended solution for flushing peripheral intermittent devices?
What is the recommended solution for flushing peripheral intermittent devices?
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Which term is used to describe devices that allow connection to IV catheters without using a needle?
Which term is used to describe devices that allow connection to IV catheters without using a needle?
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What is the recommended solution for flushing peripheral intermittent devices?
What is the recommended solution for flushing peripheral intermittent devices?
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Which type of solution is used for fluid replacement, treatment of shock, hyponatremia, and metabolic acidosis?
Which type of solution is used for fluid replacement, treatment of shock, hyponatremia, and metabolic acidosis?
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What is the purpose of Patient-Controlled Analgesia (PCA)?
What is the purpose of Patient-Controlled Analgesia (PCA)?
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Which organization provides guidelines for isolation precautions, hand hygiene, and prevention of intravascular catheter-related infections?
Which organization provides guidelines for isolation precautions, hand hygiene, and prevention of intravascular catheter-related infections?
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What is the term used to describe the administration of fluids or medication via a needle or catheter directly into the bloodstream?
What is the term used to describe the administration of fluids or medication via a needle or catheter directly into the bloodstream?
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What is the main purpose of intermittent infusion?
What is the main purpose of intermittent infusion?
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Which type of IV therapy is used when a medication must be highly diluted or a constant plasma concentration of a drug must be maintained?
Which type of IV therapy is used when a medication must be highly diluted or a constant plasma concentration of a drug must be maintained?
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Which type of solution is commonly used for continuous peripheral infusions?
Which type of solution is commonly used for continuous peripheral infusions?
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What is the potential disadvantage of administering hypertonic dextrose solutions in a peripheral vein?
What is the potential disadvantage of administering hypertonic dextrose solutions in a peripheral vein?
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Which type of solution is commonly used for treating hypoglycemia or in combination with TPN because they supply a large number of calories?
Which type of solution is commonly used for treating hypoglycemia or in combination with TPN because they supply a large number of calories?
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What is the potential disadvantage of administering sodium chloride solutions if the prescribed rate is not monitored?
What is the potential disadvantage of administering sodium chloride solutions if the prescribed rate is not monitored?
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Which of the following is the correct technique to maintain positive pressure in the lumen of the cannula during the administration of the flush solution?
Which of the following is the correct technique to maintain positive pressure in the lumen of the cannula during the administration of the flush solution?
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Which of the following is the correct term for a rapid injection of medication directly into the patient's bloodstream?
Which of the following is the correct term for a rapid injection of medication directly into the patient's bloodstream?
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Which of the following is the correct method used to administer analgesic or pain medications using an electronic infusion device (EID) or pump?
Which of the following is the correct method used to administer analgesic or pain medications using an electronic infusion device (EID) or pump?
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Which of the following is the correct formula to calculate the drops per minute for IV solution delivery using a gravity set?
Which of the following is the correct formula to calculate the drops per minute for IV solution delivery using a gravity set?
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Which of the following solutions is considered isotonic and expands the extracellular fluid volume when administered to patients requiring water?
Which of the following solutions is considered isotonic and expands the extracellular fluid volume when administered to patients requiring water?
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Which type of solution is quickly metabolized, making it hypotonic when infused?
Which type of solution is quickly metabolized, making it hypotonic when infused?
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Which type of solution is used for fluid replacement, treatment of shock, hyponatremia, and metabolic acidosis?
Which type of solution is used for fluid replacement, treatment of shock, hyponatremia, and metabolic acidosis?
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Which type of solution is considered isotonic when infused, but the dextrose is quickly metabolized, making the solution hypotonic?
Which type of solution is considered isotonic when infused, but the dextrose is quickly metabolized, making the solution hypotonic?
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Which type of solution has the same tonicity as body fluid and neither enters cells nor pulls water from cells?
Which type of solution has the same tonicity as body fluid and neither enters cells nor pulls water from cells?
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Which type of solution is commonly used for fluid replacement, treatment of shock, hyponatremia, and metabolic acidosis?
Which type of solution is commonly used for fluid replacement, treatment of shock, hyponatremia, and metabolic acidosis?
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Which organization is recognized as a global authority in infusion nursing and publishes standards of practice for infusion therapy?
Which organization is recognized as a global authority in infusion nursing and publishes standards of practice for infusion therapy?
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What is the purpose of Patient-Controlled Analgesia (PCA)?
What is the purpose of Patient-Controlled Analgesia (PCA)?
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Which type of solution has the same osmotic pressure as blood?
Which type of solution has the same osmotic pressure as blood?
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Where can IV therapy be administered into the systemic circulation?
Where can IV therapy be administered into the systemic circulation?
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Which of the following factors can influence the condition, size, and long-term use of veins for IV therapy?
Which of the following factors can influence the condition, size, and long-term use of veins for IV therapy?
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Which of the following is a potential complication associated with IV therapy?
Which of the following is a potential complication associated with IV therapy?
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What is the purpose of maintaining positive pressure in the lumen of the cannula during the administration of the flush solution?
What is the purpose of maintaining positive pressure in the lumen of the cannula during the administration of the flush solution?
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What is the recommended flow rate for the IV solution ordered for Mrs. Brown?
What is the recommended flow rate for the IV solution ordered for Mrs. Brown?
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Which type of filter is used for nonlipid solutions in IV fluids?
Which type of filter is used for nonlipid solutions in IV fluids?
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What is the potential disadvantage of administering hypertonic dextrose solutions in a peripheral vein?
What is the potential disadvantage of administering hypertonic dextrose solutions in a peripheral vein?
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Which type of solution is used for fluid replacement, treatment of shock, hyponatremia, and metabolic acidosis?
Which type of solution is used for fluid replacement, treatment of shock, hyponatremia, and metabolic acidosis?
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Which type of solution has the same tonicity as body fluid and neither enters cells nor pulls water from cells?
Which type of solution has the same tonicity as body fluid and neither enters cells nor pulls water from cells?
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Which factor can affect the flow rate of gravity infusions?
Which factor can affect the flow rate of gravity infusions?
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What is the formula for determining drops per minute in intravenous therapy?
What is the formula for determining drops per minute in intravenous therapy?
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What is the recommended height for a solution in relation to the patient's heart?
What is the recommended height for a solution in relation to the patient's heart?
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Which device uses positive pressure to deliver the solution in intravenous therapy?
Which device uses positive pressure to deliver the solution in intravenous therapy?
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Which term is used to describe devices that allow connection to IV catheters without using a needle?
Which term is used to describe devices that allow connection to IV catheters without using a needle?
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Which type of solution is used for fluid replacement, treatment of shock, hyponatremia, and metabolic acidosis?
Which type of solution is used for fluid replacement, treatment of shock, hyponatremia, and metabolic acidosis?
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What is the purpose of Patient-Controlled Analgesia (PCA)?
What is the purpose of Patient-Controlled Analgesia (PCA)?
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What is the recommended solution for flushing central venous access devices (CVADs)?
What is the recommended solution for flushing central venous access devices (CVADs)?
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Which of the following is the correct technique for maintaining positive pressure in the lumen of the cannula during the administration of the flush solution?
Which of the following is the correct technique for maintaining positive pressure in the lumen of the cannula during the administration of the flush solution?
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Which of the following is the correct formula to calculate the drops per minute for IV solution delivery?
Which of the following is the correct formula to calculate the drops per minute for IV solution delivery?
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Which of the following is the correct term for injecting medication slowly into an IV site or port?
Which of the following is the correct term for injecting medication slowly into an IV site or port?
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Which of the following factors can influence the condition, size, and long-term use of veins for IV therapy?
Which of the following factors can influence the condition, size, and long-term use of veins for IV therapy?
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Which of the following solutions is an example of an isotonic solution?
Which of the following solutions is an example of an isotonic solution?
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What happens when hypotonic solutions are administered to cells?
What happens when hypotonic solutions are administered to cells?
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What happens when hypertonic solutions are administered to cells?
What happens when hypertonic solutions are administered to cells?
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Which type of IV therapy provides easy access to the venous system?
Which type of IV therapy provides easy access to the venous system?
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Which type of IV therapy is deeper and located closer to the heart?
Which type of IV therapy is deeper and located closer to the heart?
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Which type of IV therapy has a tip that ends in a large vessel near the heart?
Which type of IV therapy has a tip that ends in a large vessel near the heart?
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Hypotonic solutions send water into areas of greater concentration (cells)
Hypotonic solutions send water into areas of greater concentration (cells)
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Hypertonic solutions pull water from the more highly concentrated cells
Hypertonic solutions pull water from the more highly concentrated cells
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Isotonic solutions have the same tonicity as body fluid
Isotonic solutions have the same tonicity as body fluid
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Normal saline (0.9% sodium chloride) solution is an isotonic solution
Normal saline (0.9% sodium chloride) solution is an isotonic solution
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A solution of 5% dextrose in water (D5W) is isotonic when infused
A solution of 5% dextrose in water (D5W) is isotonic when infused
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Lactated Ringer’s is an example of an isotonic solution
Lactated Ringer’s is an example of an isotonic solution
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Peripheral veins provide easy access to the venous system
Peripheral veins provide easy access to the venous system
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Central veins are located closer to the heart
Central veins are located closer to the heart
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CVADs are catheters with a tip that ends in a large vessel near the heart
CVADs are catheters with a tip that ends in a large vessel near the heart
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This chapter primarily focuses on short peripheral catheters
This chapter primarily focuses on short peripheral catheters
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True or false: Hypotonic solutions send water into areas of greater concentration (cells)
True or false: Hypotonic solutions send water into areas of greater concentration (cells)
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True or false: Isotonic solutions neither enter cells nor pull water from cells
True or false: Isotonic solutions neither enter cells nor pull water from cells
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True or false: 5% dextrose in water (D5W) is an isotonic solution when infused
True or false: 5% dextrose in water (D5W) is an isotonic solution when infused
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True or false: Lactated Ringer's is an example of an isotonic solution
True or false: Lactated Ringer's is an example of an isotonic solution
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True or false: IV therapy can be administered into the systemic circulation via the peripheral or central veins
True or false: IV therapy can be administered into the systemic circulation via the peripheral or central veins
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True or false: Peripheral veins provide easy access to the venous system
True or false: Peripheral veins provide easy access to the venous system
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True or false: Central veins are located closer to the heart
True or false: Central veins are located closer to the heart
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True or false: CVADs are catheters with a tip that ends in a large vessel near the heart
True or false: CVADs are catheters with a tip that ends in a large vessel near the heart
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True or false: Normal saline (0.9% sodium chloride) solution is an isotonic solution
True or false: Normal saline (0.9% sodium chloride) solution is an isotonic solution
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True or false: 5% albumin is an example of an isotonic solution
True or false: 5% albumin is an example of an isotonic solution
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Study Notes
Key Terms and Concepts
- Cannula: a tube or sheath used to administer IV therapy
- Extravasation: the leakage of IV solution into the tissue
- Hematoma: a collection of blood outside the blood vessels
- Infiltration: the accidental administration of IV solution into the tissue
- Intravenous (IV) therapy: the administration of fluids or medications directly into the bloodstream
- Macrodrop: a large drop of IV solution (10, 15, or 20 drops per milliliter)
- Microdrop: a small drop of IV solution (60 drops per milliliter)
- Parenteral: a route of administration other than the digestive tract
- Phlebitis: inflammation of the vein
- Peripheral IV (PIV): a type of IV administration that uses a cannula inserted into a peripheral vein
Regulation of IV Therapy
- IV therapy is regulated by state nurse practice acts
- National organizations, such as the Infusion Nurses Society (INS), provide guidelines and standards for IV therapy
- The Centers for Disease Control and Prevention (CDC) and the Institute for Healthcare Improvement (IHI) provide guidelines for infection prevention and central line care
Indications for IV Therapy
- Administration of medications, fluids, electrolytes, and nutrients
- Rapid delivery of medication in emergency situations
- Maintenance of therapeutic blood levels
- Life-sustaining fluids, electrolytes, and nutrition
- Parenteral nutrition (total parenteral nutrition (TPN) and peripheral parenteral nutrition (PPN))
Types of Infusions
- Continuous infusion: a large-volume infusion of solution or medication administered over a prolonged period
- Intermittent infusion: a small-volume infusion of solution or medication administered over a short period
- Direct injection/IV push: a rapid injection of medication into the bloodstream
- Patient-controlled analgesia (PCA): a system that allows patients to self-administer analgesic medications
Methods of Infusion
- Gravity drip: a method of infusion that uses gravity to deliver the solution
- Mechanical flow device: a device that controls the flow rate of the solution
- Electronic infusion device (EID): a device that uses positive pressure to deliver the solution
- Ambulatory infusion device: a portable device designed to be worn on the body
Factors Affecting Flow Rates
- Height of the solution: a change in the height of the solution can affect the flow rate
- Patency of the cannula: a small clot or fibrin sheath can occlude the cannula lumen and decrease the flow rate
- Change in cannula position: a change in the position of the cannula's tip can affect the flow rate
Filters and Sodium Chloride Solutions
- Filters are used to remove bacteria, fungi, particulate matter, air, and some endotoxins from IV fluids
- A 0.22-micron filter is used for nonlipid solutions
- A 170-micron filter is used for blood infusions
- Sodium chloride solutions are used for fluid replacement, treatment of shock, and as a primer for blood transfusions### Leukocyte-Depleting Filters and Types of Fluids
- Leukocyte-depleting filters are used in blood administration sets to prevent febrile reactions to leukocytes.
- Other types of filters (e.g., 1.2-micron) are used for nutritional products such as parenteral nutrition and fat emulsions.
- Institutional policies and manufacturer guidelines should be consulted for filter use.
Types of IV Solutions
- Isotonic solutions have the same concentration of solutes as body fluids (e.g., normal saline, 5% dextrose in water).
- Hypotonic solutions have fewer solutes than body fluids.
- Hypertonic solutions have more solutes than body fluids.
- Dextrose solutions provide carbohydrates and calories, reducing breakdown of glycogen and protein.
- Sodium chloride solutions are used to replace lost fluids and electrolytes.
Advantages and Disadvantages of Dextrose and Sodium Chloride Solutions
- Dextrose solutions:
- Advantages: provide carbohydrates and calories, well metabolized by all tissues.
- Disadvantages: may cause vein irritation, damage, and thrombosis.
- Sodium chloride solutions:
- Advantages: replace lost fluids and electrolytes.
- Disadvantages: may cause circulatory overload, hypernatremia if patient cannot excrete excess sodium.
Balanced Electrolyte Solutions
- Used to replace lost fluids and electrolytes.
- Contain lactate or acetate, which helps combat acidosis.
- Potassium may be added to replace potassium deficits.
Osmolarity of IV Solutions
- Isotonic solutions have the same tonicity as body fluids.
- Hypotonic solutions have less tonicity than body fluids.
- Hypertonic solutions have more tonicity than body fluids.
IV Access
- Peripheral veins lie beneath the epidermis, dermis, and subcutaneous tissue.
- Central veins are deeper and located closer to the heart.
- Special catheters (CVADs) are used for central venous access.
IV Therapy
- Regulated by state nurse practice acts.
- Indications for IV therapy: fluids, electrolytes, nutrients, blood products, and medications.
- IV therapy can be continuous or intermittent.
- IV solutions can be delivered via gravity, mechanical controllers, or electronic infusion devices.
Types of Infusions
- Continuous infusion: large-volume infusion of solution or medication over 2-24 hours.
- Intermittent infusion: small-volume infusion of medication or solution over 15 minutes to 2 hours.
- Direct injection/IV push: medication injected slowly via a syringe into an IV site or port.
- Patient-controlled analgesia (PCA): used to deliver analgesic medications.
Gravity Drip
- Solution is positioned 3 feet above the infusion site.
- Flow is controlled with a roller, screw, or slide clamp.
- Mechanical flow devices can be added to achieve accurate delivery of fluid.
Calculating Administration Rates
-
Drops per minute (gtt/min) are calculated based on the amount of fluid to be given, time interval, and drop factor of the administration set.
-
Sets delivering 10, 15, or 20 drops per milliliter are called macrodrop sets.
-
Sets delivering 60 drops per milliliter are called microdrop or minidrop sets.### Calculating Drops per Minute
-
Formula: mL/hour ÷ 60 minutes = drops per minute, where gtt is the drop factor
-
Always round to the nearest whole number when calculating drops per minute
-
Example: 125 mL of 5% dextrose and 0.45% sodium chloride per hour, with a drop factor of 15 gtt/mL = 31 gtt per minute
Factors Affecting Flow Rates of Gravity Infusions
- Height of the solution: increasing the distance between the solution and the patient increases the flow rate
- Ideal height for a solution is 3 feet above the level of the patient's heart
- Patency of the cannula: a small clot or fibrin sheath can occlude the cannula lumen and decrease the flow rate or stop the flow completely
- Avoid using a blood pressure cuff on the affected limb, as it can increase venous pressure and cause clot formation
- Regular flush schedule helps maintain patency
- Never exert pressure with a saline or heparin flush to restore patency, as it can dislodge a clot or rupture the cannula
Mechanical and Electronic Infusion Devices
- Flow-control devices regulate the rate of infusion and are used in all healthcare settings
- Mechanical controllers measure the amount of solution delivered and depend on gravity to deliver the infusion
- Electronic infusion devices (EIDs) use positive pressure to deliver the solution
- Pumps and controllers are used for infusing precise volumes and rates of solution
- Institution policy often dictates the use of controllers for infusion of potent medications, such as heparin, concentrated morphine, and chemotherapy solutions
Sodium Chloride Solutions
- Used for fluid replacement, treatment of shock, hyponatremia, and metabolic acidosis, and as a primer for blood transfusions
- 0.9% sodium chloride solution is used most commonly
- According to the American Association of Blood Banks, blood component administration sets can be primed only with 0.9% sodium chloride solution
Filters
- Remove bacteria, fungi, particulate matter, air, and some endotoxins from IV fluids
- 0.22-micron filter is used for nonlipid solutions
- 170-micron filter is used for blood infusions
- Leukocyte-depleting filters are used for blood administration sets when concern for febrile reactions to leukocytes is anticipated
Types of Fluids
- Isotonic, hypotonic, and hypertonic fluids
- Isotonic fluids have the same concentration of solutes as body fluids
- Hypotonic fluids have fewer solutes than body fluids, causing water to move into cells
- Hypertonic fluids have more solutes than body fluids, causing water to move out of cells
Crystalloid Solutions
- Dextrose solutions:
- Provide carbohydrates in a readily usable form and calories for energy
- Reduce breakdown of glycogen and catabolism of protein
- May cause vein irritation, damage, and thrombosis when administered in a peripheral vein
- Sodium chloride solutions:
- Can cause circulatory overload if the prescribed rate is not monitored
- May cause hypernatremia if the patient is unable to excrete excess sodium
Balanced Electrolyte Solutions
- Maintenance electrolyte solutions, such as lactated Ringer's solution, approximate normal body electrolyte needs
- Balanced solutions often contain lactate or acetate, which helps combat acidosis and provide a truly balanced solution
- Potassium is an electrolyte that is commonly added to balanced solutions to replace potassium deficits
Osmolarity of IV Solutions
- Isotonic fluids have the same concentration of solutes as body fluids
- Hypertonic solutions have more solutes than body fluids, causing water to move out of cells
- Hypotonic solutions have fewer solutes than body fluids, causing water to move into cells
Intravenous Access
- IV therapy can be administered into the systemic circulation via peripheral or central veins
- Peripheral veins are closer to the skin and provide easy access to the venous system
- Central veins are deeper and located closer to the heart, and require special catheters with a tip that ends in a large vessel near the heart
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Test your knowledge on the use of inline filters in medical administration sets. Learn about the different types of filters and their role in hydration and kidney function testing. Explore the INS standards for filter usage.
