IV Therapy PDF - Document for Students

7/17/24 INTRAVENOUS THERAPY...

7/17/24 INTRAVENOUS THERAPY PROF. VINZ ACENA, MAN, RN, RM PROF. VINZ ACENA, MAN, RN, RM 1 2 OVERVIEW 2 Fluid Compartment 1 Fluids & Electrolytes The body’s fluid is contained within 3 compartments: Cells, blood vessels, and the tissue space. The body normally maintains a balance between the amount of fluid taken in and the amount excreted. 1. Intracellular- within the cell The term body fluid is used to denote both water and electrolytes, whereas 2. Intravascular- within blood the term body water refers to water alone. vessels 3. Interstitial- between cells; Homeostasis (Equilibrium) of the internal environment , refers to the state of fluid that surrounds the cells balance of body fluid. 3 4 1  7/17/24 3 Types of Body Fluid 4 Key terms - used in explaining the m ovem ent of m olecules in body fluid; 1. Solute: substance dissolved in a solution 1. Intracellular Fluid (ICF) 2. Solvent: liquid that contains a 2. Extracellular Fluid substance in solution (ECF) 3. Permeability: capability of a -fluids in the substance, molecule or ion to diffuse intravascular and through a membrane interstitial 4. Semipermeable: selectively permeable (all membranes in the body allow some solutes to pass through the membrane without restriction but will prevent the passage of other solutes). 5 6 4 Key terms - cont. 5 Body Water Distribution Cells have permeable membranes that allow fluid and Water is the largest single constituent of the body, solutes to pass into and out of the cells. Permeability allows representing approximately 50-60% of the body’s total body the cell to acquire the nutrients it needs from ECF to carry weight. on metabolism and to eliminate metabolic waste products. 2/3’s of the body fluid is ICF 1/3 is ECF (1/4 Intravascular and ¾ Interstitial) 7 8 2  7/17/24 5 Body Water Distribution (cont.) 5 Body Water Distribution (cont.) Bones are made up of nearly 1/3 water Water is present in all body tissues and cells, and serves Muscles & Brain cells contain 70% water two main functions; Body fat is essentially free of water ; therefore, the ratio of water to body weight is greater in leaner people than in 1. To act as a solvent for the essential nutrients so that obese people. they can be used by the body 2. To transport nutrients and oxygen from the blood to the cells, and remove waste materials and other substances from the cells back to the blood so they can be excreted by the body. 9 10 5 Body Water Distribution (cont.) 6 Electrolytes Electrolyte is a compound that, when dissolved in water or another solvent, forms and dissociates Water is also needed by the body to: Give shape and form to the cells into ions (electrically charged particles) Regulate body temperature Act as lubricant in joints The electrolytes provide inorganic chemicals for Cushion body organs cellular reactions and control mechanisms. Maintain peak physical performance Electrolytes have special physiologic functions in the body that promote neuromuscular irritability, and maintain body fluid osmolarity, regulate acid- base balance, and distribute body fluids between the fluid compartments. 11 12 3  7/17/24 6 Electrolytes (cont.) 6 Electrolytes (cont.) Electrolytes are measured in terms of their electrical combining power; that is, the quantities of cations and anions in a solution, expressed as millimoles per liter (mmol/L) Cations: Positively charged ions Anions: Negatively charged ions 13 14 6 Electrolytes (cont.) 7 Movement of Body Fluids The physiological forces that affect the movement of body fluids through the The Main Electrolytes in the Body Fluid cell walls and capillaries can be ELECTROLYTE ION EXTRACELLULAR INTRACELLULAR perceived as a mass transportation system that carries traffic between the Sodium (Na+) 135-145 15-20 compartments. Potassium (K+) 3.5- 5.2 150-155 Calcium (Ca2+) 2.1- 2.6 1-2 These forces transport molecules of water, foods, gases, wastes and ions to Magnesium (Mg2+) 0.7- 1.1 27-29 maintain a physiological balance between ECF and ICF volumes. These transport processes account for fluid shifts between compartments. 15 16 4  7/17/24 7 Movement of Body Fluids 7 Movement of Body Fluids PHYSIOLOGICAL FORCE PROCESS PHYSIOLOGICAL FORCE The net movement of 1. DIFFUSION particles from an area of 2. OSMOSIS The rate of diffusion HIGH concentration TO an The process of osmosis, the (continual movement of molecules in area of LOW concentration. passage of a solvent from an area of a solution or gas) is influenced by: LOW concentration TO an area of HIGH Doesn’t need energy- concentration of solutes. Size of the molecule (Smaller molecules diffuse faster than larger molecules) PASSIVE TRANSPORT Concentration of molecules (molecules (The net movement of water particles from an move from an area of greater concentration area of HIGH water potential TO an area of to an area of lesser concentration) LOW water potential through a Temperature of the solution (higher semipermeable membrane) temperatures increase the rate of diffusion) 17 18 REGULATORS OF 7 Movement of Body Fluids FLUID BALANCE PHYSIOLOGICAL FORCE PROCESS The net movement of 1. Fluid and food intake 3. ACTIVE TRANSPORT particles from an area of LOW concentration TO an and loss An electrochemical gradient (the sum of all the diffusion forces area of HIGH concentration. 2. Skin acting on a membrane, from either a 3. Lungs concentration gradient of an electrical Needs energy- ACTIVE PROCESS 4. GIT or a pressure gradient) exists when there is active transport. 5. Kidneys 19 20 5  7/17/24 IV Therapy INTRAVENOUS -is the administration of fluids, electrolytes, nutrients or medications by the venous THERAPY route. The prescribing practitioner prescribes IV therapy to treat or prevent fluid & electrolyte or nutritional imbalances PROF. VINZ ACENA, MAN, RN, RM 21 22 PURPOSES OF NURSING IV THERAPY HIGHLIGHTS: IV Therapy To supply fluid when clients are unable to take in an adequate volume of fluids by mouth. Implementation To provide salts and other electrolytes needed Know why the therapy is prescribed. to maintain electrolyte balance. Document the person’s understanding, Select the appropriate equipment in To provide glucose (dextrose), the main fuel for accordance with hospital policy metabolism Obtain the correct solution as prescribed. To provide water-soluble vitamins and Assess the person for allergies: tape, iodine, latex, ointment or antibiotic medications preparations to be used for skin To establish a lifeline for rapidly needed preparation of the venipuncture site medications. Administer the fluid at prescribed rate Deliver parenteral nutrients and nutritional Observe for signs of IV complications Document implementation supplements 23 24 6  7/17/24 NURSING CHECKLIST: 3 TYPES OF PARENTERAL FLUIDS Venepuncture Site Contraindications Classified in accord with the tonicity of the Signs of infection, infiltration or fluid relative to normal blood plasma. thrombosis *The type of solution is prescribed based on Affected arm of a person post- the person’s Dx and the goal of therapy mastectomy NOTE: The normal osmolarity of the blood is Arm with a functioning arteriovenous between 280 and 295 mmol/L fistula Affected arm of a person with 1. HYPOTONIC FLUID paralysis 2. ISOTONIC FLUID Any arm that has circulatory or 3. HYPERTONIC FLUID neurologic impairments. 25 26 01 HYPOTONIC FLUID (Hypo-osmolar, less than 290 mmol/L) ØHave lesser concentration and contain fewer solutes 02 ISOTONIC FLUID Ø (Iso-osmolar, 290 mmol/L) have the same concentration of solutes as blood plasma. than plasma. - increases ECF volume fluid shifts INTO cells) -Often used to restore vascular volume. -stays in intravascular compartment (no fluid shifts) Hydrate cells May cause Cellular Swelling - lowers the osmotic pressure and causes fluid to move into cells, if -* if fluid is infused beyond the person’s tolerance, cardiac fluid is infused beyond the person’s tolerance, water intoxication may overload may result result. 27 28 7  7/17/24 HYPERTONIC FLUID 03 (Hyperosmolar, greater tham 290 mmol/L) ØHave higher concentration of solutes than blood plasma - increases the osmotic pressure of the blood plasma, drawing fluid from the cells; -*if fluid is infused beyond the person’s tolerance, cellular dehydration may result. Classification of IV Drips 29 30 1. Crystalloids are aqueous solutions of mineral salts or Colloids contain larger insoluble molecules, such as gelatin; blood other water-soluble molecules. itself is a colloid. The most commonly used crystalloid fluid is normal saline, a solution of sodium chloride at 0.9% concentration, which is Colloids have large particles in them so they are not as easily close to the concentration in the blood (isotonic). absorbed into the vascular bed. Because of this property colloids Crystalloids are commonly used for rehydration, and are used to replace lost blood, maintain healthy blood pressure, electrolyte replacement and volume expansion. 31 32 8  7/17/24 Formula for Drops per minute (gtts/min) I.V. Volume in mL X Drop factor Time in min. COMPUTATION 33 34 Formula for (mL/hr) Flow rate: mL EQUIPMENT hr For IV Therapy 35 36 9  7/17/24 IV Catheter/ Cannula 37 38 IV Catheter/ Cannula (cont.) IV SET/ INFUSION SET MACROset- Adult - Drop factor (15 or 20 drops/ mL) *depends on manufacturer MICROset- *Pedia -Drop factor: 60 drops/mL 39 40 10  7/17/24 SOLUSET 41 42 IV REGULATOR SET 3-WAY STOPCOCK 43 44 11  7/17/24 SPLINT 45 46 COMPLICATIONS of IV Therapy 47 48 12  7/17/24 49 50 51 52 13  7/17/24 53 54 55 56 14  7/17/24 57 58 THANKS! CREDITS: This presentation template was created by Slidesgo, and includes icons by Flaticon, and infographics & images by Freepik 59 15