IV Fluids

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IV Fluids

• Nur 105 Adult Health

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Learning Objectives

• Identify sources of law.
• Define Legal Terms
• Describe the difference between standards of
  practice and standards of care.

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Sources of Law
Constitution Law
Statues Law
Administrative Law
Common Law
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Legal Terms

• Criminal
• Civil
• Tort
• Intentional/unintentional
• Negligent and Malpractice

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Standards of Practice and Care

• Standards of Practice
• Standards of Care
• Breach of Duty
• I.V. Nurses Role as Expert Witness

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Factors to Reduce RisksRisk Management

• Informed consent
• Unusual Occurrence Report (Incident Report)
• Documentation

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Nursing Competency inIV Therapy

• Competency Standards
• Accountability
• Communication
• Collaboration
• Autonomy
• Competency Model
• Cognitive, Psychomotor, Evaluation

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Occupational Risks

• Physical Hazards
• Needlestick injuries, abrasions and contusions,
  chemical exposure, latex allergy
• Biologic Hazards

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Summary
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Infection Control Meaures

• Nur 105 Adult Health

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Learning Objectives

• Describe the purpose and components of the immune
  systems.
• Identify basic principles in infection control.
• Define the six chains of infection.
• Describe methods to break the chains of
  infection.
• Describe the causes for infusion-related
  infections.
• State measures to prevent and treat infections.

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Immune System

• The Body System that protects the body from
  invasion of pathogens.

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The Immune SystemsOrgans

• Primary
• Thymus and Bone Marrow
• Secondary
• Lymph Nodes, Liver, Lungs
• Spleen, Peyers patches, appendix and Tonsils and
  adenoids

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Immune Systems Defense Mechanisms

• Nonspecific Immune Responses
• Skin, mucous membranes, epiglottis, respiratory
  tract, sphincters
• Tears, gastric acidity, vaginal secretions
• Lacrimation, intestinal peristalsis,urinary flow

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Immune Systems Defense Mechanisms

• Specific Immune Responses
• Active acquired and Passive acquired
• Leukocytes
• B and T Lymphocytes
• Immunglobulins
• Phagocytic cells
• Complement system

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Immune Systems Defense Mechanisms

• Impaired Host Resistence
• Primary immunodeficiency disorders
• Secondary immunodeficiency disorders

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Principles of Infection Control(Epideminology)

• Colonization
• Dissemination
• Nosocomial

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Chains of Infection
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Break the Chains of Infection

• New Methods microbiology and epideminology
• Survelience or Monitoring Quality Improvement
  Programs and Risk Management
• Pharmacology Treatment
• Stage 1
• Stage 2
• Emporiatrics

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IV Related InfectionsSources of Catheter-Related

• Skin Organisms
• Contamination of Catheter Hub
• Contaminated Infusate
• Contaminated Device (prior to insertion)
• Hematogenous
• Clinical Manifestations
• Cellulitis/Phlebitis warmth, swelling,
  erythema, pain, discharge (serosanguineous or
  purulent)

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IV Related InfectionsRisk Factors

• Host
• Hematogenesis
• Provider
• Catheter
• Infusate Fluids

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Treatment of Infections

• Catheter Antibiotics
• Infusate-Related
• Mechanism of contamination
• manufacturer
• during infusion
• Duration and frequent interruption or
  manipulation of access devices (ports)

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Treatment of InfectionPrevention and Treatment

• Inspect All Infusates
• Before use check fluid for leaks, expiration
  dates, color, consistency
• Preparation
• Aseptic Techniques
• Periodic Replacement of Administration Set
• Monitor adjunct devices
• Assess for infections
• Obtain cultures

• CDC Precauations
• Universal
• Transmission-Based
• Airborne
• Droplet
• Contact
• Hand Hygiene
• Skin Antiseptics
• Catheter site dressings
• Sutures or sutureless
• Topical Antimicrobial ointments
• Antimicrobial catheters/cuffs
• Anticoagulants and antibiotic locks

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Summary
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Parenteral Solutions

• Chapter 5

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Purposes of IV Therapy

• Maintenance
• Replacement
• Restoration

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Components of Parenteral Solutions

• Water
• Glucose
• Amino Acids

• Vitamins
• Electrolytes
• PH

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Osmolarity of Parenteral Solutions

• Isotonic
• Hypotonic
• Hypertonic

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Types of Parenteral Solutions

• Crystalloid
• Dextrose
• Sodium Chloride
• Dextrose with Sodium Chloride
• Hydrating solutions
• Electrolytes Fluids
• Ringers/Lactated Ringers
• Alkalizing/Acidifying
• Potassium Chloride

• Colloid
• Dextran
• Albumin
• Mannitol
• Hetastarch

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Nursing Role

• Check MD order
• Check IV fluid three times 5 RS
• Check IV fluid for
• Color,
• Consistency,
• Expiration date,
• Leaks

• Monitor IV Fluids every hour
• Check IV site
• No catch ups
• Check compatibility
• Use aseptic technique

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Summary
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Parenteral Equipment
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Infusion Container

• Glass
• Plastic
• Use-Activated Containers

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Basic Administration Sets

• Single line or Y sets
• Spike/piercing pin
• Flange
• Drop orifice
• Drop chamber
• Tubing

• Roller Clamp
• Injection ports
• Backcheck valve
• Hub
• Final filter
• Primary/Secondary

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Administration Sets

• Primary Y
• Pump Specific Administration set
• Lipid Administration
• Nitroglycerin

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IV Accessory Devices

• Filters
• Different sizes (170 micorns to 0.22)
• Different locations( inline)
• Different types ( depth, membrane , blood
  administration)
• Follow agency policy and procedures
• Extension tubing
• Adapters and Connectors (used at injection site)

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Accessory Devices

• Stopcocks
• Needleless System

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Peripheral Infusion Devices

• Scalp vein needles (butterfly) short therapy
• Over-the-Needle Catheter most commonly used
  14-22 gauge
• Thin wall, flashback chamber, wings, color coding
  for sizes
• Dual Lumen
• Through the-Needle Catheter
• Midline Catheter

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Infusion Regulation Devices

• Mechanical Gravity Devices
• Dial A- Flow
• Electronic Infusion Devices
• Controller
• Positive-Pressure Infusion Pumps
• Volumetric Pumps
• Peristalic Pumps
• Syringe Pumps/PCA
• Ambulatory Pump
• Multi/Dual Channel Pumps

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Summary