IV Therapy

1
IV Therapy

• NUR 201
• Lee Ann Mitchell, MSN

2
Nursing Responsibilities

• Initiation, maintenance, assessment, and
  discontinuation of therapy
• Understanding the patients need for therapy
• Type of IV solution to be used and the desired
  effect
• Monitoring for adverse reactions
• Sterile technique
• Safe administration of IV medications according
  to the five rights

3
IV Tubing and Catheters

• Vented versus non-vented (plastic or glass)
• Basic infusion, blood infusion, microdrip
  chambers, specialty tubing
• Over-the-needle catheters and butterfly needles

4
IV Solutions

• Isotonic
• Hypotonic
• Hypertonic
• TPN
• Blood products

5
Site Selection

• Accessibility of vein
• Start with the most distal site
• Avoid the antecubital site
• Avoid the lower extremities
• Condition of the vein
• Scarring
• Thin walls
• valves

6
Site Selection

• Solution to be infused
• Duration of infusion
• Avoid restricting movement when possible
• Catheter size
• Smallest gauge/shortest length
• 18 gauge for surgery, OB, blood

7
Monitoring and Maintenance

• IV sites should be changed every 72-96 hours or
  per agency policy
• IV solution should be changed at least every 24
  hours
• IV tubing should be changed every 24-96 hours per
  agency policy
• IV sites should be assessed every 2 hours or per
  agency policy, with site care performed prn

8
Documentation

• Document IV insertion, assessments,
  interventions, and evaluations in the nursing
  notes.
• Document IV fluids on the MAR.
• If you didnt document, you didnt do it!!!

9
Medication Administration

• Intravenous route is the most dangerous route of
  administration, because the drug is placed
  directly into the bloodstream, it cannot be
  recalled and its actions cannot be slowed.
• Emergency route
• Route used when medications are toxic to the
  tissue

10
Administration of medications via IV solution

• Allows medication to be administered slowly
• Continuous infusion
• Recommended procedure is for the pharmacist to
  prepare the IV solution by adding the drug to a
  large volume of fluid
• Examples Heparin, Dopamine, Pitocin

11
Administration of medications via IV push (bolus)

• A single injection of a concentrated solution is
  given directly into an intravenous line.
• Must be aware of administration rates and drug
  incompatibilities
• Most drugs are pushed over at least one minute
• Examples Morphine, Phenergan, Toradol

12
Administration of medications via Intermittent IV
infusion (piggyback)

• Drug is mixed with a small amount of IV solution
  (generally 50-100ml) and administered over a
  short period (generally 30-60) minutes at
  prescribed intervals (every 4 hours, for example)
• Must be aware of administration rates and drug
  incompatibilities

13
Documentation

• Medications given via the intravenous route are
  documented on the MAR.
• If you didnt document it, YOU DIDNT DO IT!