IV Therapy Class

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IV Therapy Class

• Carolyn McCune, RN, MSN, CRNP
• Teresa Peck RN, BSN

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Orientation To Class

• Review syllabus and course requirements
• Answers any questions related to class
• www.emprocedures.com/index.htm
• Then go to Peripheral IV access

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4723.171 Intravenous therapy procedures. (A) A
licensed practical nurse may perform on any
person any of the intravenous therapy procedures
specified in division (B) of this section without
receiving authorization to perform intravenous
therapy from the board of nursing under section
4723.17 of the Revised Code, if both of the
following apply (1) The licensed practical nurse
acts at the direction of a registered nurse or a
licensed physician, dentist, optometrist, or
podiatrist and the registered nurse, physician,
dentist, optometrist, or podiatrist is on the
premises where the procedure is to be performed
or accessible by some form of telecommunication. (
2) The licensed practical nurse can demonstrate
the knowledge, skills, and ability to perform the
procedure safely. (B) The intravenous therapy
procedures that a licensed practical nurse may
perform pursuant to division (A) of this section
are limited to the following (1) Verification of
the type of peripheral intravenous solution being
administered (2) Examination of a peripheral
infusion site and the extremity for possible
infiltration (3) Regulation of a peripheral
intravenous infusion according to the prescribed
flow rate (4) Discontinuation of a peripheral
intravenous device at the appropriate time (5)
Performance of routine dressing changes at the
insertion site of a peripheral venous or arterial
infusion, peripherally inserted central catheter
infusion, or central venous pressure subclavian
infusion. Effective Date 04-10-2001
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History

• First began in the 17th century
• 19th century-infection control procedures
• mid 1950s-used for surgery and hydration(20)
• Today approximately 90 of pts in hospital
  receive IVs
• Skilled nursing homes, doctors office and home

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Purpose for IV Therapy

• Fluid and electrolyte maintenance, restoration
  and replacement
• Administer medications and nutritional feedings
• Give blood and blood products
• Chemotherapy
• Patient controlled analgesics
• KVO for quick access

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• Oral medications-absorbed in the digestive tract
• IV- faster acting and distributed throughout the
  bloodstream immediately after giving

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Uses

• Unconscious pt
• Unable to swallow
• Vomiting
• Nutrition
• Others?
• Slides 3-6-material from Fulcher and
  Frazier(2007)

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Contraindications

• Pre-existing vascular compromise
• Regional infection

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IV Therapy Terms

• Adult
• Antibiotic
• Arterial Line
• Aspirate
• Central Line
• Central Venous Access Device (CVADS)

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• Continuous Infusions
• Controlled Analgesic
• Drip Factor
• Electronic Pumps and Controllers
• Flow Rateml/hr or gtts/min
• Infiltration
• Infusion Devices

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Controllers

• Thru peripheral IV sites-depend on gravity for
  administration- must be 24-36 inches above IV
  sites
• If patient changes positions volume
  decreases-back pressure greater, rate slows or
  stops
• Simplest controllers-roller or slide clamp
• Use to speed up or slow, counts gtts in drip
  chamber

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Volumetric controller pumps

• Apply external pressure to administration set
  tubing to run at specified rate
• Specific volume/time
• More accurate
• Alarm systems-kinks, air, occlusion
• Disadvantage-Cost of equipment, maintenance, more
  serious infiltration.

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• SYRINGE PUMPS
• Holds prefilled syringe
• Positive pressure to plunger delivers specific
  volume
• Used for small volume
• Insulin pumps, PCA pumps
• Safer, preprogramming to prevent calculator
  errors

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• Initiate
• Intermittent Infusion (Piggyback)
• Intravenous (IV)
• IV Bolus
• IV Push
• Maintain

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• Nurse Practice Act (Ohio)
• Palpation
• Peripheral
• Peripherally Inserted Central Catheters (PICCs)
• Phlebitis

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• Piggyback
• Roller clamp
• Tourniquet
• TPN
• Transparent Dressing
• Venipuncture
• Other Terms
• Questions????????

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Administration Sets

• Apparatus that connects large volume parenteral
  solution with IV access device into patient veins
• Insertion spikes
• Clip chamber
• Plastic tubing with rate control clamp
• Rubber injection port
• Needle adapter and protective cap on needle
  adapter

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Saline Lock

• Over needle cath left in for medical
  administration
• Flush every 8 hours
• Flush before/after meds

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Rules and Regulations Regarding IV Therapy for
the LPN

• See Handout from OBN website
• Chapter 4723-17
• Try to access sites