???? Intravenous infusion/ Intravenous Administration

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????Intravenous infusion/ Intravenous
Administration

• ??????????
• ? ?

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Objectives ??????????

• ?. ??
• 1. ???????????
• 2. ????????????????

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• ?. ??
• 1.????????????
• ??
• 2.?????????
• 3.?????????????
• ?????????

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• ?. ??
• 1.??????????????
• 2.?????????????
• ???????

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Intravenous infusion is the method that a large
volume of solution infused into body to handle
fluid and electrolyte disturbance.

• ??????????---
• ?????? gt???
• ?? 1. ????
• 2. ?????
• 3. ????

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??Purposes

• 1. Keep balance of fluid, electrocyte, and
  acid-base ????????,??????
• 2. Supply nutrient substances ????
• 3. Supply medication ????
• 4. Increase the blood volume ?????
• 5. Establish a lifeline

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??Types and functions of solutions(?) According
to Osmotic pressure

1. Isotonic
2. Hypertonic
3. Hypotonic

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(?)According to Functions

• 1. Crystal solution ????
• Nutrient solutions 5Glucose,
• 5Dextrose in
  water(D5W),
• 5Dextrose in
  o.45 sodium chloride
• Electrolyte solutions NS (0.9 sodium
  chloride)
• Ringers
  solution
• Lactated
  Ringers solution
• Alkalinizing solution Lactated Ringers
  solution
• 5 NB
• Hypertonic solution 50GS, 20 mannital

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2. Colloid solution ????

• Volume expenders
• Dextran ????
• Plasma ??,???
• Human serum albumin ????
• 3. TPN solution (Total parenteral nutrition)
  ??????

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??Sites of Venipuncture

• 1. Peripheral vein ???????
• (1) Superficial vein in limbs
• Basilic vein
• Cephalic vein
• Dorsal venous network
• Great saphenous vein
• Small saphenous vein
• Dorsal foot vein
• (2) Vein in the scalp

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2. External jugular vein Internal jugular
vein ???????????

• Purposes
• 1)????,?????????
• 2)??????????????
• ????,?????????
  3)???????????,????
• Central venous pressure (CVP)
• ??????

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Subclavian vein ??????????

• 1)?????????????
• ???(??????????
• ????),????????
• ?,?????????
• 2)???????????,?
• ???????,??????
• ?,?????

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• 3)???????????,??
• ??????????
• 4)??????????
• 5)??CVP (?????)?
• Central venous catheter
• Peripherally inserted central venous
• catheter

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??Regulating and Monitoring Intravenous
Infusion ?????????

• ????????????
• ????(??) ????????
• ?????60
• ???????????????
• ????? ????(??)????
• ????(??)

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Drop factor

• Macrodrops
• 10, 12, 15, 20 drops/ml
• Microdrips
• 60 drops/ml

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??Problems during infusion ?????????

• 1. Slow flow rate or no infusion
• ?????????
• 1)Infiltration ????????
• ???????????
• 2)Position of the extremity
• ??????????
• ?????????????
• ????,?????????

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• 3)Occlusion of needle or catheter
• ??or ?? ???
• ???????? ?????
• 4)Too low hydrostatic pressure
• ?????
• ??????????
• 5)venous cramp ?????
• ????????????

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• 2. Too Large volume of solution in chamber
• ???????
• 3. Too small volume of solution in chamber
• ???????
• 4. The surface of liquid fall down
• automatically
• ?????????

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??Infusion reactions ???????

• 1. Febrile reaction (fever) ????
• Etiology??????
• Impureness??
• ???????????, ??????
• Incomplete sterilization???
• ???????????????????
• ???????
• Symptoms/ Signsfever, tremble, chill,
• nausea, vomiting, headache,
  tachycardia

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Nursing interventions

• 1. Check solution, medication, IV set
• 2. Strict aseptic technique ??????
• 3. ?????????????
• ????????????
• 4. Observe ??
• 5. Notify the physician ????
• 6. Lab test ??

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2. Fluid volume excess(overload)

• Cause ?????
• SS dyspnea?chest depress ???tachypnea
• shortness of breath, tachycardia
• cough?frothy or pinkish sputum ????
  
• ? ????rales in the lungs ?????
• ????, arrhythmia, facial paleness,
• pitting edema

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Nursing Interventions

• 1. Slow or stop infusion, Observe and Notify the
  physician
• 2. Flowers position with the feet dangling at
  the bedside ???,????
• 2. Apply tourniquet to limbs ???????
• 3. Oxygen administration with great flow rate
• ???????
• Administer sedative, vasodilators, antiasthma,
  
• digitalis, and diuretics.
• 5. ????200??

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3. Phlebitis ???

• Causes Chemical or mechanical irritation
• Medications ????????????
• Unsterile ??????????
• needle or catheter ??????????
• S/S
• Redness along the vein ???????????, Swelling
  over the vein, Local pain
• Increased skin temperature
• Fever, chill, difficult mobility of limbs

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Nursing interventions

• 1. Strict aseptic technique
• 2. Change vein??????????,?? ????????,??????
• 3. Dilute and infuse irritating medication
• slowly
• 4. Elevate the limb, Immobilization
• 5. Warm moist therapy 50MgSO4,
• Physical therapy, Antibiotics

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• 4. Air embolism ????
• Cause Embolus
• ????---??????
• Symptoms/signsDiscomfort in chest ??????,pain
  under the sternum,dyspnea
• cyanosis, tachycardia,????bubble sound ???

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Nursing intervention

• 1. Prevention ????????
• 2. Position ????????????.
• ??????????????????,?????????,??????,???????,??
  ????????,?????,???????
• 3. Oxygen administration with high flow rate
• 4. Observe vital signs and Notify the
  physician
• 5. Abstract air by CVP ??????????

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????????

• ??Devices to Control infusions
• Roller clamp
• IV Controller
• Infusion pump

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? ?

• Blood transfusion

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??????????

• ?. ?? ???????????
• ?. ??
• 1.???????????????
• ???????????????
• ??????
• 2.?????????

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• 3.???????????????
• ??????
• ?. ??
• 1.??????????????
• ??????

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• Blood transfusionis the introduction of
  whole blood or blood components into the venous
  circulation.
• Indirect Blood transfusion
  ???????????????????????
• Direct Blood transfusion???????????,????????
  ??

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• Arterial Blood transfusion
• Blood aortic arch- coronary -neck artery
  -brain and heart
• ??????????????????????,?????????????,??????????
  ??????.
• Application Serious hemorrhage shock or first
  aid resuscitation?

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??Purposes of transfusion

• Restore the blood volume ?????
• Maintain Hb level ????
• Prevent or treat hemorrhagic disease ??
• Supply antibody and complement to resist the
  infection ?????
• Increase colloid osmotic pressure
• ???????,???????

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Indications

• Hemorrhage
• Anemia
• Serious infection
• Disturbances of blood coagulation
• Hypoproteinemia

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??Blood and blood products ???????

• 1. Whole blood ??
• Fresh blood ???
• Stored blood ???
• 2. Blood components ???
• Plasma ??
• Red blood cells (Erythrocytes) ???
• White blood cells (Leukocytes) ???
• Platelets ???
• 3. Others Albumin, coagulants

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??Blood typing and crossmatching
????????

• Blood groups ?????????????,?????????????,?????
• Antigens (Agglutinogens)
• A B AB O
• Antibodies (Agglutinins)
• Rh factor

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2. Blood typing ???????????????????????,???????3
. Cross-matching Test ???????????????????,??????
????????????????????????(??????????????????????)
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• Direct Cross-matching Test
• ????????????????????????????????????????,????
  ????????????????????
• Indirect Cross-matching Test
• ??????????????????????????????????

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??????

• ???
• O?
• AB?
• ??????
• ?????

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????????????

• ?????
• ??
• ????
• ?????

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??Autologous transfusion

1. ???????
2. ?????????
3. ??????

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??Transfusion reactions

• 1. Febrile reaction ????
• ????????
• ?? ?????????
• ???????????
• ????????
• ??
• ??????????
• ??

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2. Allergic reaction ????

• ?????
• ???
• ????????
• ??????????
• ?????
• ??

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3. Hemolytic reaction ????

• ???????????????
• ??RH??
• ?????? ?????????
• ?????
• ???? ????????
• ??????
• ???? ????

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??

• (1)????
• (2)????????????
• (3)????????????
• (4)?????,????????
• ??????????????
• ??,??????
• (5)?????????????
• (6)???,?????

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• 1?????????????
• ?????? A.???? B.???????
  C.706??? D.??????? E.???????

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• 2??????????,????
• ?1500ml,?????60?/?,
• ?????????? 15? 15?15?
  15?30? 15?45? 16?

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• 3?????????????(???)??????? A.???????
  B.???????? C.??????? D.????????????
• ????? E.??????????

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• 4. ????????????,??
• ??????
• A.???? B.????
  C.????? D.??? E.???

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• 5. ???????????????
• A.????B.????C.????D.??????E.??????