Sachin Dwivedi 40.2k views 38 slides Blood transfusions ppt sana usmani 203.9k views 49 slides Nursing management of hemodialysis Mustafa Abdalla 11.9k views Flexibility helps to set us apart. Slides 3-6-material from Fulcher and Frazier(2007), Contraindications Pre-existing vascular compromise Regional infection, IV Therapy Terms Adult: Antibiotic: Arterial Line: Aspirate: Central Line: Central Venous Access Device: (CVADS). This is simply to make sure that the fluids are flowing well and to check for any undue discomfort or irritation. Additionally, IV fluids can be administered by gravity or by infusion pump, and each method requires its own administration set. Signs of infection include redness, warmth, tenderness, and possible fever. For intermittent infusions, IV lines which are disconnected are to be discarded between infusions. IV infusion nurses practice infusion therapy, administering intravenous fluids and medications. nursing responsibilities for iv therapy ppt. endobj You may notice that the nurse may gently assess the access site. objectives of iv therapy. Identify critical information that writers may have missed. New environments are no problem. endobj Cover the cannula insertion site with sterile transparent semipermeable, occlusive dressing (e.g. If detected early, extravasation may be treated with medications that help avoid the complication of necrosis. Complications of IV Therapy Nursing assumed the role of A = Care & Use of IV Catheters Revised Date: 12/02, 07/04, 10/04, 05/05, 12/06, 12/08, 06/09, 12/10, 04/11 Forms: SMC form - Picc Line placement Reviewed Date: SUBJECT: Nursing . correct fluid and electrolyte imbalancesadminister medicationsadminister, Oral medications-absorbed in the digestive tract, Rules and Regulations Regarding IV Therapy for the LPN. Creative Commons Attribution 4.0 International License, Inspect established IV site for deviations from normal, Prepare and safely administer primary and secondary IV fluids and medication, Calculate and ensure designated flow rate, Modify the procedure to reflect variations across the life span, monitoring the effectiveness of IV therapy. Share . Upper limit infusion pump pressure can be manually increased with clinical discretion to accommodate: If pump pressure exceeds the recommended limits, check the patency of the PIVC. Now customize the name of a clipboard to store your clips. Once the priming is complete, your nurse will get started on placing your IV. Job Summary: The Registered Nurse (RN) II is a professional caregiver who assumes responsibility and accountability for a group of patients for a designated time frame. HISTORICAL BACKGROUND In 1993 the Nursing Standards on Intravenous Practice was established October 1993 - ANSAP Board Members and Advisers had undergone the Training for Trainers at Philippine Heart Center February 4, 1994 - the first edition of Intravenous Standards on IV therapy was printed and circulated June 9-11, 1994 - first Training for Trainers as conducted in Cagayan de Oro May . Infiltration occurs when the tip of the IV catheter slips out of the vein, the catheter passes through the wall of the vein, or the blood vessel wall allows part of the fluid to infuse into the surrounding tissue, resulting in the leakage of IV fluids into the surrounding tissue. 1. NurseJournal.org is an advertising-supported site. Deshaies' clinical area of expertise is critical care nursing and she is a certified critical care nurse. Part of a team of other healthcare workers, like physicians and nurse practitioners. $^pUTq^#P$|.\ |7 The SlideShare family just got bigger. With the access point placed, the nurse attaches the primed IV bag tubing to the port on the catheter. [4],[5] Additionally, clinical pharmacists can also be helpful resources for determining the appropriate type of infiltration treatment. Locate the best place to insert the IV. If the patient (inpatient setting) is having intermittent infusion, eight hourly assessments are a minimum. How do they go about making magic happen? They act rapidly within the body to restore fluid volume and deliver medications. (2) The licensed practical nurse can demonstrate the knowledge, skills, and ability to perform the procedure safely. Activate your 30 day free trialto continue reading. It is important to communicate with your nurse while they are doing their checks. It is important for the nurse to continually monitor a patients skin turgor, urinary output, lung sounds, and oxygen requirements and to assess for any new edema to offer important insight into their fluid volume status. The provider will order primary fluids based on the patients fluid and electrolyte statuses. Extravasation refers to infiltration of damaging intravenous medications, such as chemotherapy, into the extravascular tissue around the site of infusion. A few final checks are completed, and youre all done! the main learning areas . About this job. Explore our full list of Integrity Network members. Follow agency policy regarding initiating tubing change before initiating a new bag of fluid or medications. Want to create or adapt books like this? Infiltration/Extravasation: delivery of fluids Updated December 2022. correct fluid and. Whether youre looking to get your pre-licensure degree or taking the next step in your career, the education you need could be more affordable than you think. By whitelisting SlideShare on your ad-blocker, you are supporting our community of content creators. Check the expiration date when obtaining a new tubing administration set. bGKqvf6 Z9-mVKvw=#TmOW:hz2Z^'8]!+\CE&T5$J{jIV^4i]Y>,HMc ^#2KgS;U9eGTE~%/ &t$:f|/c #op;{T;P}qUkY1axSdsp)}MJ5KPkw!H:~"`6P __Vv/g-lvOjt]Ltc ~ 9rfRKdE\,b&2 ki,1xH@:0I\:mv?27n(I\JJXEKO8@5ik up to 24 hours, Remove gloves, $4%&'()*56789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz ? hbbd```b``"Cd$&?Hn "]RDfgi`r2X>"@d6'DWj"`Y3i]g 20:? TT$+iGJK}?wS0[L tFjo}*&]CHd @\r:q8:waFh0T\lP4w1"G "c:(|IR DQ}=V.DP)2cud,rgoz)y+b62 \tQH3"P-zdd1fLW4]I])`]YwTw"e7 Comfortably seated, you can rest your eyes, watch television, or play on your phone. Continuous Infusions: Controlled Analgesic: Drip Factor: Electronic Pumps and Controllers: Flow Rate:ml/hr or gtts/min Infiltration: Infusion Devices: 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. Nursing Skills by Open Resources for Nursing (Open RN) is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted. We've updated our privacy policy. 1. Role Definition The IV nurses are RNs committed to ensure the safety of all patients receiving IV Therapy. There is no evidence for routine amy e. irwin, dnp, ms, rn denver school of nursing. 0 ) or medications into surrounding tissue, If the holliday- segard nomogram. presentation. Extension sets are to be primed and attached to the cannula at the time of IV insertion using an aseptic non touch technique. Here are just a few of the other duties and responsibilities that Reset IV nurses have as they prepare, administer, and monitor you during treatment. por | Jun 14, 2022 | jacksonville housing authority portal | radford job level guide | Jun 14, 2022 | jacksonville housing authority portal | radford job level guide For example, primary fluids may be started at a higher rate of infusion when a patient is receiving nothing by mouth (NPO), but should be tapered as they resume normal diet and fluid intake. Peripheral intravenous catheters (PIVCs) are the most commonly used intravenous devices in hospitalised paediatric patients. When initiating or changing an IV bag of fluids or medications, it is important to remember these items: While monitoring a patient receiving IV fluids, it is important to assess for potential complications such as infiltration, extravasation, phlebitis, or infection. IV THERAPY - . IV Therapy: Tips, Care, and Complications Contact Hours: 2.0 Course Expires: 01/31/2019 First Published: 5/30/2014 Reproduction and distribution of these materials is prohibited without an RN.com content licensing agreement. Secondary IV therapy is often referred to as IV piggyback (IVPB) medication because it is attached to the primary bag of intravenous fluids. safeguard your body and fight, IV FLUID THERAPY - . Not all services are the same. If a manual calculation is needed to set the IV flow rate, calculate the rate and double-check the calculated rate with another registered nurse. the birds. Enjoy access to millions of ebooks, audiobooks, magazines, and more from Scribd. objectives of iv therapy. Syringes with an internal diameter smaller than that of a 10mL syringe can produce higher pressure in the lumen and rupture the catheter. IV bags are built to hang so that gravity can pull the fluids through an opening on the bottom of the bag. This compensation does not influence our school rankings, resource guides, or other editorially-independent information published on this site. purpose of iv therapy. Be sure to follow evidence-based infection prevention practices, such as performing hand hygiene, performing a vigorous mechanical scrub of needleless connectors, limiting catheter access, and following sterile no-touch technique during intravenous infusion to reduce the risk of vascular catheterassociated infection. Dressings to PIVC sites are the first line of defence against infection and dislodgements. Becoming an IV infusion nurse involves four steps: earning a nursing degree, obtaining an RN license, logging work experience, and pursuing certification. For Opioid infusion bolus refer to the specific guidelines: If the cannula is to be accessed intermittently for the administration of medications or fluids, the cannula should be flushed prior to infusion or at least once a shift. Find the right nursing program for you. Your time is important, and our team has flexible options to maximize it. <> at least every4hrs, check skin status at iv site, status of dressing, client's ability to perform self-care activities; & client's understanding of any mobility limitations assess . Average time for the bags to empty is about an hour, though many people report feeling better within minutes. You can read the details below. These may also be referred to as Y ports.. Intravenous therapy By- Dr. ASHOK DHAKA BISHNOI Director, JINC. Special consideration: Patients admitted to the Neonatal Unit should have line pressure documented within the Peripheral IV Cannula Lines, Drains, and Airway (LDA) tab. 'jw#fAd4}=MY;iSOs2D5]d6zjzkIfaqOG]~G:I">fSy~jF!FXH3*}?fV'&Glz\fWKTe)cOUc8$qb{R] C[$y/hA-}MOsBIfbm,. in the summer, when the sun is burning, CLASS IV - . They are primarily used for therapeutic purposes such as administration of medications, fluids, and blood products. perform hand hygiene, Dispose of waste nursing care related to intravenous therapy verify order and patient identity ensure correct infusion solution and rate avoid using hand veins as a last resort. _? rn. Patient care and safety is always number one, and they love making a difference in peoples lives. Secondary fluids should always be piggybacked into primary infusion lines to ensure that the correct amount of medication is infused. Some of these complications can be prevented by the correct use of aseptic Access PIVC only after scrubbing the hub. Administration sets that have been disconnected (either accidentally or planned) are no longer sterile and are to be discarded and replaced. Indications for dressing change include when it becomes insecure or if there is blood or fluid leakage under the dressing. 0 See Figure 23.3[3] for an example of an IV infusion pump. 3. i&h~ ~^=_PQEQ@G`Ry$xWJti]v|I>4C$Il2k~$s_:H--KK9 Coordinating and administering therapeutic IV treatments and infusions, Managing complications with infusion therapies, Monitoring patient responses to treatment, Reviewing lab reports and drug information, 2023 NurseJournal.org, a Red Ventures Company. Secondary IV tubing is shorter in length than primary tubing and is connected to a primary line via an access port or an IV pump. Label the fluid bag/syringe with date, time, patient name and signature of two checking staff. It appears that you have an ad-blocker running. However, readers should be advised that only a low number of infusion nurses reported salaries. 0 Ensure the device is also removed from the LDA in EMR. Effective Date: 04-10-2001, 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, 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, Oral medications-absorbed in the digestive tract IV- faster acting and distributed throughout the bloodstream immediately after giving, Uses: Unconscious pt: Unable to swallow: Vomiting: Nutrition: Others? Like any career, IV infusion nursing work comes with benefits and drawbacks. Perform the six rights of medication administration three times as you would when giving any other medication. Without contaminating the key part (spike)using a non-touch technique insert the spike of the administration set into the septum of the infusion bag. Create stunning presentation online in just 3 steps. Primary fluids are typically administered using an IV pump. %%EOF Looks like youve clipped this slide to already. So you do not need to waste the time on rewritings. Prevention of Central Line Associated Blood Stream Infection (CLABSI )[compa Intravenous medication, Care and Complications, Safe iv cannulation (prevention of iv thrombophlebitis), Iv fluid therapy (types, indications, doses calculation), Society for Microbiology and Infection care. Free access to premium services like Tuneln, Mubi and more. Keeping your patient involved in his care fosters a constructive dialogue. Drawing on their firsthand industry expertise, our Integrity Network members serve as an additional step in our editing process, helping us confirm our content is accurate and up to date. Secondary IV fluid administration is usually an intermittent infusion that infuses at regular intervals (e.g., every 8 hours). This responsibility includes selecting the appropriate venipuncture site and type of cannula and being pro-ficient in the technique of vein entry. The aim of this guideline is to provide an outline of the ongoing maintenance and management of the PIVC for patients in hospital, outpatient, and home healthcare settings. The development of this nursing guideline was coordinated by Eloise Borello, CNC Quality & Improvement, and Lauren Nichols, CSN PICU, approved by the Nursing Clinical Effectiveness Committee. reason for removal. an infiltration or extravasation injury. Check the type of fluid and the expiration date, and verify the fluid is free of discoloration and sediment. Suggest changes to inaccurate or misleading information. The. <> PREPARING TO ADMINISTER IV THERAPY Before performing venipuncture, the nurse carries out hand hy-giene, applies gloves, and informs the patient about the proce-dure. indicated. It can cause redness and tenderness along the vein and can lead to infection if not treated appropriately. 22. Because a patients fluid and electrolyte statuses are constantly changing when receiving IV fluids, it is important for the nurse to monitor for signs of fluid or electrolyte imbalances and appropriately notify the health care provider of any concerns. Illustration post oak toyota commercial actors / delta flight crew luggage. Determining the rate of flow is an important step. Primary fluids are run at consistent infusion rates for a prescribed period of time. Sterilize the chosen area, usually with a simple alcohol swab. a busy month. endstream endobj 113 0 obj <>>>/Subtype/Form/Type/XObject>>stream Becoming a registered nurse (RN) requires passing the. exposed skin with your other hand. See Figure 23.2[2] for an illustration of the set up of a primary and secondary tubing for administration of fluids and a secondary medication by gravity. 4723.171 Intravenous therapy procedures. 2.8 Functional Health and Activities of Daily Living, 2.11 Checklist for Obtaining a Health History, Chapter Resources A: Sample Health History Form, 3.6 Supplementary Video of Blood Pressure Assessment, 4.5 Checklist for Hand Hygiene with Soap and Water, 4.6 Checklist for Hand Hygiene with Alcohol-Based Hand Sanitizer, 4.7 Checklist for Personal Protective Equipment (PPE), 4.8 Checklist for Applying and Removing Sterile Gloves, 6.12 Checklist for Neurological Assessment, 7.1 Head and Neck Assessment Introduction, 7.3 Common Conditions of the Head and Neck, 7.6 Checklist for Head and Neck Assessment, 7.7 Supplementary Video on Head and Neck Assessment, 8.6 Supplementary Video on Eye Assessment, 9.1 Cardiovascular Assessment Introduction, 9.5 Checklist for Cardiovascular Assessment, 9.6 Supplementary Videos on Cardiovascular Assessment, 10.5 Checklist for Respiratory Assessment, 10.6 Supplementary Videos on Respiratory Assessment, 11.4 Nursing Process Related to Oxygen Therapy, 11.7 Supplementary Videos on Oxygen Therapy, 12.3 Gastrointestinal and Genitourinary Assessment, 12.6 Supplementary Video on Abdominal Assessment, 13.1 Musculoskeletal Assessment Introduction, 13.6 Checklist for Musculoskeletal Assessment, 14.1 Integumentary Assessment Introduction, 14.6 Checklist for Integumentary Assessment, 15.1 Administration of Enteral Medications Introduction, 15.2 Basic Concepts of Administering Medications, 15.3 Assessments Related to Medication Administration, 15.4 Checklist for Oral Medication Administration, 15.5 Checklist for Rectal Medication Administration, 15.6 Checklist for Enteral Tube Medication Administration, 16.1 Administration of Medications Via Other Routes Introduction, 16.3 Checklist for Transdermal, Eye, Ear, Inhalation, and Vaginal Routes Medication Administration, 17.1 Enteral Tube Management Introduction, 17.3 Assessments Related to Enteral Tubes, 17.5 Checklist for NG Tube Enteral Feeding By Gravity with Irrigation, 18.1 Administration of Parenteral Medications Introduction, 18.3 Evidence-Based Practices for Injections, 18.4 Administering Intradermal Medications, 18.5 Administering Subcutaneous Medications, 18.6 Administering Intramuscular Medications, 18.8 Checklists for Parenteral Medication Administration, 19.8 Checklist for Blood Glucose Monitoring, 19.9 Checklist for Obtaining a Nasal Swab, 19.10 Checklist for Oropharyngeal Testing, 20.8 Checklist for Simple Dressing Change, 20.10 Checklist for Intermittent Suture Removal, 20.12 Checklist for Wound Cleansing, Irrigation, and Packing, 21.1 Facilitation of Elimination Introduction, 21.4 Inserting and Managing Indwelling Urinary Catheters, 21.5 Obtaining Urine Specimen for Culture, 21.6 Removing an Indwelling Urinary Catheter, 21.8 Applying the Nursing Process to Catheterization, 21.10 Checklist for Foley Catheter Insertion (Male), 21.11 Checklist for Foley Catheter Insertion (Female), 21.12 Checklist for Obtaining a Urine Specimen from a Foley Catheter, 21.14 Checklist for Straight Catheterization Female/Male, 21.15 Checklist for Ostomy Appliance Change, 22.1 Tracheostomy Care & Suctioning Introduction, 22.2 Basic Concepts Related to Suctioning, 22.3 Assessments Related to Airway Suctioning, 22.4 Oropharyngeal and Nasopharyngeal Suctioning Checklist & Sample Documentation, 22.5 Checklist for Tracheostomy Suctioning and Sample Documentation, 22.6 Checklist for Tracheostomy Care and Sample Documentation, 23.5 Checklist for Primary IV Solution Administration, 23.6 Checklist for Secondary IV Solution Administration, 23.9 Supplementary Videos Related to IV Therapy, Chapter 15 (Administration of Enteral Medications), Chapter 16 (Administration of Medications via Other Routes), Chapter 18 (Administration of Parenteral Medications), Chapter 22 (Tracheostomy Care & Suctioning), Appendix A - Hand Hygiene and Vital Signs Checklists, Appendix C - Head-to-Toe Assessment Checklist. Instant access to millions of ebooks, audiobooks, magazines, podcasts and more. <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 720 540] /Contents 4 0 R/Group<>/Tabs/S>> It should be kept to full of solution. holding the cannula in place at all times, Hold a piece of [Gd )Q[$!Y;*% gMb|s"$;Zt#b3d k!"Xts}so-Hfx%E'g}BK,o)VlzcKXZU_>VF|18q'Rd'%z97Oq}NR[]J^xnn"DG"hMjQwLm?q* uG [vQ 3~N*1r3{u1= nursing guideline, http://www.rch.org.au/policy/policies/Blood_Product_Transfusion/. If the infiltration is severe, you may consider the application of a compress in addition to elevating the affected limb. Inject the prescribed drug into the burette via the additive port. Our nurses are trained to do this as quickly and painlessly as possible. Prior to and after fluid infusion (as an empty fluid container lacks infusion pressure and will allow blood reflux into the catheter lumen from normal venous pressure) or injection. infiltration of damaging intravenous medications, such as chemotherapy, into the extravascular tissue around the site of infusion. Description of Practice By piggybacking a medication, the solution from the primary fluid line is used to prime the secondary tubing. Read more about calculating infusion rates in the Math Calculation chapter. Draw up required volume of diluent in appropriate size syringe and then pull back the syringe plunger to enable you to inject the drug into the syringe using principles of aseptic technique. Role Definition The IV nurses are RNs committed to ensure the safety of all patients receiving IV Therapy. Parenteral fluid administration has been an essential component of the care of hospitalized patients since 1940 . A nurse must also evaluate the effects of replacement fluids and discuss their ongoing need with the prescribing provider. |cc,}1=[9] =" 4N%f-o?)6fVzQ' k!0x]'ZOb{1|G}iihb*U5P Do not sell or share my personal information, 1. Gauze is held firmly over the access site for a moment to discourage any bleeding, and sterile dressing is applied. Eligibility for the CRNI exam requires an RN license and a minimum of 1,600 hours of infusion therapy experience. Activate your 30 day free trialto unlock unlimited reading. Needle Selection 2. Treatment may include warm compresses and nonsteroidal anti-inflammatory medications. Flush the PIVC using a pulsatile flushing technique (push pause motion). Loss of medication is considered a medication error because the patient received less active medication than prescribed. H**BCS 444\ Concierge service means easy access for you, and our nurses are on call 24/7 to manage your needs. Patient and IV site assessments should be done on a regular basis. If these conditions occur, promptly notify the provider for treatment; the IV catheter will need to be removed and replaced at an alternative site, and additional medication may be prescribed. After deciding on the additives needed, your personalized blend is formulated. There are three types of intravenous fluid concentrations: isotonic, hypertonic, and hypotonic fluids. Primary IV tubing can be a macro-drip or micro-drip solution set. 5 0 obj Do Not Sell or Share My Personal Information. Check your institutions policy regarding which type of compress (warm or cold) should be applied. It appears that you have an ad-blocker running. Documentation shall contain information on the insertion site, gauge of the needle and date and time of insertion has been documented in the EMR- LDA properties. The most commonly used primary IV fluid bag contains 1,000 mL. Verify the infusion rate of IV fluids is appropriate based on the patients age, size, preexisting medical conditions, and prescribed indication. She has worked in various surgical ICUs throughout her career, including cardiovascular, trauma, and neurosurgery. Resources and articles written by professionals and other nurses like you. Priming the tubing by allowing the fluid to flow through so that there is no air in the line. Safely dispose of the materials that were used. achieve & maintain normal, IV Therapy - . (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. Do not sell or share my personal information, 1. While checking the access site, your nurse will also talk with you about how you are feeling. correct fluid and IV Vitamin Therapy - Contact adress: 635 madison ave, suite 1400c, new york, ny 10022 phone: (347) 434-9815 website url: 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, Initiate: Intermittent Infusion: (Piggyback) Intravenous: (IV) IV Bolus: IV Push: Maintain. Patient Assessment and Psychological Preparation 5. Youre there to feel better and our nurses are there to help make that happen. Consider placing a small piece of sterile cotton wool ball or gauze underneath the hub of the cannula to reduce pressure. During the therapy, the nurse will periodically check in to ensure that everything is going well. Enjoy access to millions of ebooks, audiobooks, magazines, and more from Scribd. Simple dehydration, illness, or other concerns cant be scheduled, but they can be managed. An example of isotonic fluid is 0.9% normal saline. We've encountered a problem, please try again. 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, Saline Lock Over needle cath left in for medical administration Flush every 8 hours Flush before/after meds, Rules and Regulations Regarding IV Therapy for the LPN See Handout from OBN website Chapter 4723-17 Try to access sites, 2023 SlideServe | Powered By DigitalOfficePro, - - - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - - -.