RE/P HARM -C HAPTERS 3 & 4 Intravenous Drug Therapy & Dose Calculation

O BJECTIVES Upon completion of these chapters the student will be able to: Clinical implications for IV use Selection of appropriate equipment Care and discontinue IV Maintain central line IV Correctly administer meds through IV Identify complications of IV use

I MPLICATIONS FOR USE When the patient is receiving intravenous infusion therapy, the RN is responsible for understanding why the therapy is needed and potential outcomes for the patient.

I MPLICATIONS FOR USE Maintain homeostasis by: Replacing fluids, electrolytes, calories, nutrients Provide fluids, electrolytes, calories, nutrients Transfuse blood/blood products Administer medications

T YPES OF SOLUTION D5W=5% dextrose-Isotonic D10W= 10% dextrose- Hypertonic D5 and ½ NS=5% dextrose & 0.45NS-Hypertonic NS=0.9NaCl-Isotonic LR=Lactated Ringer’s-Isotonic Plasma Expanders= Dextran-Isotonic

E QUIPMENT / MAINTENANCE Equipment-p.78,81,83,84 Electric infusion devices/Pump Pole Volume control set/solution Needle –Butterfly & Angio-cath Occlusive drsg./tape Maintenance The RN’s highest priority during IV infusion therapy is maintaining the patency of the IV Assess site hrly

I NITIATING AN IV 7 rights Explain procedure to patient Wash hands Organize equip & supplies Gloves *We will practice further steps in Lab-yippie!

D OSE CALCULATION DD DH X Quantity Rate for gtts/min Volume Time (minutes) X drop factor Rate for mL/hr Volume Hour X 60

D OSE CALCULATION IV flow rate: Volume divided by time X drop factor = rate (gtts/min) Dr. orders D5 ½ L/hr to infuse over 8hrs 1000 mL divided by 8 divided by 60 x 10 (gtt factor) = 20.8 gtts/min (round to 20 or 21) Dr. orders NS 400 mL IV over next 2 hrs (gtt factor is 10) 400 mL divided by 2 divided by 60 x 10 = 33 gtt/min A nurse is to administer 500mL NS over 4hrs 500 divided by 4hrs (4 x 60=240) 500 divided by 240 x 60=124.9 mL/hr Dr. orders Ampicillin 500 mg in 100 mL D5W to infuse in 30 minutes 100 mL divided by 0.5 hr =200 mL/hr