1. Dr. Kareema Ahmed Hussein 2017 -2018
Fluid Transfusion
Dr. Kareema Ahmed Hussein

3. Homeostasis
State of equilibrium in body
Naturally maintained by adaptive responses
Body fluids and electrolytes are maintained within narrow limits

4. Water Content of the Body
60 % of body weight in adult
45 % to 55% in older adult
70 % to 80% in infants
Varies with gender, body mass, and age

5. Fluid Balance

6. Compartments Intracellular fluid (ICF)
_______ ______ ______cell membrane
Extracellular fluid (ECF)
Interstitial = tissue
______________________capillary membrane
Intravascular (plasma)

7. Fluid Compartments of the Body

8. Extracellular Fluid (ECF)
One third of body fluid
3 major components
Interstitial fluid
Intravascular
Trans-cellular fluid over or across the cells

9. Fluid Volume Deficit
Hypo-volemia: Abnormally low volume of body fluid in intravascular and/or interstitial compartments
Causes
Vomiting
Diarrhea
Fever
Excess sweating
Burns
Diabetes insipidus
Inadequate intake
Hemorrhage
Overuse of diuretics
Third spacing

10. Intravenous Infusion:
The injection of relatively large quantities of solution into a vein .
OBJECTIVES:
1-To give fluids when the patient cannot obtain adequate fluid intake orally.
2-To maintain normal electrolyte balance.
3-To nutrition the pt. as energy source.
4-To administer medications IV.
5-To administer blood products.
6-To access venous for emergencies.

11. Factors influencing the selection of a site to introduce
intervene infusion .
1-Accessibility of a vein
Determine the most desirable accessible vein : cephalic vein basilica V. , superficial V in dorsal aspect of the hand metacarpal V.
Based on pt's condition ( severe burns)
Avoid anticubital V , for long term infusion because it limits the arm movement .{ its satisfaction for blood transfusion and small amounts of medication administration }.
Avoid V. in the leg because of danger of complications .

12. E. Avoid V. in the surgical areas because of vascular disturbance in area
F. Select scalp V. for infants .
2-Condition of the V.:
Thin – walled and scarred V. especially in elderly pt. make continued of fluid a problem .

13. Complication associated with in infusion
1 - Infiltration: The escape of fluid in to the subcutaneous tissue
Causes :
a- Dislodged needle
b- Penetrated vessel wall
signs and symptoms(Infiltration)
Swelling .
Pallor .
Coldness .
Pain around the site
nursing care :
a-Check the site for symptoms .
b-Discontinue the infusion .
c-Restart infusion at other site .
d-Limit movement of extremity.

14. 2-Extravasation:The escape of medication in to the subcutaneous tissue
Causes :
a- Dislodged needle
b- Penetrated vessel wall
signs and symptoms(Infiltration)
a- Swelling .
B-Redness .
C-Warm .
D-Pain around the site
nursing care :
a-Check the site for symptoms .
b-Discontinue the infusion .
c-Restart infusion at other site .
d-Limit movement of extremity.
E- Call the physician

15. 3- Phlebitis :An inflammation of a vein .
Causes:
a- Mechanical trauma from needle or by irritation to internal lumen of vein during insertion of vascular access device and usually appears shortly after insertion.
b- Chemical trauma from solution
S&S :
a-Tenderness
b-Redness.
c-Warmth .
d-Slight edema of V. above site .
Nursing care .
a-Stop infusion .
b-Warm compresses .
c-Avoid further use of V.
d-Replase in other site .

16. 4-Thrombus A blood clot .
causes: Tissue trauma from needle or catheter .
S&S : Same of phlebitis.
N.C.
Discontinue infusion.
Warm compresses .
Replace in other v.
Don't rub or massage the affected area
5. Anti-inflammatory and analgesic medications are often used,

17. 5-Cellulites:Inflammation of loose connective tissue around insertion site.
Caused: by poor insertion technique
S&S :
Red swollen area spreads from insertion site outwardly in a diffuse circular pattern
Nursing care:
Treated with antibiotics

18. 6-Septicemia/Pulmonary Edema/Embolism
Severe infection that occurs to a system or entire body
Most often caused by poor insertion technique or poor site care
Discontinue device immediately, culture and treat appropriately
Pulmonary edema- Caused by rapid infusion
Pulmonary embolism - Caused by any free floating substances that require thrombolytic therapy for several months.
Air embolism- Caused by air injected into IV system.
Keep insertion site below level of heart

19. 7-Speed shock :
the body's reaction to a substance that is injected into the circulatory system too rapidly
causes : too rapid rate of fluid
S&S:
a- headache .
b-Fainting, V.S.
c-Rapid pulse d-Chills .
e-Bach pain's f- Dyspnea.
N. C.
a-discontinue infusion .
b- monitor V.S.
c-report symptoms to physician .
d- carefully monitor the rate .

21. 8-Fluid overload
The condition causes when too large volume of fluid infuses into the circulatory system .
S&S:
a- Low tempture
b-Feel cooling
c- Dyspnea .
N.C.
Slow rate .
Notify physician .
Check V.S.
Monitor rate of fluid .
Check the rate frequency .

22. Fluids classified:
1-Isotonic fluids:-such as normal saline 0.9% Nacl ,ringer.
2-Hypotonic fluids:-such as normal saline 0.45 Nacl ,dextrose
3-Hpertonic fluids:- Nacl 3%,and5%

23. :The method for determinin flow rate IN infusion: By using this formula
Amount of solution * amount of solution in Icc
Hours to infuse solution * 60 min / h .
Amount of solu. * 15 drops /Icc
Hours to infuse solu. *60 m/h

24. Example :
Physician prescribes 1000 ml of solution to be infused in a 10 hours period , determine the number of drops to infused each minute
1000 cc x 15 Drop/ Icc = =25drop to be infused /m.
10x
*drop factors may change with different manufactures because
macrodrip tubing can deliver 10 ,15 , 20 .

25. Factors alter the rate of flow of I.V. infusion:
Height of the container in relation to pt.
Tubing obstruction
Position of the IV access .
Position of the extremity .

27. Thank You