1. Introduction to IV Therapy
Chapter 17
Introduction to IV Therapy

2. Primary Line Typically connected to maintenance IV fluids
Includes spike, drip chamber, and roller clamps for adjusting drip rate and ports for IV medications

3. Primary Line Set-Up: Step 1
Assumes IV fluid bag is ready
Open package containing tubing
Close all roller clamps on IV tubing to prevent air bubbles

4. Primary Line Set-Up: Step 2
Use sterile technique
Pull cover off port on bag
Pull cover off IV tubing spike
Spike IV bag

5. Primary Line Set-Up: Step 3
Squeeze drip chamber
Fill approximately half full with IV fluids
Or to mark provided by tubing manufacturer

6. Primary Line Set-Up: Step 4
Prime tubing with IV fluids to remove air
Open roller clamp closest to drip chamber
Air must be displaced to prevent client from experiencing air embolism

7. Primary Line Set-Up: Step 5
Close roller clamp

8. Primary Line Set-Up: Step 6
Label tubing with the following information:
Date
Time
Initials

9. Remember
With gravity drip IV lines, pressure in line is created when fluid drop falls in drip chamber
With electronic volumetric IV pump, pump maintains constant pressure in line to maintain patency of IV access

10. Secondary Line Shorter tubing used to infuse small-volume medications
Also referred to as IV piggybacks (IVPB) or minibags (IVMB)

11. ADD-Vantage® Bags
Have powdered medication in vial in top of small-volume bag with IV fluid in it
Vial opened within IV bag
Medication mixes with fluid for infusion
Used to package medications with short shelf life in solution

12. Volume-Controlled Burettes
For greater accuracy in measurement of small-volume IV medications or fluids, use calibrated burette chamber
Used most often in intensive care unit (ICU) for frequent small-volume fluid replacement

13. Indwelling Infusion Ports
Used for intermittent IV medication administration either IVMB or IV bolus
Most often referred to as:
Saline locks
Heparin locks
Medlocks

14. IV Bolus/IV Push
Medications administered directly through lock or into IV tubing port if IV fluids infusing

15. Flush with IV Bolus
When administering IV bolus medications, must flush before and after medication with 5-10 mL of compatible flush fluid

16. Volumetric Pumps Electronic devices
Force fluids into vein under pressure
Control infusion rates

17. Volumetric Pumps
Hospital or clinical in-service education required for use of all infusion pumps
Programming of pumps must be double-checked
IVs still should be checked every hour

18. Syringe Pump Variations on electronic volumetric pumps
Used to infuse drugs that cannot be mixed with other solutions or medications
Used with very small volumes
E.g., infants, ICU clients

19. Patient-Controlled Analgesia (PCA) Devices
Allow client to self-administer medication to control pain
Pre-filled syringe or medication bag containing analgesics (opioids) inserted into device

20. PCA Pumps The following items programmed into device: Dosage Frequency
Lock-out time
Amount

21. Introduction to IV Fluids
Manufactured and packaged under sterile conditions
Most prepared in plastic bags
Volumes range from 25 mL to 1000 mL

22. IV Fluids Abbreviations Numbers identify percentage strengths
Dextrose (D)
Water (W)
Saline (S)
Normal saline (NS)
Numbers identify percentage strengths

23. Fluid Strengths Percentages means grams of drug per 100 mL of fluid
E.g., 5% dextrose, 0.9% normal saline, 0.45% normal saline, 3% saline

24. Parenteral Nutrition
Administer nutrition solution via central vein through central venous access device (CVAD)

25. Types of Parenteral Nutrition
Total parenteral nutrition (TPN)
Partial parenteral nutrition (PPN)
Hyperalimentation