1. Linda S. Williams / Paula D. Hopper Copyright © 2011. F.A. Davis Company Understanding Medical Surgical Nursing, 4th Edition Chapter 7 Nursing Care of Patients Receiving IV Therapy

2. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Intravenous (IV) Therapy The Administration of Fluids or Medication Via a Needle or Catheter (Cannula) Directly Into the Bloodstream

3. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Indications for IV Therapy  Hydration  Electrolyte Replacement  Nutrition (PPN or TPN)  Medication Administration  Blood Product Transfusions

4. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Types of Infusions  Continuous  Intermittent  Piggy Back  Injection Caps  Direct Injection/IVP

5. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Methods of Infusion  Gravity Drip  Electronic Infusion Devices (EIDs)  Mechanical Controllers

6. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Factors Affecting Flow  Change in Catheter Position  Height of Solution  Patency of Catheter

7. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Calculation Practice You need to administer 1,000 mL of 0.9% sodium chloride over 6 hours. You have tubing with a drop factor of 10. How many drops per minute will you deliver?

8. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Calculate Drip Rate 1,000 mL1 hour10 gtt= 28 gtts 6 hours60 minutes1 mLmin

9. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Types of Fluids  Dextrose Solutions  Sodium Chloride Solutions  Balanced Electrolyte Solutions

10. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Osmolarity of IV Solutions  Isotonic  e.g., 0.9% Sodium Chloride  Hypotonic  e.g., 0.45% Sodium Chloride  Hypertonic  e.g., Dextrose 5% in 0.9% Sodium Chloride

11. Understanding Medical Surgical Nursing, 4th Edition Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Access  Peripheral  Central

12. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Starting a Peripheral Line

13. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Nursing Care  Fear  Impaired Physical Mobility  Risk for Infection

14. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Gerontological Issues  Monitor for Fluid Overload  Elevated Blood Pressure  Increasing Weight  Bounding Pulse  Shallow, Rapid Respirations  Jugular Venous Distention (JVD)  Increased Urine Output  Crackles

15. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Local Complications  Hematoma  Thrombosis  Phlebitis  Infiltration/Extravasation  Local Infection  Venous Spasm

16. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Systemic Complications  Septicemia  Circulatory Overload  Venous Air Embolism  Speed

17. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Central Venous Catheters  Types  Non-tunneled Central Catheter  Tunneled Catheter  Picc  Ports  Rationale for Use

18. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Central Venous Catheters (cont’d)

19. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Nutritional Support  Rationale  For Patients Unable to Eat or Tolerate Tube Feedings  Contents  Carbohydrates (CHOs)  Amino acids  Electrolytes  Trace Elements  Vitamins  Lipids

20. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Nursing Care of Patients Receiving TPN  Initial and Ongoing Assessment  Monitor Blood Glucose  Monitor Signs and Symptoms of Infection  Initiate and Discontinue Slowly

21. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Home IV Therapy  Fluid Replacement  Treatment of Infection  Nutritional Support