What is intravenous therapy (IV therapy)?
Intravenous therapy is giving fluids and other nutrients through a vein.
It is given to clients who can't take fluids orally or when there is dehydration.
What are the steps to insert an IV?
What is the difference between a peripheral IV site and a central line?
Peripheral IV site: a short IV that goes into a vein into the arm
Central line: an IV that also goes into a vein but is threaded much further in so that the tip of the catheter site is closer to the heart for quicker administration
What are the 3 types of IV solutions?
Explain what a hypotonic solution is and give some examples:
Hypotonic solutions are "more watery". There is a lower concentration of solutes compared to body fluids.
When given, HypOtonic fluids will first go into the vascular space then will shift "Out of the vessels" and into the cells to replace cellular fluid.
Examples: 0.45% saline, 1/2 normal saline, D2.5W, 0.33%NS
In what situations is a hypotonic solution given?
Hypotonic solution is given for:
- fluid replacement for those with nausea/vomiting, burns or hemorrhage for a client who has cardiac or renal disease
Why is a hypotonic solution given for fluid replacement for clients with cardiac or renal disease?
Clients with cardiac or renal disease cannot handle extra fluids too quickly.
A hypotonic solution prevents the client from receiving fluids too quickly because it goes into the vascular space and then leaves quickly to go into the cells.
Why is a hypotonic solution given to clients with hypernatremia?
A hypotonic solution will dilute the sodium in the blood.
Explain what an isotonic solution is and give some examples:
Isotonic solutions have the same concentration of solutes as body fluids.
When given, iSotonic fluids will first go right into the vascular space and then "Stay in the vessels" to treat dehydration.
Examples: 0.9% NS, Lactated Ringers or LR, D5W, D5 1/4 NS
In what situations is an isotonic solution given?
Isotonic solution is fluid replacement for those with nausea/vomiting, burns or hemorrhage.
Who should NOT receive isotonic solutions?
Do NOT give isotonic solutions to clients with renal or cardiac disease.
The kidneys and heart cannot handle the extra fluid. It will cause fluid volume overload.
What is a complication of administering too much isotonic solution?
It can cause fluid volume overload and increased blood pressure.
Explain what a hypertonic solution is and give some examples:
Hypertonic solutions have an increased concentration of solutes as compared to body fluids.
When given, fluids will first go into the vascular space and the pull fluids from the 3rd space to go back into the vessels.
Examples: D10W, 3%NS, 5%NS, D5LR, D5NS, TPN, albumin
In what situations is a hypertonic solution given?
Hypertonic solution is given when a client has too much fluid in the 3rd space such as severe edema, burns or ascites.
What is a complication of administering too much hypertonic solution?
Too much hypertonic solution can cause severe fluid volume overload.
This client is usually in an ICU with frequent monitoring of blood pressure, heart rate, and central venous pressure.
What substances are in D5W and D10W?
- D5W: 5% dextrose and water
- D10W: 10% dextrose and water
Dextrose is a type of sugar.
Which type of client should typically NOT receive D5W or D10W?
Clients with diabetes should NOT receive fluids with dextrose because the blood sugar is already elevated.
What substances are in lactated ringers (LR)?
Lactated ringer's has sodium, potassium, calcium, and water.
Which clients is Lactated Ringer's NOT given to because of electrolyte overload?
Clients with acute kidney injury or chronic kidney disease should not receive LR because their potassium is already elevated.
What are IV gauges?
IV gauges are the size of the diameter of the needle.
It is sometimes called a lumen or cannula.
The ______the IV gauge number the _______the diameter.
The smaller the IV gauge number the larger the diameter of the needle.
What IV gauge would be used for rapid fluid administration or blood products?
Rapid fluid or blood administration: 18 or 19 gauge lumen
What IV gauge would be used for fat emulsion (lipids)?
Fat emulsion (lipids): 20 or 21 gauge lumen
What IV gauge would be used for standard IV fluids or IV meds?
Standard IV fluids or IV meds:
- 22 or 24 gauge lumen
- 25 gauge lumen for very small veins
Label the parts of IV tubing:
- drip chamber
- extension hook
- flow control clamp
- piggyback set
- piggyback Y-port
- primary set
- secondary Y-port
- slide clamp
What does it mean to "prime the tubing"?
Prime the tubing means to make sure the tubing has fluid in it before it is connected to the client's IV access and started.
What is an IV piggyback or secondary tubing?
IV piggyback / secondary tubing is an IV medicine that goes through the IV tubing that is hung above the main bag of IV fluids.
What is the purpose of an IV filter?
An IV filter is to catch and prevent larger molecules from entering the client's veins.
What is an IV pump?
An IV pump is a machine where the IV tubing is placed to control the amount of fluids a client gets without having to calculate and count drips.
What is a normal IV fluid rate for a typical client?
Normal IV fluid rate is 100-125 ml/hour.