DISC.
BASED (note: read mod 1-2 - nandun lahat)
IVT - Intravenous Therapy
- ex: PNSS (Plain Normal Saline Solution)
Things we can administer thru iv:
a. medication
b. nutrition - parenteral nutri (tpn)
c. blood transfusion
d. contrast for ct scan
Indication:
a. f&e replacement,
b. IV chemotherapy,
c. BM
Sizes: (gauge no.)
- use large gauge no. for BT, large amt of flds - ensures fast drop rate
- the smaller the gauge number, the larger the catheter diameter
1. 26 - purple
2. 24 - yellow
3. 22 - blue
4. 20 - pink - for BT
5. 18 - green - for surgery and infusion of large flds
Mostly used for OR:
6. 16 - grey
7. 14 - orange
macro - no needle - adult
micro - needle - pedia
Materials (check mod)
Steps: (inc, mod 2 mas accurate)
1. check physician's order
- prime iv tubing - put iv fluid in iv tubing - done to expel the air - regulate q 15-20 mins -
rgltn depends on dr's order - rate of ilan gtt/min
2. hh
3. gather equipment - eg: tourniquet, cotton balls w alcohol, micropore, forceps
4. disinfect opened iv fld container w cotton ball w alcohol
5. tourniquet the picked site
6. pinch chamber to fill it w iv fld -1/2 or ⅓
7. ask pt to open and close hand para lumabas ang vein
8. assess what gauge to put in
9. Disinfect area
10. Secure cath
11. Connect IV fld line
12 plaster
13. Check patency
- whoever inserts, they discard
Choose gauge # size wisely - if puputok vein bec of wrong size → ecchymosis or hematoma
Documentation
1. type of iv fld,
2. device used,
3. place inserted,
4. no. of attempts,
5. date,
6. Adverse reactions
7. PT name who received IVT
- write date and time inserted on dorsal part of hand
Complications (Mod 1)
1. Local - outside - phlebitis - inner vein lining inflamm - (check module)
a. Extravasation - leakage of vesicant meds into tissues - chemotherapy, potassium
chloride, dopamine
b. Hematoma - blood collects outside vein dahil sa trauma/bad insertion
c. Ecchymosis - masakit na lump at insertion site
d. Thrombophlebitis - vein inflamm + blood clot near IV site
- if no backflow, dont continue IV fld - no backflow means that catheter is not in vein
- extravasation may tissue dmg/necrosis → lead to amputation
- if picking iv site, start distal to prox
2. Systemic
- sepsis/septicemia - fever chills headache vomiting
- circ overload - too much fluid will then leak to lungs --> SOB
- air embolism - SOB
3 types of IV flds (Mods 1 - diff examples),
1. Isotonic - 0.9 NaCl - = conc of solute/solvent
2. Hypertonic - larger solute, less solvent
3. hypotonic - 0.45 NaCl - less solute, larger solvent
IV fld color coding: may depend on institution, most common:
1. D5W- pink or red
2. D5LR - pink
3. D10 - blue or green
4. NaCl 50% - sky blue
5. D5I - violet - for pedia PTs w DKA
6. NS - green
7. LR - orange
8. Ringer’s Soln - yellow
Extra
opening iv flds:
- the higher the regulator - faster drip, when lowered - closed
- threeway iv - trifuse - manage multiple infusions, give meds thru single IV line
- incorporation - ihahalo sa iv fluid
