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Intravenous Therapy IV Infusion Preparations Fluid and Electrolytes

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Intravenous Therapy IV Infusion Preparations Fluid and Electrolytes Sasha A. Rarang, RN, MSN Intravenous (IV)Therapy : Definition: Infusion of a fluid into a vein to ... – PowerPoint PPT presentation

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Title: Intravenous Therapy IV Infusion Preparations Fluid and Electrolytes


1
Intravenous Therapy IV Infusion Preparations
Fluid and Electrolytes
  • Sasha A. Rarang, RN, MSN

2
Intravenous (IV)Therapy
  • Definition Infusion of a fluid into a vein
  • to prevent or treat fluid /or electrolyte
    imbalance(s)
  • to deliver medications
  • to deliver blood products
  • VENIPUNCTURE technique of accessing a vein via
    insertion of a needle or catheter
  • sterile procedure because skin integrity is broken

3
Purposes of Infusion Therapy
  • Provide fluids when PO intake not possible
  • replace fluids/lytes
  • Maintain normal electrolyte balances
  • Provide glucose as energy source
  • Provide access for administration of meds
  • Administer blood products
  • Emergency access
  • Maintain urine output

4
Distribution of Body Fluids Electrolytes
  • Typical adult 60 body weight consists
    of fluid (water lytes)
  • varies with body fat content, age, sex
  • ex. fat cells contain little water lean tissue
    is rich with water
  • ex. infants have a high body fluid content
    (approx 70 - 80 of body weight)

5
Fluid Distribution
  • INTRACELLULAR (ICF)
  • within the cells
  • approx 2/3 of total fluid found within ICF
  • EXTRACELLULAR (ECF)
  • outside the cells
  • approx 1/3 of total fluid found within ECF
  • ECF 2 compartments
  • Intravascular Within a vessel Plasma
  • Interstitial/Extravascular Between around the
    cells Tissue Fluid

6
Electrolytes
  • A substance that develops an electrical charge
    when dissolved in water
  • Electrolyte content of ICF is different from ECF
  • Major electrolytes in ICF Potassium Phosphate
    Magnesium
  • Major electrolytes in ECF Sodium Chloride
    Bicarbonate Calcium

7
Movement of FluidsNormal mvmt of fluids through
capillary walls depends on 2 forces
  • Hydrostatic Pressure - pressure exerted by the
    heart pressure of blood volume in vessels
  • Oncotic Pressure - pressure exerted by plasma
    proteins such as albumin
  • Water is pulled toward higher oncotic pressure

8
Movement of Fluids
  • When solutions are separated by a membrane
    impermeable to dissolved substances, a shift of
    water occurs through the membrane from an area of
    low solute concentration to higher solute
    concentration
  • Magnitude of this force dependent on the number
    of particles dissolved
  • OSMOLALITY number of dissolved particles
  • TONICITY OSMOLARITY
  • amt of solutes (ex sugar, Na, protein) in a
    liter of solution

9
Intravenous Infusion Preparations
  • Osmolality osmotic pull or pressure exerted by
    all particles by unit of water
  • ( expressed in milliosmoles per kilogram)
  • Osmolarity- is the osmotic pull by all particles
    per unit of solution. Unit of osmotic pressure
    osmole ( Osm) and the milliosmole is mOsm is
    1/1000th of an osmole. Osmotic cpressure
    determines osmotic activity.
  • Osmotic pressure determines osmotic activity.

10
Osmolality
  • Influience by the quantity of dissolved particles
    that exerts an osmotic pull in the intracellular
    and extracelluar fluids.
  • Primary solutes serum sodium, urea, and
    glucose.
  • Plasma (intravascular compartment ) contains
    protein and slightly higher osmolality than fluid
    in other areas.
  • 25 concentration only that found in the ICF.
  • Interstitial fluid has little to no protein.
  • It is the responsibuility of the nurse to
    knowwherther a prescribed infusate is hypertonic,
    hypotonic, or isotonic.

11
Osmolality
  • The more solute present the higher the
    osmolality
  • ISOTONIC solutions have the same osmolality as
    body fluids
  • HYPOTONIC solutions have a lower osmolality as
    body fluids
  • HYPERTONIC solutions have a higher osmolality as
    body fluids

12
Isotonic Solutionssame osmotic pressure as that
found in the cell
  • Will not alter intracellular fluid compartments
  • ex. Normal Saline (NS) used to expand ECF
    compartments
  • ex. Lactate Ringers (LR) similar to plasma
    content (Na, K, Ca, Cl, Lactate) used to
    correct ECF deficits

13
Hypotonic Solutionsless osmotic pressure as
that found in the cell
  • have lower osmolality than body fluids within the
    cell (ICF)
  • cause fluids to shift out of the vasculature
    (ECF) into the cells (ICF)
  • used to provide water, cellular hydration
  • ex. 0.45 NS (half Normal Saline)
  • ex. D5W (5 dextrose water)

14
Hypertonic Solutionsgreater osmotic pressure as
that found in the cell
  • HIGHER osmolality than body fluids
  • causes fluids to shift out of the cells (ICF)
    into the vascular space
  • rapid shift fr ICF into the ECF/ vascular beds
  • given to treat specific problems
  • can potentially have serious side effects
  • ex. CHF, PE, overload
  • ex. Hypertonic saline (3 or 5 NS)
  • ex. TPN
  • ex. 50 dextrose

15
Classification of Infusates
  • Crystalloid
  • Colloids
  • Hydrating Solution
  • Electrolyte Solution
  • Dextrose Solution

16
Crystalloids
  • Materials that are capable of crystallization.
  • Solution that when place on solvent ,
    homogeneously mixed with and dissolved into a
    solution and cannot be distinguished from the
    resultant solution.
  • Can be isotonic, hypertonic, or hypotonic.

17
Hydrating Solution
  • Provide free water for maintenance or hydration.
  • When used chemical make-up or rate of
    administration is adjuted so the equilibria of
    fluids are not disturbed.
  • E.g. glucose solution are most often used.
  • Dextrose 21/2 in 0.45 saline
  • Dextrose 5 in water
  • Dextrose 5 in 0.45 saline
  • Sodium Chloride 0.45
  • Dextrose 5 in 0.2 saline.

18
Electrolyte Solution
  • Substance capable of ionization such as sodium
    chloride

19
Dextrose solutions
  • Are frequently used as infusates, are
    manufactured as percentage solutions expressed
    the numberof grams per 100 g of solvent,.
  • A 5 dextrose in water (D5W) infusions contains 5
    g of dextrose in 100 ml of water 1 ml of water
    equals 1 gr.

20
Colloids
  • Are glutinous substances whose particles, when
    submerge into a solvent, cannot form a true
    solution because their molecules when thoroughly
    dispersed no not dissolve, but remained uniformly
    suspended and distributed throughout the fluid.
  • Can raise osmotic pressure.
  • Plasma or volume expander.
  • E.g. dextran, plamanate, and artificial blood
    substitute, hetastarch.

21
Indications for IV Therapy
  • Fluid Volume maintenance
  • Fluid Volume replacement
  • Medication Administration
  • Blood and Blood Producct Donation and
    administration
  • Nutritional support.

22
Equipment and Supplies
  • Infusate container glass
  • Plastic
    flexible

  • Semiregid
  • Infusate administration container
  • Drop factor
  • Primary administration set
  • Secondary administration set
  • Volume control administration set
  • Blood and Blood product administration set
  • Accessory Devices for use with administration
    set
  • Needleless Systems and Needlestick Safety System
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