Assisting

Intravenous
Infusion

DAGANGON
Starting an Intravenous infusion

INTRAVENOUS (IV)
THERAPY
is the aseptic
instillation of fluid,
electrolytes, nutrients
or medications
through a needle into
a vein.

DAGANGON
Purposes:
• To administer fluids and chemical substances when
circumstances prevent the patient from consuming a
normal diet and oral liquids
• To replace fluids and chemical substances when
the patient has experienced loss through vomiting,
diarrhea, bleeding, etc.
• To provide access to the circulatory system if it
becomes necessary to administer emergency
medications
• To maintain an access to the circulatory system for
the intermittent administration of scheduled
medications
DAGANGON
Possible Nursing Diagnosis:
1. Fluid Volume Excess
2. Fluid Volume Deficit
3. Altered Nutrition: Less than Body
Requirements
4. Altered Oral Mucous Membrane
5. Self Care Deficit
6. High Risk for Infection
7. High Risk for Injury
DAGANGON
Factors affecting flow rate:
Age
Condition of the patient
Solution used
Manufacturer’s drop factor
Patency of the needle
Position of the site
Height of the IV pole
Kinking of the tube
DAGANGON
2 Types of I.V. Therapy
Peripheral IV Therapy__________________
• given through an arm,
or a hand vein and
sometimes through a
leg or foot vein.

DAGANGON
Peripheral veins used in iv
therapy
• Basilic Vein
• Cephalic Vein
• Radial Vein
• Metacarpal Veins

DAGANGON
 S I T ES
MM ON
C O

DAGANGON
 S I T E S
MMON
C O

DAGANGON
 2 Types of I.V. Therapy
Central Venous Therapy_____________
• a catheter inserted into a
central vein, commonly the
right or left subclavian vein or
the internal or ext. jugular
veins.
• For Long term therapy or a
large volume of fluid; may be
used for an emergency when
the pt.has inaccessible
peripheral veins or in long
term therapy at home.

DAGANGON
 Subclavian Vein

Internal Jugular Vein Basilic Vein

DAGANGON
Equipment______ IV stand

An IV tray containing the

following:
IV solution as ordered
IV tubing
Needle (IV catheter/ cannula)
Tourniquet
Alcohol swabs or CB with ROH
Plaster
Armboard (splint), if needed
Scissors
Medicine ticket
IVF label
DAGANGON
 AN NU L A
IV C

DAGANGON
DAGANGON
IV catheter gauge
•Grey - 16 G
•Green - 18 G
• Pink - 20 G
• Blue - 22 G
• Yellow - 24 G

DAGANGON
 Types of iv set

t (1 0 -2 0 g t ts / c c)
e
1. Macrodrip s s / c c)
t ( 6 0 g t t
2. Microdrip se
e – co n t r o l s e t
3. Volum

DAGANGON
PARTS OF IV SET

DAGANGON
Volume- control set

DAGANGON
Volume-control set

DAGANGON
 IV bottle
IV bag DAGANGON
DAGANGON
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DAGANGON
Starting iv infusion
procedure

DDC
DAGANGON
1. Check the IV solution and medication additives with
the physician’s order.

2. Wash hands

3. Gather all equipment and prepare the

IV solution and tubing

4. Maintain aseptic technique when

opening sterile packages and
IV solution
5. Close the regulator, uncap the spike and
insert it into the entry site on the bag or bottle
as the manufacturer directs. If an additive is
ordered, incorporate it before inserting spike
into the entry site
6. Suspend the IV solution on a hook in the
preparation area and press the drip chamber
and allow it to fill at least halfway
7. Remove the cap
at the end of the
tubing , release the
clamp and allow the
fluid to flow through
the tubing. (This is
termed PRIMING).
Allow the fluid to flow
until all air bubbles
have disappeared.
Close the clamp and
recap the end of the
tubing.
 8. Notify the physician or the nurse who will insert
the IV. When he/she arrives , bring preparation to
the bedside
9. Identify the patient and explain the procedure.
10. Have the patient in a supine or low
Fowler’s position in bed.
11. Hang the bag or bottle
of solution on IV stand.
12. Hand the tourniquet to
the doctor/ nurse, followed
by a CB with alcohol and
the IV catheter/cannula.
Observe while the doctor/nurse
is inserting.
DAGANGON
13. Release the tourniquet when he/she
indicates or when a return flow of blood to
the adapter is observed (optional- can be
done by the doctor)
14. Connect the tubing to the needle
15. Start the flow of solution promptly by
releasing the clamp on the tubing.
Examine
the site for signs of infiltration
16. Loop the tubing near the
site of entry and anchor it
with plaster to prevent
pulling of the needle.

17. Anchor the arm to an

armboard for support if
necessary.

18. Adjust the rate of flow

according to the doctor’s
order.
19. Complete the label and tape
it to the IV bag/bottle.

20. Do the aftercare of equipment

and wash hands.

21. Document the procedure and

the patient’s response. Chart the
time, site, device used, solution
and rate of flow and the
physician or nurse who inserted the needle.

22. Monitor patient periodically.

Nursing alert:

If infusion is not flowing well, lower the

bottle/bag to check if the line is still
patent

DAGANGON
Common acronyms used in
iv therapy
•C/D (consume and discontinue)
• KVO (keep vein open)

• D/C (discontinue)

• KSS (keep set sterile)

DAGANGON
COMPLICATIONS
ASSOCIATED
WITH IV THERAPY

DAGANGON
SYSTEMIC
COMPLICATIONS
COMPLICATIONS ASSOCIATED WITH IV THERAPY

DAGANGON
FLUID
R L O A D
OVE SIGNS AND SYMPTOMS_________________________________
• Moist crackles upon lung auscultation
• Edema
• Weight gain
• Dyspnea
• Shallow respirations and increase rate
INTERVENTION_________________________________________
• Decreasing the IV rate
• Monitoring vital signs frequently
• Assessing breath sounds
• High Fowler’s position.
• Contact physician stat
 MANIFESTATION___________
• dyspnea and cyanosis AIR E
• hypotension MBO
• weak, rapid pulse LISM
• Loss of consciousness
• chest, shoulder, and low back pain.

INTERVENTIONS___________________________________
___
• Clamping the cannula
• Placing the patient on the left side in the
Trendelenburg position
• Assessing vital signs and breath sounds,
• and administering oxygen.
 SEPTICEMIA
& OTHER INFECTIONS
Signs and symptoms________________________________
• abrupt temperature elevation
• backache, headache
• Increased pulse and respiratory rate,
• Nausea and vomiting,
• diarrhea, chills and shaking,
• general malaise
Prevention__________________________________________
• Strict aseptic technique
• Examine IV bag for cracks, leaks
• Inspecting the IV site daily
• Replacing the peripheral IV cannula every 48 to 72 hours
• Removing the IV cannula at the rst sign of local inammation,
contamination, or complication
LOCAL
COMPLICATIONS
COMPLICATIONS ASSOCIATED WITH IV THERAPY

DAGANGON
 T R A T I O N
INFIL

•Inltration is the
unintentional
administration of a
nonvesicant solution
or medication into
surrounding tissue
 r at i o n
Infilt
• Occurs when the IV
cannula dislodges or perforates the wall of
the vein.
• characterized by edema around the
insertion site, leakage of IV uid from the
insertion site, discomfort and coolness in
the area of inltration, and a signicant
decrease in the ow rate.

DAGANGON
Infiltration
Intervention:

• Remove IVF
• Apply cold compress (recent), warm
compress (long period)

DAGANGON
• Similar to inltration, with an inadvertent administration of
vesicant or irritant solution or medication into the surrounding
tissue.
• Medications such as dopamine, calcium preparations, and
chemotherapeutic agents can cause pain, burning, and
redness at the site.
• Blistering, inammation, and necrosis of tissues can occur.

Intervention_____________________________________________
• Notify physician
• Stop infusion immediately
• Apply warm or cold compress

I O N
A S AT
T R AV
E X
• inammation of a vein related to a chemical or
mechanical irritation, or both.
• It is characterized by a reddened, warm area around
the insertion site or along the path of the vein, pain or
tenderness at the site or along the vein, and swelling

Intervention__________________________________
• Discontinue IV
• Apply a warm, moist compress to the affected site.

B I T I S
PHLE
 IVF follow up
Procedure

DAGANGON
Regulating IV Infusion
Purpose:
• To comply with the prescribed rate ordered by the
physician
• Regulating IV Infusion
• To maintain an equal & constant rate of fluid
administration throughout the duration of the infusion.

• To assist in reassessing the progress of the fluid infusion.

• To prevent circulatory overload or insufficient correction

of hypovolemia.

DAGANGON
Nursing Considerations:
• Read the current written medical order for the
volume & number of hours of infusion.

• Determine the manufacturer’s drop factor &

the ratio of drops per millimeter.

• The hourly rate of infusion will not deviate by

more or less than 25% of the hourly calculated
rate.

DAGANGON
 Equipment:

• Jot down notebook &

ballpen.
• Wrist watch with a second
hand.
• IV tag
• IV bottle

DAGANGON
IV TAG
Davao Doctors Hospital
  IV TAG

Date:___________
 
Name:_______________RM #:___________
IVFluid:______________________________
Incorporation:________________________
Rate:________________________________
Time started:_________________________
Time ended:__________________________
Signature:____________________________
 
  DAGANGON
 PROCEDURE

1. Check the Start IVF P

NSS 1L @
physician’s order. 120cc/hr

2. Wash hands and

prepare needed materials.

DAGANGON
3. Countercheck the
available IV solution
against the doctor’s
order.
4. FILL UP the necessary
data in the IV tag.
5. Calculate the flow rate using standard formula

Standard Formula:
Rate = Volume (cc) x gtt factor (gtts/cc)
Duration (hrs) x 60 min/hr

Duration = Volume (cc) / RATE = hours to tun

ex: 1000ml/ 100ml/hr =10hours

If ml/hr is known: ml/hr X drop factor

60 min
sample
6. Explain the procedure to the patient.

7. Close the regulator and remove the

IVF bottle from the IV pole and pull the
spike from the empty IV container.
8. Maintain the sterility of the spike; open
the new IV solution and insert the spike.
9. Hang the IV
solution and press
the drip chamber
and fill it halfway
with the solution.

10. Open the

regulator and
regulate the desired
rate.
11. Put the IV tag.

12. Does after care of the

equipments and proper
disposal of needles
12. Document the ff:
type of IV
amount
flow rate
time started
patient’s response
Discontinuing IV
infusion
procedure

DAGANGON
Discontinuing IV
infusion

DAGANGON
 Discontinuing IV infusion

• The pt’s oral fluid intake & hydration status

are satisfactory.
• IV lines are obstructed, dislodged & site is
inflamed.
• The medications administered by IV route are
no longer required.

DAGANGON
 equipment

An IV tray containing the following:

• Dry CB & plaster to cover the site temporarily.
• CB soaked in 70% alcohol
• Working gloves
• Waste Receptacle

DAGANGON
PROCEDURE
1. Check the physician’s order for
discontinuing IVF
2. Wash hands and assemble equipment
3. Identify and explain the procedure.
4. Close the regulator and Release
anchorage of arm, tubing & needle.
Loosen the tape @ the venipuncture site
while holding the counteraction to the
skin. DAGANGON
5. Hold a swab above the venipuncture site,
withdraw the needle quickly by pulling it
out along the line of the vein.

6. Immediately apply firm pressure to the

site, using the dry CB for 2-3 minutes.
7. Hold the client’s arm or leg above the body if
any bleeding persists.

8. Check the needle or catheter to make sure it

is intact. Report a broken needle or catheter
to the nurse in-charge immediately. If the
broken needle piece can be palpated, apply
a tourniquet above the insertion site .
9. Apply the sterile dry CB/ Band aid to cover the
IV site.
10. Discard the IV solution container & used
supplies appropriately.

11. Record the amount of fluid infused on the I

& O record sheet & on the chart. Include the
type of solution used, time, & reason for
discontinuing the infusion & the pt’s
response.
-end-

DAGANGON