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Purposes of IVF’s

Purposes of IVF’s. Continuous-fluid replacement, correct acid-base imbalances, nutrition, medications Intermittent-medications or bolus fluids. Types of IVF’s. Hypotonic- Hypertonic Isotonic Electrolytes TPN Blood. Methods of Delivery. Peripheral-arms, legs, scalp Central-subclavian

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Purposes of IVF’s

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  1. Purposes of IVF’s • Continuous-fluid replacement, correct acid-base imbalances, nutrition, medications • Intermittent-medications or bolus fluids

  2. Types of IVF’s • Hypotonic- • Hypertonic • Isotonic • Electrolytes • TPN • Blood

  3. Methods of Delivery • Peripheral-arms, legs, scalp • Central-subclavian • PICC-antecubital • Midline-antecubital but not as long • Ports-implanted reservior

  4. Initiating IVF’s • Verify order • Inform patient • Assess patient-risk for FVE, labs, S&S FVD • Review patient’s condition,allergies • Choose site if peripheral-RN- other sites by MD or specially trained RN • Prepare IVF

  5. Site Selection • Hands & arms preferred-distal to proximal • Name that vein! • Cannula size? What are the IVF’s & how long is therapy? • Condition of vein? “My veins roll.”

  6. Starting IVF’s • Site chosen! • Attempt X2! STOP! Call someone else! • Start flow-observe site-infiltration • Reassess patient • Reassess flow rate • IVF’s=I&O

  7. IVF Maintenance • Assess site q 4 hr • Assess VS, lungs sounds, edema, cough • Assess labs-lytes • IV site change q 72 hr & tubing for peripheral • Blood- tubing each unit • TPN-tubing q 24 hr

  8. Discontinuing IVF’s • Verify order • INT/Hep lock/Saline lock • Remove cannula-inspect • Cover site-pressure if needed • Discard all materials • Reassess site

  9. Complications of IVF therapy • Infiltration/extravasion/phelebitis • Infection • Embolism-air • Metabolic • Electrolytes • FVD • Allergic reaction-latex or blood

  10. Preventing Complications • Verify order-6 rights of drug administration • Assess site • Assess labs • Assess lung sounds,edema cough

  11. Blood Administration • Informed consent • Patient right to refusal • Site • 18 gauge preferred • Lab to perform T & C • Go to blood bank-sign for blood • Adm over prescribed time

  12. Types of Blood Products • Whole blood (500 mL) • PRBC’s-autologus vs donor (250 mL) • Platelets (125 mL) • FFP (200 mL) • Check bag for specific amount (I&O) • Assess compatability

  13. More Bloody Maintenance • VS prior to blood product then follow policy • Saline is primary, blood secondary • Use only blood adm tubing-filter • Hang time- 4 hr or< • VS when discontinue and 1 hr p unit • Return to lab for each unit • Have #2 RN to verify patient & unit each time • Patient must have blood band-lab/T&C

  14. Complications of Blood Administration • Febrile non-hemolytic • Acute hemolytic • Allergic • Overload • Bacterial • Iron overload • Diseases

  15. Documentation of IV Therapy • Time, site, IVF, rate, pt condition & tolerance • IV site assessment • FVD • Other

  16. Healthcare personnel involved in IVF’s • Physician • RN • Pharmacy • Lab • Case Manager • Home Health

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