Question

• Discuss action, indication, side effects, adverse effects, nursing considerations/ patient education associated with administration of electrolytes, Blood and IV infusions.

Answer 1

Ans) Intravenous therapy is treatment that infuses intravenous solutions, medications, blood, or blood products directly into a vein. Intravenous therapy is an effective and fast-acting way to administer fluid or medication treatment in an emergency situation, and for patients who are unable to take medications orally.

- Approximately 80% of all patients in the hospital setting will receive intravenous therapy.

The most common reasons for IV therapy include:

• To replace fluids and electrolytes and maintain fluid and electrolyte balance: The body’s fluid balance is regulated through hormones and is affected by fluid volumes, distribution of fluids in the body, and the concentration of solutes in the fluid. If a patient is ill and has fluid loss related to decreased intake, surgery, vomiting, diarrhea, or diaphoresis, the patient may require IV therapy.
• To administer medications, including chemotherapy, anesthetics, and diagnostic reagants: About 40% of all antibiotics are given intravenously.
• To administer blood or blood products: The donated blood from another individual can be used in surgery, to treat medical conditions such as shock or trauma, or to treat a failure in the production of red blood cells. The infusion restores circulating volumes, improving the ability to carry oxygen and replace blood components that are deficient in the body.
• To deliver nutrients and nutritional supplements: IV therapy can deliver some or all of the nutritional requirements for patients unable to obtain adequate amounts orally or by other routes.

- Guidelines Related to Intravenous Therapy
The following are general guidelines for peripheral IV therapy:

I• V fluid therapy is ordered by a physician or nurse practitioner. The order must include the type of solution or medication, rate of infusion, duration, date, and time. IV therapy may be for short or long duration, depending on the needs of the patient.
• IV therapy is an invasive procedure, and therefore significant complications can occur if the wrong amount of IV fluids or the incorrect medication is given.
• Aseptic technique must be maintained throughout all IV therapy procedures, including initiation of IV therapy, preparing and maintaining equipment, and discontinuing an IV system. Always perform hand hygiene before handling all IV equipment. If an administration set or solution becomes contaminated with a non-sterile surface, it should be replaced with a new one to prevent introducing bacteria or other contaminants into the system.

• Understand the indications and duration for IV therapy for each patient. Practice guidelines recommend that patients receiving IV therapy for more than six days should be assessed for an intermediate or long-term device.
If a patient has an order to keep a vein open, or “TKVO,” the usual rate of infusion is 20 to 50 ml per hour.

- Complications may occur with IV therapy, including but not limited to localized infection, catheter-related bloodstream infection (CR-BSI), fluid overload, and complications related to the type and amount of solution or medication given.
For an infusing peripheral IV, the site must be assessed every 2 hours and p.r.n.
A saline lock site must be assessed every 12 hours and p.r.n.

- An IV therapy nurse inserts, monitors and removes an IV used to give medications, blood products and nutrition to a patient. During the IV therapy, the nurse monitors the patient for adverse reactions and ensures that the tubing, bandages and needle stay in place.