Parenteral Administration: Intravenous Route
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introduction of fluids directly into the venous bloodstream.
Intravenous (IV) adminstration
an apparatus that connects a large volume of parenteral solution with the IV access device in the patient's vein.
IV administration set
Which of all the parenteral routes is the most rapid because it bypasses all barriers to drug absorption?
Intravenous (IV) administration
All IV therapy requires a written order from a health care provider that is:
- has type of solution or medication
- the dosage
is defined by the INS as the use of the nursing process as it relates to technology and clinical application, fluids and electrolytes, pharmacology, infection control, pediatrics, transfusion therapy, oncology, parenteral nutrition, and quality assurance.
Drugs can be administered by IV in three ways:
- direct injection with a needle in the vein
- continuous infusion through peripheral or Central IV
The (INS), a professional nursing organization, publishes the Infusion Nursing Standards of Practice and the Centers for Disease Control (CDC) publish recommendations for infection control relating to infusion therapy.
Infusion Nurses Society
Publishes recommendations for infection control relating to infusion therapy.
Centers for Disease Control (CDC)
Chambers- used for IV fluids administered more than 100mL per hour.
chambers-used when a small volume of fluid is being administered (less than 100mL per hour) or for accurate volume administration for neonatal and pediatric patients.
constricting devices that regulate flow by being adjusted while the nurse counts the number of drops that pass through the drip chamber per minute; not very accurate
Roller and slide clamps
applies external pressure to the administration set tubing to squeeze the solution through the tubing at a specific rate;
Pumps/ Volumetric IV controllers
devices used for short term use in the peripheral veins in the hand and forearm; should be changed every 72 hours to prevent infection and phlebitis; blood samples should never be drawn from these
Peripheral Devices (blood should never be drawn from peripheral catheters)
devices often left in place for 2-4 weeks; catheters are flexible and are inserted at the antecubital site and advanced to the distal subclavian vein; have lower rates of infection and phlebitis than with peripheral catheters; cost less than central venous catheters; blood should not be drawn from this type of catheter
devices that are used when the purpose of therapy dictates (e.g. large volumes, irritating medications, or hypertonic solutions such as TPN's are to be infused); when peripheral sites have been exhausted because of repeated use or the condition of veins for access is poor; when long-term or home therapy is required; and when emergency conditions mandate adequate vascular access.
Most common used sites for Central Line insertion:
Inserted into the superior vena cava or just outside the right atrium by way of the antecubital space; blood should not be drawn through these; TPN should not be given through these; these can remain in place for 1-3 months or longer if properly cared for.
Peripherally inserted Central venous catheters (PICCs)
surgically placed in an outpatient procedure under local anesthesia; inserted into the subclavian vein and advanced to the superior vena cava`
Tunneled Central Venous Catheters
Three common types of Tunneled central venous catheters
placed into central veins for long-term therapy of IV fluids, medications, total parenteral nutrition, and blood products; also referred to as Port-A-Caths; this type of access is implanted and sutured into a subcutaneous pocket in the chest area; must be accessed with a 90 degree angle Huber needle
Implantable venous infusion ports
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