Parenteral Fluid

7/27/2019 Parenteral Fluid

1/145

PARENTERAL FLUID

THERAPYMaria Carmela L. Domocmat, RN, MSNAssistant Professor

School of Nursing

Northern Luzon Adventist College


2/145

Outline Definition of IV therapy Indication of IV therapy

Type of IV solution

Nursing role in managing patient receiving IV therapy


3/145

DEFINITION OF IV

THERAPY


4/145

Definition of IV therapy

It is an effective and efficient method of supplying fluiddirectly into intravenous fluid compartment producing

rapid effect with availability of injecting large volume

of fluid more than other method of administration.


5/145

INDICATION OF IV THERAPY


6/145

PURPOSE

The choice of an IV solution depends on the purpose of

its administration.

Restore or maintain F & E

Administer meds

Provide nutrition

Transfusion

Route for blood samples


7/145

TYPE OF IV SOLUTION


8/145

Types of Solutions

Isotonic

Expand intravascular volume

0.9% Saline

D5W

Lactated ringers


9/145

Types of Solutions

Hypertonic

Draw fluid from cells

D5 in 0.45 Saline

D5 in NS

D5 LR

3% NaCl

D10W

Hypotonic

Shift fluid into cells

0.33% Saline

0.45% Saline

2.5 Dextrose


10/145

EQUIPMENT OF I.V. THERAPY


11/145

Equipment

Containers

Glass bottles

Plastic bags

Administration Sets IV set

Macro drips

Microdrips

Y ports

Buretrols

In line filters

Timing strips

Electronic InfusionDevices


12/145

IV Infusion Method

IVInfusion

Method

I.V. Bolus(I.V. push)

Continuous-drip infusion

Intermittentinfusion


13/145

Equipment of I.V. therapy

Solution containers administration sets


14/145


15/145


16/145

VENIPUNCTURE DEVICES

Equipment used to gain access to the vasculature

includes

Cannulas

needleless IV delivery systems

peripherally inserted central catheter or midline catheter access

lines.


17/145

Venipuncture Devices: CANNULAS

Most common peripheral access devices

have an obturator inside a tube that is later removed.

Catheter and cannula : used interchangeably.

main types of cannula devices available are thosereferred to

winged infusion sets (butterfly) with a steel needle or as over-the-

needle catheter with wings

indwelling plastic cannulas inserted over a steel needle

indwelling plastic cannulas inserted through a steel needle.


18/145

Scalp vein or butterfly needles

short steel needles with plastic wing handles

Easy to insert

but infiltration occurs easily

because they are small and nonpliable,

use should be limited to obtaining blood specimens or

administering bolus injections or infusions lasting only a few hours

increase the risk for vein injury and infiltration.


19/145

over-the-needle catheter

less likely to cause infiltration

available in long lengths

well suited for placement in central locations.

Parts:

Intracatheters: Plastic cannulas inserted through a hollow needle

Stylet


20/145


21/145


22/145


23/145


24/145

Venipuncture Devices: NEEDLELESS IV

DELIVERY SYSTEMS an effort to decrease needlestick injuries and exposure to

HIV, hepatitis, and other bloodborne pathogens


25/145

Blunt cannula syringe


26/145


27/145


28/145

Venipuncture Devices: Peripherally Inserted Central

Catheter or Midline Catheter Access Lines

Patients who need moderate- to long-term parenteral

therapy

For patients with limited peripheral access

obese or emaciated patients, IV/injection drug users

require IV antibiotics, blood, and parenteral nutrition.

Requires median cephalic, basilic, and cephalic veins

pliable (not sclerosed or hardened)

not subject to repeated puncture.

If these veins are damaged

central venous access via the subclavian or internal jugular vein

surgical placement of an implanted port or a vascular access

device


29/145

NURSING MANAGEMENT OF

THE PATIENT RECEIVING IV

THERAPY


30/145

Components of IV Orders

Type of Solution

Additives

Rate and volume

Duration Method


31/145

ASSESSMENT


32/145

Nursing assessment

1- assess the solution:

2- Reading the label on the solution.

3- Determine the compatibility of all fluid and additives.

No leakage SterileNo smallparticles

Clear andnot

expired


33/145

Nursing assessment

4- observe I.V sets

Cracks HolesMissing

clamps

Expired

date


34/145

Also assess the patient for :

1-Any allergies and arm placement preference.

2- Any planned surgeries.

3- Patients activities of daily living.4- Type and duration of I.V therapy, amount, and rate.


35/145

PREPARING TO ADMINISTER IV

THERAPY Before performing venipuncture

hand hygiene

applies gloves

informs patient about procedure

Select most appropriate insertion site and type of cannulafor a particular patient.


36/145


37/145

Factors influencing choices of insertion

site type of solution to be administered

expected duration of IV therapy

patients general condition

availability of veins skill of the person initiating the infusion


38/145

CHOOSING AN IV SITE

Many sites can be used for IV therapy, but ease of access

and potential hazards vary.

peripheral locations

ordinarily only sites used by nurses

arm veins are most commonly used coz safe and easy to enter

arm veins

metacarpal, cephalic, basilic, and median veins

More distal sites should be used first, with more proximal

sites used subsequently.


39/145

CHOOSING AN IV SITE

Avoid the following

Leg veins because of high risk of thromboembolism.

veins distal to a previous IV infiltration or phlebitic area, sclerosed

or thrombosed veins,

arm with arteriovenous shunt or fistula arm affected by edema, infection, blood clot, or skin breakdown.

arm on side of mastectomy because of impaired lymphatic flow.


40/145

Central veins

commonly used by physicians

subclavian and internal jugular veins.

Can gain access to (or cannulate) even when peripheral sites have

collapsed allow for administration of hyperosmolar solutions.

Hazards are much greater


41/145

Consider mobility

Inspect both arms and hands and choose the site that does not

interfere with mobility.

antecubital fossa is avoided : except as a last resort.

Take note from far to near most distal site of the arm or hand is generally used first so that

subsequent IV access sites can be moved progressively upward.


42/145

factors to consider when selecting a site

for venipuncture: Condition of the vein

Type of fluid or medication to be infused

Duration of therapy

Patients age and size Whether the patient is right- or left-handed

Patients medical history and current health status

Skill of the person performing the venipuncture


43/145

After applying a tourniquet, the nurse palpates and

inspects the vein.

The vein should feel firm, elastic, engorged, and round,

not hard, flat, or bumpy.

Because arteries lie close to veins in the antecubital

fossa, the vessel should be palpated for arterial pulsation

(even with a tourniquet on), and cannulation of pulsating

vessels should be avoided.


44/145

General guidelines for selecting a cannula

include: Length: 34 to 1.25 inches long

Diameter: narrow diameter of the cannula to occupy minimal

space within the vein

Gauge:

20 to 22 gauge for most IV fluids; a larger gauge for caustic or viscous

solutions

14 to 18 gauge for blood administration and for trauma patients and

those undergoing surgery

22 to 24gauge for elderly

Note: Hand veins are easiest to cannulate.

Cannula tips should not rest in a flexion area (eg, the antecubital

fossa) as this could inhibit the IV flow.


45/145

PREPARING THE IV SITE

Before preparing the skin, ask patient allergy to latex or

iodine

Excessive hair at selected site may be removed by

clipping

to increase the visibility of the veins and

to facilitate insertion of the cannula and adherence of dressings to

the IV insertion site.


46/145

Sites

Peripheral

arms

legs

Central

subclavian

internal jugular

uses


47/145

Figure 48.13b


48/145

Figure 48.13a


49/145

?

?


50/145

Figure 48.14


51/145

Figure 48.14b


52/145

NURSING DIAGNOSIS


53/145

Nursing diagnosis:

Anxiety (mild, moderate, severe) related to threat

regarding therapy.

Fluid volume excess.

Fluid volume deficit.

Risk for infection.

Risk for sleep pattern disturbance.

Knowledge deficit related to

I.V therapy.


54/145

PLANNING


55/145

Planning

Identify expected outcomes which focus on:

preventing complications from I.V therapy.

minimal discomfort to the patient.

restoration of normal fluid and electrolyte balance .

patients ability to verbalize complications.


56/145

IMPLEMENTATION


57/145

Implementation during initiation phase

Solut ion preparation

Label the I.V container.

Avoid the use of felt-tip pens or permanent markers on plastic

bag.

Hang I.V bag or bottle


58/145

Site preparation

1. Cleanse infusion site

The insertion site is scrubbed with a sterile pad soaked in 10%

povidoneiodine (Betadine) or chlorhexidine gluconate solution for 2 to

3 minutes

from the center of the area to the periphery

Allow the area to air day.

site should not be wiped with 70% alcohol because the alcohol negates the effect of the disinfecting solution

Alcohol pledgets are used for 30 seconds instead, only if the patient is allergic

to iodine

2. Excessive hair at selected site should be clipped with scissor .


59/145

Maintain sterility of equipment

IV device, the fluid, the container, and tubing must be sterile

Because infection can be a major complication of IV therapy

perform hand hygiene

put on gloves: nonsterile disposable gloves


60/145

PERFORMING VENIPUNCTURE

Venipuncture: the ability to gain access to the venous

system for administering fluids and medications


61/145


62/145


63/145


64/145


65/145

Source: Brunner and Suddhart, 2010)


66/145


67/145


68/145


69/145

Implementation during maintenance

phase inspect the tubing.

inspect the I.V set at routine intervals at least daily.

Monitor vital signs .

recount the flow rate after 5 and 15 minutes after

initiation

Site care

Dressings

Tubing and bag changes Prevent complications


70/145

Interm ittent f lushing o f I.V l ines Peripheral intermittent are usually flushed with saline (2-3 ml

0.9% NS.)

Replacing equ ipm ents (I.V con tainer, I.V set, I.V

dressing): I.V container should be changed when it is empty.

I.V set should be changed every 24 hours.

The site should be inspected and palpated for tenderness every

shift or daily/cannula should be changed every 72hours and if

needs.

I.V dressing should be changed daily and when needed


71/145

Regu lat ing flow rate

gtt/minmin/1h)(60minutesintime

set)gtt/ml(IV(ml/h)infusedbetovolume


72/145

MONITORING THERAPY

Maintaining an existing IV infusion is a nursingresponsibility that demands knowledge of the solutions

being administered and the principles of flow.

patients must be assessed carefully for both local and

systemic complications.


73/145

Monitoring Therapy

Flow Rate

Influences

Height of container

Diameter of tubing/cannula

Length of tubing

Viscosity

Cannula position

Position of extremity

Site care

dressings

site change

Tubing and bag changes

Prevent complications


74/145

FACTORS AFFECTING FLOW

Height of container

Flow is directly proportional to the height of the liquid column.

Raising the height of the infusion container may improve sluggish

flow.

Diameter of tubing and cannula

Flow is directly proportional to the diameter of the tubing.

The clamp on IV tubing regulates the flow by changing the tubing

diameter.

flow is faster through large-gauge rather than small- gauge

cannulas.


75/145

FACTORS AFFECTING FLOW

Length of tubing Flow is inversely proportional to the length of the tubing.

Adding extension tubing to an IV line will decrease the flow.

Viscosity

Flow is inversely proportional to the viscosity of a fluid.

viscous IV solutions (ex: blood) require a larger cannula than water

or saline solutions

Cannula position

Position of extremity


76/145

IV infusion pumps


77/145

EVALUATION


78/145

Evaluation

Produce therapeutic response to medication, fluid andelectrolyte balance.

Observe functioning and patency of I.V system.

Absence of complications.


79/145


80/145

DISCONTINUING AN INFUSION

The nurse never use scissors to remove the tape ordressing.

Apply pressure to the site for 2 to 3 minutes using a dry,

sterile gauze pad.

Inspect the catheter for intactness.

The arm or hand may be flexed

or extended several times.


81/145

DISCONTINUING AN INFUSION

The removal of an IV catheter is associated with twopossible dangers:

bleeding

catheter embolism

To prevent excessive bleeding dry, sterile pressure dressing should be held over the site as the

catheter is removed.

Firm pressure is applied until hemostasis occurs.


82/145

Catheter embolism Preventive measures

Avoid using scissors near the catheter.

Avoid withdrawing the catheter through the insertion needle.

Follow the manufacturers guidelines carefully (eg, cover the needle

point with the bevel shield to prevent severance of the catheter).

Management

If the catheter clearly has been severed, the nurse can attempt to

occlude the vein above the site by applying a tourniquet to prevent the

catheter from entering the central circulation (until surgical removal is

possible). As always, however, it is better to prevent a potentially fatalproblem than to deal with it after it has occurred


83/145

DOCUMENTATION


84/145

Recording and reporting:

Type of fluid, amount, flow rate, and any drug added.

Insertion site.

Size and type of I.V catheter or needle.

The use of pump.

When infusion was begun and discontinuing.

Expected time to change I.V bag or bottle, tubing,

cannula, and dressing.


85/145

Any side effect.

Type and amount of flush solution.

Intake and output every shift, daily weight.

Temperature every 4 hours.

Blood glucose monitoring every 6 hours, and rate of

infusion.


86/145

Documentation

Starting the IV

10/3/08 0900 hours #22 1-inch Gelco inserted on first attempt to

R cephalic vein, NS infusing via pump at 125cc/hr. Pt tolerated

procedure well. S. Wise, RNC

Discontinuing the IV 10/3/08 2000 hours IV R wrist removed without difficulty, cathlon

intact. Pt tolerated well. S. Wise, RNC


87/145

COMPLICATIONS


88/145

Complications

Local

Hematoma

Thrombosis

Thrombophlebitis

Phlebitis

Infiltration

Extravasation Infection


89/145

Local Complication

Infiltration Extravasation


90/145

Infiltration and Extravasation

Infiltration : unintentional administration of a nonvesicantsolution or medication into surrounding tissue.

occur when IV cannula dislodges or perforates the wall of

the vein.


91/145

Infiltration: S/S

edema around insertion site

leakage of IV fluid from insertion site

discomfort and coolness in area of infiltration

significant decrease in the flow rate

When solution is particularly irritating, sloughing of tissue

may result.


92/145

Closely monitoring the insertion site is necessary to detectinfiltration before it becomes severe.

How to check?

insertion area is largerthan same site of the opposite extremity

Backflow of blood into tubing proves that the catheter is properlyplaced within the vein. True or false?

If the catheter tip has pierced the wall of the vessel, however, IV fluid

will seep into tissues as well as flow into the vein.

Although blood return occurs, infiltration has occurred as well.


93/145

Closely monitoring the insertion site is necessary to detectinfiltration before it becomes severe.

How to check?

apply a tourniquet above (or proximal to) infusion site and

tighten it enough to restrict venous flow. If the infusion continues to drip despite the venous obstruction,

infiltration is present.


94/145

Management

infusion should be stopped

IV discontinued

a sterile dressing applied to the site after careful

inspection to determine the extent of infiltration.

infiltration of any amount of blood product, irritant, or vesicant isconsidered the most severe.

Start another IV infusion at new site or proximal to

infiltration if same extremity is used.


95/145

Management

warm compress to the site if small volumes of noncaustic solutions have infiltrated over a long

time

cold compress

ithe infiltration is recent Elevate affected extremity to promote the absorption of

fluid

Use standardized infiltration scale to document the

infiltration (Infusion Nursing Standards of Practice)


96/145

Standardized infiltration scale

0 = No symptoms1 = Skin blanched, edema less than 1 inch in any direction,

cool to touch, with or without pain

2 = Skin blanched, edema 1 to 6 inches in any direction, cool

to touch, with or without pain3 = Skin blanched, translucent, gross edema greater than

6 inches in any direction, cool to touch, mild to moderate

pain, possible numbness

4 = Skin blanched, translucent, skin tight, leaking, skin

discolored, bruised, swollen, gross edema greater than 6 inchesin any direction, deep pitting tissue edema, circulatory

impairment, moderate to severe pain, infiltration of any

amount of blood products, irritant, or vesicant


97/145

Prevention

Inspect site every hour for Redness

Pain

Edema

blood return coolness at the site

IV fluid draining from the IV site.

Use appropriate size and type of cannula for vein

prevents this complication


98/145

Very Serious Complications Can Occur

Infiltration Non vesicant solution

Extravasation

Vesicant solution


99/145

Extravasation

similar to infiltration with an inadvertent administration ofvesicant or irritant solution or medication into the

surrounding tissue.

Medications such as dopamine

calcium preparations chemotherapeutic agents

can cause pain, burning, and redness at the site

Blistering, inflammation, and necrosis of tissues can

occur.


100/145

Vesicant Medications/Solutions

Fluoroquinolones Cipro, levaquin, floxin

Gentamicin

Nafcillin

Penicillin

Vancomycin

Calcium chloride

Calcium gluconate

Potassium chloride

Sodium bicarbonate Cytotoxic agents

Valium

Dextrose

Dobutrex

Dopamine

Fat emulsion TPN

Dilantin

Phenergan

Diprovan

Radiographic contrast agents


101/145

The extent of tissue damage is determined by concentration of medication

quantity that extravasated

location of the infusion site

tissue response duration of process of extravasation

M t


102/145

Management

Stop infusion Notify physician promptly.

Initiate agencys protocol for extravasation protocol may specify specific treatments, including

Antidotes specific to the medication that extravasated IV line should remain in place or be removed before treatment.

infusion site be infiltrated with an antidote prescribed afterassessment by the physician and application of warm or coldcompresses, depending on the medication infusing.

extremity should not be used for further cannulaplacement.

Thorough neurovascular assessments of the affectedextremity must be performed frequently

P ti


103/145

Prevention

Review institutions IV policy and procedures andincompatibility charts and checking with the pharmacist

before administering any IV medication, whether given

peripherally or centrally

to determine incompatibilities and vesicant potential. Careful, frequent monitoring of the IV site

avoid insertion of IV devices in areas of flexion

P ti


104/145

Prevention

secure the IV line use smallest catheter possible that accommodates the

vein

when vesicant medication is administered by IV push, it

should be given through a side port of an infusing IVsolution to dilute the medication and decrease severity of

tissue damage if extravasation occurs


105/145

Phl biti


106/145

Phlebitis

inflammation of a vein related to a chemical or mechanicalirritation, or both.

S/S


107/145

S/S

reddened, warm area around the insertion site or alongthe path of the vein

pain or tenderness at the site or along the vein, and

swelling.

incidence of phlebitis increases with Length of time the IV line is in place

composition of the fluid or medication infused (especially its pH and

tonicity)

size and site of the cannula inserted

ineffective filtration

improper anchoring of the line

introduction of microorganisms at the time of insertion.

ifi t d d f i hl biti


108/145

specific standards for assessing phlebitis

Intravenous Nursing Society

Th b hl biti


109/145

Thrombophlebitis

refers to presence of a clot plus inflammation in the vein.

Th b hl biti S/S


110/145

Thrombophlebitis- S/S

Localized pain redness, warmth, and swelling around the insertion site or

along the path of the vein

immobility of the extremity because of discomfort

swelling, sluggish flow rate

Fever

Malaise

Leukocytosis

M t


111/145

Management

D/C IV infusion 1st: cold compress to decrease the flow of blood and

increase platelet aggregation

followed by a warm compress

Elevate extremity

Restart line in the opposite extremity

If (+) patient has signs and symptoms of thrombophlebitis,

the IV line should not be flushed

(although flushing may be indicated in the absence of phlebitis to

ensure cannula patency and to prevent mixing incompatible

medications and solutions).

Pre ention


112/145

Prevention

Avoid trauma to vein at time the IV is inserted, Observe site every hour

Check medication additives for compatibility

Local Complication Hematoma


113/145

Local Complication- Hematoma

Hematoma S & S

Interventions

Prevention

Hematoma


114/145

Hematoma

Hematoma results when blood leaks into tissuessurrounding the IV insertion site.

Leakage can result from

perforation of opposite vein wall during venipuncture

Needle slipping out of vein insufficient pressure applied to the site after removing the needle or

cannula.

s/s


115/145

s/s

Ecchymosis immediate swelling at site

leakage of blood at site.

Management


116/145

Management

Remove needle or cannula and apply pressure with asterile dressing

Apply ice for 24 hours to

site to avoid extension of the hematoma

then warm compress to increase absorption of blood; assessing the site

Restart the line in the other extremity if indicated.

Prevention


117/145

Prevention

carefully insert needle use diligent care when a patient has a bleeding disorder,

takes anticoagulant medication, or has advanced liver

disease

Clotting and Obstruction


118/145

Clotting and Obstruction

Blood clots may form in the IV line as a result of kinked IV tubing

very slow infusion rate

Empty IV bag

failure to flush the IV line after intermittent medication or solutionadministrations.

The signs are decreased flow rate and blood backflow

into the IV tubing.

Management


119/145

Management

If blood clots in the IV line DC infusion

Restart another site with a new cannula and administration set.

The tubing should not be irrigated or milked. Neither the infusion

rate nor the solution container should be raised, and the clot should

not be aspirated from the tubing

Prevention


120/145

Prevention

Do not permit IV solution bag to run dry Tape the tubing to prevent kinking and maintain patency

Maintain adequate flow rate

Flushing line after intermittent medication or other solution

administration.

In some cases, a specially trained nurse or physician

may inject a thrombolytic agent into the catheter to clear

an occlusion resulting from fibrin or clotted blood.

Local Complication-


121/145

Site Infection

Site infection S & S

Interventions

Prevention

Local complication-


122/145

Tissue Sloughing

Tissue Sloughing S & S

Interventions

Prevention


123/145

Systemic Complication


124/145

Systemic Complication

Circulatory or Fluid Overload Septicemia/ Systemic Infection

Pulmonary Edema

Catheter Embolism

Air Embolism

Pulmonary Embolus

Fluid Overload


125/145

Fluid Overload

Overloading the circulatory system with excessive IVfluids causes increased blood pressure and central

venous pressure.

Fluid Overload S/S


126/145

Fluid Overload S/S

moist crackles on auscultation of the lungs Edema

weight gain

Dyspnea

respirations : shallow and increased rate.

Fluid Overload causes


127/145

Fluid Overload causes

rapid infusion of an IV solution or hepatic, cardiac, orrenal disease.

risk for fluid overload and subsequent pulmonary edema

is especially increased in elderly patients with cardiac

disease; this is referred to as circulatory overload.

Management


128/145

Management

Decrease IV rate Monitor VS frequently

Assess breath sounds

Place patient in high Fowlers position

Contact physician immediately.

Prevention


129/145

Prevention

Use infusion pump for infusions carefully monitoring all infusions.

Complications of circulatory overload

include heart failure and pulmonary edema.

Air Embolism


130/145

Air Embolism

risk of air embolism is rare but ever-present. most often associated with cannulation of central veins.

Air Embolism


131/145

Air Embolism

dyspnea Cyanosis

hypotension

weak, rapid pulse

loss of consciousness

chest, shoulder, and low back pain.

Management


132/145

Management

Immediately clamp the cannula Place patient on the left side in Trendelenburg position,

Assess VS and breath sounds

Administer oxygen.

Prevention


133/145

Prevention

Use a Luer-Lock adapter on all lines filling all tubing completely with solution

Use an air detection alarm on an IV pump.

Septicemia and Other Infection


134/145

Septicemia and Other Infection

Pyrogenic substances in either the infusion solution or theIV administration set can induce a febrile reaction and

septicemia.

S/s


135/145

S/s

abrupt temperature elevation shortly after the infusion isstarted

Backache

Headache

increased pulse and respiratory rate

Nausea and vomiting

Diarrhea

chills and shaking

general malaise.

In severe septicemia:

vascular collapse and septic shock

Causes of septicemia


136/145

Causes of septicemia

contamination of the IV product or a break in aseptictechnique

especially in immunocompromised patients.

Management


137/145

Management

Treatment is symptomatic culturing of the IV cannula, tubing, or solution if suspect

establishing a new IV site for medication or fluid

administration.


138/145

Infection ranges in severity from local involvement of theinsertion site to systemic dissemination of organisms

through the bloodstream, as in septicemia.

Measures to prevent infection are essential at the time the

IV line is inserted and throughout the entire infusion.

Prevention


139/145

Prevention

Careful hand hygiene before every contact with any partof the infusion system or patient

Examine the IV containers for cracks, leaks, or

cloudiness, which may indicate a contaminated solution

Use strict aseptic technique

Prevention


140/145

Prevention

Firmly anchor the IV cannula to prevent to-and-fromotion

Inspect the IV site daily and replace a soiled or wet

dressing with a dry sterile dressing. (Antimicrobial agents

that should be used for site care include 2% tincture of

iodine, 10% povidoneiodine, alcohol, or chlorhexidine,

used alone or in combination.

Prevention


141/145

Prevention

Remove the IV cannula at the first sign of localinflammation, contamination, or complication

Replace the peripheral IV cannula every 48 to 72 hours,

or as indicated

Replace the IV cannula inserted during emergencyconditions

(with questionable asepsis) as soon as possible

Prevention


142/145

Prevention

Use a 0.2-micron air-eliminating and bacteria/particulateretentive filter with non-lipid-containing solutions that

require filtration.

The filter can be added to the proximal or distal end of the

administration set.

If added to the proximal end between the fluid container and the

tubing spike, the filter ensures sterility and particulate removal from

the infusate container and prevents inadvertent infusion of air.

If added to the distal end of the administration set, it filters air

particles and contaminants introduced from add-on devices,

secondary administration sets, or interruptions to the primary

system

Disposable Infusion Set IV Filter


143/145

Disposable Infusion Set IV Filter

Prevention


144/145

Replace solution bag and administration set inaccordance with agency policy and procedure

Infuse or discard medication or solution within 24 hours of

its addition to an administration set

Change primary and secondary continuous administrationsets every 72 hours, or immediately if contamination is

suspected

Change primary intermittent administration sets every 24

hours, or immediately if contamination is suspected

References


145/145

Brunner, L. S., Suddarth, D. S., & Smeltzer, S. C. O.(2008). Brunner & Suddarth's textbook of medical-

surgical nursing (11th ed.). Philadelphia: Lippincott

Williams & Wilkins.

http://webhome.broward.edu/~gbrickma/Slides/IV%20Therapy%209-12-08.ppt

http://www.mc.vanderbilt.edu/root/sbworddocs/proceed_n

ursing/Revised_web_IV_therapy.ppt

http://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20ther

%202
http://webhome.broward.edu/~gbrickma/Slides/IV%20Therapy%209-12-08.ppthttp://webhome.broward.edu/~gbrickma/Slides/IV%20Therapy%209-12-08.ppthttp://www.mc.vanderbilt.edu/root/sbworddocs/proceed_nursing/Revised_web_IV_therapy.ppthttp://www.mc.vanderbilt.edu/root/sbworddocs/proceed_nursing/Revised_web_IV_therapy.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://uqu.edu.sa/files2/tiny_mce/plugins/filemanager/files/4300164/Type%20and%20indication%20of%20IV%20therapy%202.ppthttp://www.mc.vanderbilt.edu/root/sbworddocs/proceed_nursing/Revised_web_IV_therapy.ppthttp://www.mc.vanderbilt.edu/root/sbworddocs/proceed_nursing/Revised_web_IV_therapy.ppthttp://www.mc.vanderbilt.edu/root/sbworddocs/proceed_nursing/Revised_web_IV_therapy.ppthttp://webhome.broward.edu/~gbrickma/Slides/IV%20Therapy%209-12-08.ppthttp://webhome.broward.edu/~gbrickma/Slides/IV%20Therapy%209-12-08.ppthttp://webhome.broward.edu/~gbrickma/Slides/IV%20Therapy%209-12-08.ppthttp://webhome.broward.edu/~gbrickma/Slides/IV%20Therapy%209-12-08.ppthttp://webhome.broward.edu/~gbrickma/Slides/IV%20Therapy%209-12-08.ppthttp://webhome.broward.edu/~gbrickma/Slides/IV%20Therapy%209-12-08.ppthttp://webhome.broward.edu/~gbrickma/Slides/IV%20Therapy%209-12-08.ppthttp://webhome.broward.edu/~gbrickma/Slides/IV%20Therapy%209-12-08.ppthttp://webhome.broward.edu/~gbrickma/Slides/IV%20Therapy%209-12-08.ppthttp://webhome.broward.edu/~gbrickma/Slides/IV%20Therapy%209-12-08.ppthttp://webhome.broward.edu/~gbrickma/Slides/IV%20Therapy%209-12-08.ppt

Documents

Parenteral Fluid