I'bo<phoru< level. in . . co .. of 4.5 mEqIL are Nfl.;"ont ",ith
/rJP"rp/w'pha-"mid. H),poc.lcemia i •• freq""nt CODromitant OCCUlTence, It .Iw is. freq""nt COIl",!""""e of re",,1 failure. tWlo The tre.tment for hYP"!pI>osphatemi. i. the .. "", '" for h),po<.kemi. beeau><-)"", .. rum calcium 1e",1s carry more seriou.
COIl>e-qococe> than doe. an .. ce .. of pho.phorus.
Summary
~luid and electrolytes perf 0l1'Il vitol fuoctioo. in .... in .. ining homeostlI.i., Ur>derstand in g the COH\f>05itioo of fluid and <Iertrol )1", in body fluid oom p2C1m<n", their homeostatic mechanism •. and the role of ley electrolyte> in maint1ining the fuoctioo of the", fluid compartment. and in maintoining metlIbolic fuoction i.
requi,ite to ur>de"tandinB indications fC4" LV. the~,
Quiz
I. Whioh of the fonov.'ing poIion" i, 1m" ,u",eptible to dehydntion' (a) An obese middle_.ge female
(b) A IIOfTTIOI"izN. he.lthy adult ITIlIle (e) An elderly but he.lthy IIIlIle
(d) A IIOfTTIOI"izN. he.lthy 12_month-<>1d iofatlt
2. The majority of body fluids <OIl he fOllnd in "'hioh compartment'
,.)
lntr-.rellular''l
E."""" lIu lar (0) lnte",jtium''l
lntnv ...l..-" I.V. Therapy Demystified
]. Which of the followin~ i. the major <iel<rmimnl of colloidal o,motic f'I"'''u", (COP) "'johin ,he in"",,,,,,ul .. compartment'
(.J
Sodium<'J
F\:.t ... ium (,) Fibrino~e"!',
Albumin4. Movement of water ""roM • ><mipenneable membnne from an
are. ,,'i'"
a """"' «>ne<!I'r>.tioo of ",lu'e to an >rea with. ""'k' roocontr:ation of
",Iule i. the definition of (0) diffu,ion.
(b) osrJI05;'.
(oj the pon .ystem.
(d) the ""mpy'tem.
~, Aldosterone f""ilila"" ,m.1 r<absorpiioo of which of the following electrolyte,?
(0) Sodium (b) Chloride (cj I\:.t."ium (d) M.gnesium
6. A ""II ... Id shrink if it were placed in a bath of ,",'h",h of the f<>lm'ing
t)'I"" of
""1,,,;00,'
(0) lS<JIooi<
(b) H)'poIooi<
(cj H)'penoo", (d) Saline
7 Which type of ronditioo can cau"" hyperchlocemi.?
(.j Mo.molic .Ik ... i.
(b) Mo.molic acidosis (oj Respiratory .Ih l",;.
(d) Re.piratory acidosis
CHAPTER 2 Fluids and Electrolytes
!. WhaI i. Ill< """",,,,,,ndcd
illlnO".""'"
inf ..."It.
of poIU>i.m in • ptiIOnt "'00 .. hypok ... mit:1(.) N<> mon than 10 ml:.q.1l in ...
MImo","
od ... iooI. lfa antnoll.V. ~". i • ....d. "" """" than :!Oml'4h
(b) N<> """" """ 20
mEq
by tV puolo(e) N<> """" ""'" Xl
mEq '" •
bolus _(d) N<> """" ""'" 10 mI:q in • «fIltaltV I;'" bal.
9. T,""""", of ~~"moll)'pooaIly i .... 'hu (.) m.ydrsuoo tV. thofapy.
(b) p"',,'rm LV ... . (e) hrmodialy ... .
(d)b~ ... _ .
CHAPTER 3
Intravenous Therapy Delivery Systems
learning Objectives
Aftef oompl .. in~ this chaf>l<r.
m.
I."""" "'illDe.<ribe f.>lure, of commonly ">Cd iolnve""". (LV.) ,be",!,), ron""oeB.
iocluding gl ... boul •• and plastic bag •.
D<fioe common terms u<ed in d....,ribing the ""up of1. V. administr:a,ioo sets.
iocluding spiking .nd priming.
Compare and o<>n'",,' indic>tion. for use of primary .nd secondary infu.ion "' ...
OI!I Identify indicaI;oo, for rue of """,h2nic.1 and elec1ronic inru,ioo deli,'ery 'Y'l<m"
eopyr., ... """" by r ... Como ... , , ... COot _ _ ... '" " .
" I.V. Therapy Demystified
Accu ... ly cak"hte J. v. drip ",te. when ~i"en . . """ific LV. admin;"""ion prescripti"" and a >pe<ific tYJ>< of LV. admini>!"",on .. t.
Describe featu,e> commonly .vailabl. in m.ny electronic infu,ion de·,ice •.
Luer locl. SpilinB
Key Terms
Primary infu,ion ....
SecoOOary infu,ion .. ts
futen.ion ~
Primin~
Dropf .... C4"
Macrodrop ..,,, Microdrop .. "
Introduction to Intravenous (!.V.) Therapy Delivery Systems
1he nu '''' mu>! be comfortable wa-ki og with commonly used LV. !he",!,),"'1" i""",nt in oru.r to ... ".re Ill .. ,he patient """'>es !he ;"fu.;on of fluid •. bloOO component •.
.... die .. i"" •. or "utrie"I> Ill .. i. prescribed by !he physic i.n or the advanced_pnct;c.
clinic;"" "'jill prescript;, .. authority authorized by hi. or "," ""I""',;ve gm..,ming
"",e bootd of """ing or med",jflf, An advaoced_pnctico clinic;"" ,,-he has Ihi.
l),pe of "uthoriz>,ion may include a n""",, ~ili"""r. nu"" midwife. nu""
""',,"'.,,; ... or pill';";"" .. ,i'l2Ill.
Any infu';oo deli.erN to. !"'tien! by lhe LV. roo .. mo" be oterile. Of p,,,hogeRS that are introduced may cau", septicemia, n.e",fore. ,II connecting po." bet .. ""n LV, cooa i ... , lilIeS, filters. ,nd """"" device. must "'lTIlIin secure.oo .terile. It i.
oot nec=ary th,t the nu"", "'0'" ~k",.". when ""tin~ up ,n odmini.tnItKln "".
How"wr. the n ... mu .. wash hi. or her h.nd. thorou~hly .00 vigorou.Jy prioI to .. ttin~ up "" l. V, admini .. "'tioo .. t .00 must be < .... ful not to touch or otberwise
<OIItaminate open port. or tips before they "'" oonnec1M into the .ystem. Connec1OB
""""'" :.s Loec locks "'" odvoc,t..J bee,use they provide • """u", """,,·_type
<OIInertiOll bet .. '""n connecting I, V, li"" • .oo hub> of l.V. o<ce .. dev;"",.' T""in~
intorroonertin~ part. of the I, V, ><Imini ... tiOll
"""I'.
thoogb performed commonly in years1"".
i. oot ><IVOC.tM,·CHAPTER 3 Intravenous Therap'i Delive ry Sy e >le",mc' '--' '' ' - '
Infusion Containers
Intr;,..""" ... infu.ion coot';""B «>me in • ,.,.m.,.y of size> that ~ge from 50 to over 2000 mL One liter (i,e., 1000 mL) i, the most rommoo LV, infuYon COII!:';""r size .mpJoyed fC4" infuYon of the ... f"""",ndy u>ed LV ... ution •. which arecalled Cf)"laIloid, and >re discu..oo in Olapter 7.
'I .
The nu"" obould .iwally in>pect the lV. infu.ion coot.i"... pric4" to .piking it with an infuOOa oct, Spil;in~ an lV.OOfltlIiner with an infu.ion oct "",an, that the >teri Ie ti p of the infuOOa .. t 1= pen!'tr;ued the .. al of the cont.aillCl. If the ..,]ulion "I'P""'" di>OOlored. noI of unifonn ooIor,
0.-oontai". any panicul .. e matter. the oont>iller i. di",;uded. The ronLaincf srould noI
he crxked 0.-otherwi", "I'JI<2' viol.ted. or it lik.".,i", srould he discarded.
There ... two type> of lV, infuYon con .. in<=-~l.ass boItle. and plastic bag •.
No matte! "hich type of container i. u>ed. and no matter whetherC4" noI on infu,ion pump i. used to .id in the preci« deli~ of the prescribed ",lutiOll. i, i. good prxtice to adhere. time tape to the .ide of the ront>i nero The ti me tape ... mini mum srould note the ,ime .nd date Ib .. the coot.iner ",.. .piked (or """e.sed by .n LV.
infu.ioo set), the initi.l. of the nu"" who .pikod the cooLaine.-. and inc",,,,,,ntal RWlinp that denole "PP"'-'imate time. that solu,ion srould empty from the oontainer, If there i •• change in order of 'Il< delivery nte of the ..,Iution, then the time tape .1", should he oltered to refleet this change,