IV therapy
Prescriptions
Crystalloids = isotonic, hypotonic, hypertonic
Colloids = blood
Prior to administration
Type and cross
Informed consent
baseline vitals
Baseline fluid volume stats
Gather equipment
Check order and blood unit - verify with two RN's
Expands circulating blood volume
Hypovolemia, hypoabluminemia, burns
Risk for Fluid volume excess
Infiltration
Pallor, local swelling, decreased skin temp at site, damp dressing slow infusion
Stop and elevate extremety encourage active ROM cold or warm compress
Used in trauma
Used with significant bleeding, burns, dehydration, shock
Considerations
Must start within 30 min of removing from fridge
Run slowly for first 15 min(20-30mL/min)
Observe for AE
After 15 min if no AE increase rate
Unit should be done in 4 hours
Change out tubing every 2 units if instilling multiple
Extravasation
Pain, burning, redness, swelling
leakage from entry site to surrounding tissue
stop and notify provider
Packed Red blood cells
Increase RBC mass
Low Hgb and/or Hct
symptomatic anemia
Transfusion reactions S/S
Restlessness
Hives
N/V
Torso or flank pain
SOB
Flushing
Hematuria
Fever or chills
Fluid volume overload
Distended neck veins, increased BP, Tachycardia, shortness of breath
Slow rate or infusion, raise head of bed
Platelets
Increase platelet count
used in aplastec anemia, chemo induced
Severe bleeding d/t decrease in platelets
Polypharmacy
Mutiple med usage
Older population, chronic ill at risk
Parenteral nutrition
Short term- 3-5 days
Can be given peripherally, usually 5% dextrose and 1/2NS
Weeks to months
Given through central line
Can have separate bag of fat emulsion
fluid consists of water, sugar, electrolytes, proteins, vitamins
Plasma
Replaces coagulation factor
Active bleeding, massive hemorrhage
extensive burns, shock