RE/PHARM -CHAPTERS 3 & 4

Intravenous Drug Therapy

& Dose Calculation

OBJECTIVES

Upon completion of these chapters the student will be able to: Clinical implications for IV use Selection of appropriate equipment Care and discontinue IV Maintain central line IV Correctly administer meds through IV Identify complications of IV use

IMPLICATIONS FOR USEWhen the patient is receiving intravenous infusion therapy, the RN is responsible for understanding why the therapy is needed and potential outcomes for the patient.

IMPLICATIONS FOR USE

Maintain homeostasis by: Replacing fluids, electrolytes, calories, nutrients

Provide fluids, electrolytes, calories, nutrients

Transfuse blood/blood products

Administer medications

TYPES OF SOLUTION

D5W=5% dextrose-Isotonic D10W= 10% dextrose- Hypertonic D5 and ½ NS=5% dextrose & 0.45NS-Hypertonic NS=0.9NaCl-Isotonic LR=Lactated Ringer’s-Isotonic Plasma Expanders= Dextran-Isotonic

EQUIPMENT / MAINTENANCE

Equipment-p.78,81,83,84 Electric infusion devices/Pump Pole Volume control set/solution Needle –Butterfly & Angio-cath Occlusive drsg./tape

Maintenance The RN’s highest priority during IV infusion

therapy is maintaining the patency of the IV Assess site hrly

INITIATING AN IV

7 rights Explain procedure to patient Wash hands Organize equip & supplies Gloves *We will practice further steps in Lab-yippie!

DOSE CALCULATIONDDDH X Quantity

Rate for gtts/minVolume Time (minutes) X drop factor

Rate for mL/hrVolumeHour X 60

DOSE CALCULATION IV flow rate: Volume divided by time X drop

factor = rate (gtts/min)

Dr. orders D5 ½ NS @1 L/hr to infuse over 8hrs 1000 mL divided by 8 divided by 60 x 10 (gtt factor) =

20.8 gtts/min (round to 20 or 21)

Dr. orders NS 400 mL IV over next 2 hrs (gtt factor is 10) 400 mL divided by 2 divided by 60 x 10 = 33 gtt/min

A nurse is to administer 500mL NS over 4hrs 500 divided by 4hrs (4 x 60=240) 500 divided by 240 x

60=124.9 mL/hr

Dr. orders Ampicillin 500 mg in 100 mL D5W to infuse in 30 minutes 100 mL divided by 0.5 hr =200 mL/hr