Carolyn McCune, RN, MSN, CRNP Teresa Peck RN, BSN

Carolyn McCune, RN, MSN, CRNP

Teresa Peck RN, BSN

Review syllabus and course requirements

Answers any questions related to class www.emprocedures.com/index.htm Then go to Peripheral IV access

4723.171 Intravenous therapy procedures.(A) A licensed practical nurse may perform on any person any of the intravenous therapy procedures specified in division (B) of this section without receiving authorization to perform intravenous therapy from the board of nursing under section 4723.17 of the Revised Code, if both of the following apply:(1) The licensed practical nurse acts at the direction of a registered nurse or a licensed physician, dentist, optometrist, or podiatrist and the registered nurse, physician, dentist, optometrist, or podiatrist is on the premises where the procedure is to be performed or accessible by some form of telecommunication.(2) The licensed practical nurse can demonstrate the knowledge, skills, and ability to perform the procedure safely.(B) The intravenous therapy procedures that a licensed practical nurse may perform pursuant to division (A) of this section are limited to the following:(1) Verification of the type of peripheral intravenous solution being administered;(2) Examination of a peripheral infusion site and the extremity for possible infiltration;(3) Regulation of a peripheral intravenous infusion according to the prescribed flow rate;(4) Discontinuation of a peripheral intravenous device at the appropriate time;(5) Performance of routine dressing changes at the insertion site of a peripheral venous or arterial infusion, peripherally inserted central catheter infusion, or central venous pressure subclavian infusion.Effective Date: 04-10-2001

First began in the 17th century 19th century-infection control procedures mid 1950’s-used for surgery and

hydration(20%) Today approximately 90 % of pts in

hospital receive IV’s Skilled nursing homes, doctors office

and home

Fluid and electrolyte maintenance, restoration and replacement

Administer medications and nutritional feedings

Give blood and blood products Chemotherapy Patient controlled analgesics KVO for quick access

Oral medications-absorbed in the digestive tract

IV- faster acting and distributed throughout the bloodstream immediately after giving

Unconscious pt: Unable to swallow: Vomiting: Nutrition: Others?

Slides 3-6-material from Fulcher and Frazier(2007)

Pre-existing vascular compromise Regional infection

Adult: Antibiotic: Arterial Line: Aspirate: Central Line: Central Venous Access Device: (CVAD’S)

Continuous Infusions: Controlled Analgesic: Drip Factor: Electronic Pumps and Controllers: Flow Rate:ml/hr or gtts/min Infiltration: Infusion Devices:

Thru peripheral IV sites-depend on gravity for administration- must be 24-36 inches above IV sites

If patient changes positions volume decreases-back pressure greater, rate slows or stops

Simplest controllers-roller or slide clamp Use to speed up or slow, counts gtts in

drip chamber

Apply external pressure to administration set tubing to run at specified rate

Specific volume/time More accurate Alarm systems-kinks, air, occlusion Disadvantage-Cost of equipment,

maintenance, more serious infiltration.

SYRINGE PUMPS Holds prefilled syringe Positive pressure to plunger delivers

specific volume Used for small volume Insulin pumps, PCA pumps Safer, preprogramming to prevent

calculator errors

Initiate: Intermittent Infusion: (Piggyback) Intravenous: (IV) IV Bolus: IV Push: Maintain

Nurse Practice Act: (Ohio) Palpation: Peripheral: Peripherally Inserted Central Catheters:

(PICC’s) Phlebitis:

Piggyback: Roller clamp: Tourniquet: TPN: Transparent Dressing: Venipuncture: Other Terms: Questions????????

Apparatus that connects large volume parenteral solution with IV access device into patient veins

Insertion spikes Clip chamber Plastic tubing with rate control clamp Rubber injection port Needle adapter and protective cap on

needle adapter

Over needle cath left in for medical administration

Flush every 8 hours Flush before/after meds

See Handout from OBN website Chapter 4723-17

Try to access sites