Nursing Management in Intravenous Therapy  Infusion therapy is initiated by a health care provider who prescribes the type and

amount of solution, additives and rate of flow.  When administering parenteral fluids, the nurse monitors the patients response to the fluids, considering the volume, the fluid content, and the patients clinical status. Preparing to Administer Intravenous Therapy      Hand hygiene Applies gloves Informs the patient about the procedure Selecting appropriate insertion site Type of cannula

Choosing an Intravenous Site eins of the extremities are designated as peripheral locations and ordinarily the only sites used by nurses.  Metacarpal  Cephalic  Basilica  And median veins and their branches are recommended sites.  Leg veins rare  Central venous vein  Subclavian  Internal jugular veins  Sites to avoid:  Phlebitis area  Thrombosed veins  An arm with AV fistula / graft  Edematous  Infection  Blood clot  Skin breakdown  Arm on the side of mastectomy  Factors considered when selecting site:  Condition of the vein  Type of fluid or medication to be infused  Duration of therapy  Patients age and size  Whether the patient is left or right handed 

 Skills of person performing the venipuncture  The vein should:  Feel firm, Elastic  Engorged and round  Not hard, flat or bumpy.  General guidelines in selecting a cannula:  Length: 0.75 to 1.25 inches long  Diameter: narrow diameter of the cannula to occupy minimal space within the vein.  Gauge: y 20 to 22 for most IV fluids y 14 to 18 for blood administration and for trauma patients and those undergoing surgery y 22 to 24 for elderly patients Selecting Venipuncture Devices 1. Cannulas y Winged infusion sets with a steel needle y over the needle catheters with wings commonly used infusion device y Indwelling plastic cannula that is inserted over a steel needle. y Indwelling cannula that is inserted through a steel needle. Biocompatibility characteristic of catheter which ensures that inflammation and irritation do not occur. 2. Needleless Intravenous Delivery System y Piggybank Delivery 3. Peripherally inserted central catheter or midline catheter access lines y Patients who need moderate to long-term parenteral therapy y Used for patients with limited peripheral access who require antibiotics, blood and parenteral nutrition. y Had the advantage of reducing cost y Avoiding repeated venipuncture y Decreasing the incidence of catheter-related infections y Used of dominant arm is recommended y The size of the catheter lumen is based on the:  Type of solution, Patients body size, Vein to be use