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IV Infusion Preparations Fluid and Electrolytes: DR Anita Janadri

This document provides information on intravenous (IV) fluid preparations and therapy. It defines IV therapy as the infusion of fluids or medications directly into a vein. It discusses the purposes of IV infusion such as fluid replacement when oral intake is not possible or maintaining electrolyte balances. It also describes the distribution of body fluids and electrolytes between intracellular and extracellular fluid compartments. Furthermore, it explains the concepts of isotonic, hypotonic and hypertonic solutions and how they impact fluid movement across cell membranes. Finally, it lists various types of IV infusates such as crystalloids, colloids and dextrose solutions as well as indications for IV therapy and necessary equipment.

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Mohamed Rasool
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64 views

IV Infusion Preparations Fluid and Electrolytes: DR Anita Janadri

This document provides information on intravenous (IV) fluid preparations and therapy. It defines IV therapy as the infusion of fluids or medications directly into a vein. It discusses the purposes of IV infusion such as fluid replacement when oral intake is not possible or maintaining electrolyte balances. It also describes the distribution of body fluids and electrolytes between intracellular and extracellular fluid compartments. Furthermore, it explains the concepts of isotonic, hypotonic and hypertonic solutions and how they impact fluid movement across cell membranes. Finally, it lists various types of IV infusates such as crystalloids, colloids and dextrose solutions as well as indications for IV therapy and necessary equipment.

Uploaded by

Mohamed Rasool
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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IV Infusion Preparations

Fluid and Electrolytes

Dr Anita Janadri
Intravenous (IV)Therapy :
 Definition: Infusion of a fluid into a vein
 to prevent or treat fluid &/or electrolyte
imbalance(s)
 to deliver medications
 to deliver blood products
 VENIPUNCTURE: technique of
accessing a vein via insertion of a
needle or catheter
 sterile procedure because skin integrity is
broken
Purposes of Infusion Therapy:
 Provide fluids when PO intake not possible
 replace fluids/lytes
 Maintain normal electrolyte balances
 Provide glucose as energy source
 Provide access for administration of meds
 Administer blood products
 Emergency access
 Maintain urine output
Distribution of Body Fluids &
Electrolytes:

 Typical adult 60% body weight


consists of fluid (water & lytes)
 varies with body fat content, age, sex
– ex. fat cells contain little water; lean tissue is
rich with water
– ex. infants have a high body fluid content
(approx 70 - 80% of body weight)
Fluid Distribution:
 INTRACELLULAR (ICF)
 within the cells
 approx 2/3 of total fluid found within ICF
 EXTRACELLULAR (ECF)
 outside the cells
 approx 1/3 of total fluid found within ECF
 ECF: 2 compartments
– Intravascular Within a vessel; Plasma
– Interstitial/Extravascular Between & around the
cells; Tissue Fluid
Electrolytes:

 A substance that develops an electrical


charge when dissolved in water
 Electrolyte content of ICF is different
from ECF
 Major electrolytes in ICF: Potassium;
Phosphate; Magnesium
 Major electrolytes in ECF: Sodium;
Chloride; Bicarbonate; Calcium
Movement of Fluids:
Normal mvmt of fluids through capillary walls depends on 2
forces

 Hydrostatic Pressure - pressure exerted


by the heart; pressure of blood volume
in vessels
 Oncotic Pressure - pressure exerted by
plasma proteins such as albumin
 Water is pulled toward higher oncotic
pressure
Movement of Fluids:
 When solutions are separated by a membrane
impermeable to dissolved substances, a shift of
water occurs through the membrane from an
area of low solute concentration to higher solute
concentration
 Magnitude of this force dependent on the
number of particles dissolved
 OSMOLALITY: number of dissolved particles
– TONICITY; OSMOLARITY
– amt of solutes (ex sugar, Na+, protein) in a liter of
solution
Intravenous Infusion Preparations

 Osmolality – osmotic pull or pressure exerted


by all particles by unit of water
( expressed in milliosmoles per kilogram)

 Osmolarity- is the osmotic pull by all particles


per unit of solution. Unit of osmotic pressure –
osmole ( Osm) and the milliosmole is mOsm
is 1/1000th of an osmole. Osmotic cpressure
determines osmotic activity.
 Osmotic pressure determines osmotic activity.
Osmolality

 Influience by the quantity of dissolved particles that


exerts an osmotic pull in the intracellular and
extracelluar fluids.
 Primary solutes – serum sodium, urea, and glucose.
 Plasma (intravascular compartment ) contains protein
and slightly higher osmolality than fluid in other areas.
 25% concentration only that found in the ICF.
 Interstitial fluid has little to no protein.
 It is the responsibuility of the nurse to knowwherther a
prescribed infusate is hypertonic, hypotonic, or
isotonic.
Osmolality:

 The more solute present; the higher the


osmolality
 ISOTONIC solutions have the same
osmolality as body fluids
 HYPOTONIC solutions have a lower
osmolality as body fluids
 HYPERTONIC solutions have a higher
osmolality as body fluids
Isotonic Solutions:
same osmotic pressure as that found in the cell

 Will not alter intracellular fluid


compartments
 ex. Normal Saline (NS): used to expand
ECF compartments
 ex. Lactate Ringers (LR): similar to
plasma content (Na, K, Ca, Cl, Lactate);
used to correct ECF deficits
Hypotonic Solutions:
less osmotic pressure as that found in the cell

 have lower osmolality than body fluids


within the cell (ICF)
 cause fluids to shift out of the
vasculature (ECF) & into the cells (ICF)
 used to provide water, cellular hydration
 ex. 0.45% NS (“half Normal Saline”)
 ex. D5W (“5% dextrose water”)
Hypertonic Solutions:
greater osmotic pressure as that found in the cell
 HIGHER osmolality than body fluids
 causes fluids to shift out of the cells (ICF) into
the vascular space
 rapid shift fr ICF into the ECF/ vascular beds
 given to treat specific problems
 can potentially have serious side effects
– ex. CHF, PE, overload
 ex. Hypertonic saline (3% or 5% NS)
 ex. TPN
 ex. 50% dextrose
Classification of Infusates

 Crystalloid
 Colloids
 Hydrating Solution
 Electrolyte Solution
 Dextrose Solution
Crystalloids
 Materials that are capable of
crystallization.
 Solution that when place on solvent ,
homogeneously mixed with and
dissolved into a solution and cannot be
distinguished from the resultant solution.
 Can be isotonic, hypertonic, or
hypotonic.
Hydrating Solution
 Provide free water for maintenance or
hydration.
 When used chemical make-up or rate of
administration is adjuted so the equilibria of
fluids are not disturbed.
 E.g. glucose solution are most often used.
 Dextrose 21/2 % in 0.45 % saline
 Dextrose 5% in water
 Dextrose 5% in 0.45 saline
 Sodium Chloride 0.45%
 Dextrose 5% in 0.2% saline.
Electrolyte Solution

 Substance capable of ionization such as


sodium chloride
Dextrose solutions

 Are frequently used as infusates, are


manufactured as percentage solutions
expressed the numberof grams per 100
g of solvent,.
 A 5% dextrose in water (D5W) infusions
contains 5 g of dextrose in 100 ml of
water 1 ml of water equals 1 gr.
Colloids
 Are glutinous substances whose particles,
when submerge into a solvent, cannot form a
true solution because their molecules when
thoroughly dispersed no not dissolve, but
remained uniformly suspended and distributed
throughout the fluid.
 Can raise osmotic pressure.
 Plasma or volume expander.
 E.g. dextran, plamanate, and artificial blood
substitute, hetastarch.
Indications for IV Therapy

 Fluid Volume maintenance


 Fluid Volume replacement
 Medication Administration
 Blood and Blood Producct Donation and
administration
 Nutritional support.
Equipment and Supplies
 Infusate container – glass
Plastic – flexible
Semiregid
 Infusate administration container
 Drop factor
 Primary administration set
 Secondary administration set
 Volume control administration set
 Blood and Blood product administration set
 Accessory Devices for use with administration set
 Needleless Systems and Needlestick Safety System

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