I.V. therapy
Description
May be prescribed to administer medications or to correct a fluid deficit, improve serum electrolyte balance, or provide nourishment
Primary nursing concerns related to pediatric I.V. therapy: correlating the I.V. site and equipment with the reason for therapy and the child’s age, size, and activity level (for example, a foot or scalp vein I.V. site may be used for infants, whereas a peripheral hand or wrist vein may be more suitable for ambulatory older children)
During I.V. therapy: nurse must continually assess the child and the infusion to prevent fluid overload and other complications
Equipment
Prescribed I.V. fluid ♦ volume-control set with microdrip tubing ♦ infusion pump ♦ I.V. pole ♦ normal saline solution or sterile dextrose 5% in water (D5W) for injection ♦antiseptic solution ♦ alcohol pads ♦ 3-ml syringe ♦child-size butterfly needle or I.V. catheter ♦ tourniquet ♦ ½″ or 1″ sterile tape ♦ gloves ♦ optional: arm board, insulated foam or medicine cup, luer-lock cap, air eliminator I.V. filter
Essential steps
Preparing the equipment
Gather the I.V. equipment, check the expiration date on the I.V. fluid, and inspect the I.V. container (an I.V. bag for leakage, a bottle for cracks) and tubing (for defects or cracks).
Open the wrappings on the I.V. solution and the volume-control tubing set. Close all clamps on the tubing set; then insert the tip of the tubing set into the entry port of the I.V. bag or bottle. (If you’re using an I.V. bag, be sure to hold the bag upright when attaching the tubing. This will keep the sterile air inside the bag from escaping and making the fluid level difficult to read.)
Hang the bottle or bag from the I.V. pole. Open the clamp between the bag and the volume-control set and allow 30 to 50 ml of solution to flow into the calibrated chamber. Close the clamp.
Squeeze the drip chamber located below the calibrated chamber or volume-control set to create a vacuum, allowing it to fill halfway with solution. Then release the clamp below the drip chamber so that fluid flows into the remaining tubing, removing any air. After the tubing fills, close the clamp.
If you’re using an infusion pump, attach the I.V. tubing to the infusion cassette, and insert the cassette into the infusion pump. Prime the cassette tubing according to the manufacturer’s instructions.
To minimize the risk of infection, maintain sterility at the tip of the I.V. tubing until you connect it to the I.V. needle.
Cut as many strips of ½″ or 1″ tape as you’ll need to secure the I.V. line. Prepare a syringe with 3 ml of flush solution — either the normal saline solution or D5W.
Inserting the I.V. catheter
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