Tiêu đề 3rd Year 2nd Sem RD PRS ✅

RD 3. Prepare the client a.Explain the procedure b.Provide any scheduled care before establishing infusion to minimize movement of affected limb 4. Prepare equipment. Check clarity, expiration date, sterility of IV solution, tubing and venipuncture set or IC catheter. 5. Wash hands 6. Open and prepare the infusion set aseptically a.Remove tubing from container and straighten it out. b.Slide tubing clamp among the tubing until it is just below the drip chamber. c.Close the clamp, Leave ends of tubing with plastic caps until infusion is started 7. Open seal of IV solution and disinfect port with cotton ball and alcohol 8. Spike solution container aseptically a.Remove plastic cap of spike and insert it to solution b.Follow agency protocols regarding insertion. (recommended that twisting motion be not applied while inserting the tubing in the bottle) 9. Hang solution container on IV pole. Adjust pole so container is suspended 1 meter above client's head to enable gravity to overcome venous pressure. 10. Partially fill the drip chamber with solution. Squeeze the drip chamber gently until it is half full. 11. Prime tubing a.Remove protective cap and hold tubing over a container. Maintain sterility of end of tubing and cap. b.Release clamp and let fluid run through tubing until all the bubbles removed (to prevent air from entering client. Air bubbles [about 10 ml] can act as emboli in the blood stream) c.Re-clamp tubing and replace tubing cap while maintaining sterility 12. Apply appropriate labels to solution container: client's name, solution, drugs incorporated, date, time infusion started, and IVF regulation. 13. Apply a timing label on the solution container. 14. Wash hands if necessary 15. Select and prepare venipuncture site. Starting at distal end of the vein, select a site by palpating accessible veins 16. Dilate the vein: a.Place arm in dependent position or lower than client's heart. Gravity slows venous return and distends the vein. b.Apply tourniquet firmly 6-8 inches above venipuncture site. It should be tight enough to obstruct venous flow but not so tight to occlude arterial flow. Check by palpating the radial pulse 17. Put on clean gloves, and clean venipuncture site with the povidone-iodine or alcohol. Use circular motion going form the center towards the outside of the venipuncture site. Permit the solution to dry into the skin before insertion. 18. Insert the IV catheter ad initiate the infusion. 19. Tape catheter. Commonly used is "U" method but methods may vary according to manufacturer. 20. Dress and label venipuncture site and tubing according to agency policy 21. Ensure appropriate infusion flow 22. Label the IV tubing 23. Document relevant data including assessment ➢ Prepare the necessary materials. Check the sterility and integrity of the IV solution ➢ Place the necessary labels on the IV solutions ➢ Open and disinfect the rubber port of the IV solution to flow ➢ Close the clamp or kink the tubing just below the drip chamber, then remove the existing bottle, and then spike the solution to follow aseptically ➢ Open the clamp or un-kink the tubing and regulate the new solution as prescribed MONITORING AN INTRAVENOUS INFUSION: ❖ Observe the rate of flow every hour ❖ Inspect the patency of the IV tubing and needle ❖ Observe the tubing for pinches or kinds of obstruction to flow ❖ Open the drip regulator and observe for a rapid flow. Rapid flow would indicate patency. Regulate the infusion after checking patency ❖ Lower the infusion bottle below the insertion site. A backflow of blood would indicate patency ❖ Inspect the insertion site for fluid infiltration, dislodged needle, phlebitis or bleeding ❖ Teach the client ways to maintain the infusion system. ➢ Call for assistance if: ■ The solution is not dripping ■ The venipuncture site is swollen ■ There is a sudden change in the flow of rate ■ The solution container is nearly empty ■ There is blood in the IV tubing ➢ Avoid sudden twisting or turning of the arm where the insertion site is ➢ Avoid stretching or placing tension of the tubing ❖ Document all relevant information DISCONTINUING IV INFUSION Indications: ● The client's oral fluid intake and hydration status are satisfactory, so that no further IV solutions are ordered ● There is a problem with infusion that cannot be fixed ● The medications administered by the intravenous route are no longer required 1. Verify the doctor's order to discontinue IV infusion or IV medication 2. Asses and inform the patient of the order 3. Prepare the necessary materials a. IV tray b. Sterile cotton balls with alcohol. c. Supply with pick-up forceps d. Sterile dressing- depends on hospital policy. e. Antiseptic solution f. Plaster Kidney basin 4. Wash hands before and after procedure 5. Close IV clamp of the tubing 6. Wear clean gloves for protection 7. Moisten adhesive tapes around the IV catheter with the cotton balls with alcohol. 8. Remove the plaster gently layer by layer while holding the needle firmly and applying counter traction to the skin. Holding the needle firmly can prevent damage to the vein while applying counter traction prevents pulling the skin. 9. Use pick-up forceps to get the cotton ball with alcohol and without applying pressure, withdraw the IV catheter by pulling it out along the line of the vein. Apply pressure after removal and then tape or place dressing as indicated. Applying pressure for 2-3 minutes prevents bleeding and hematoma formation! Hold the inserted extremity if bleeding persists. This decreases blood flow to the area. a. Inspect IV catheter for completeness. b. Check the IV catheter if it is intact- a piece of tubing that remains in the client's vein could move within ALTERNATE STEPS IV INSERTION 1. Explain and discuss procedure with patient. - To ensure patient understands the procedure and gives valid consent 2. If they require topical local anesthetic, apply to chosen venipuncture sites for 30–60 minutes prior to cannulation (to give adequate time for local anesthetic to be effective) 3. Assemble all equipment necessary for cannulation. - To ensure that time is not wasted and that procedure goes smoothly without unnecessary interruptions. 4. Check all packaging before opening and preparing equipment to be used. To ensure all equipment is in date and not contaminated. 5. Wash hands using bactericidal soap and water or alcohol hand rub and dry. - To minimize risk of infection 2