Any Good IV Therapy or Nursing Procedure Web Sites

I'm in my second semester and I'm kinda confused about doing this set up, like the drip factor and all that. The instructor taught us, but I still don't get it. The paper I'm referring to study from doesn't make sense. Could somebody please explain to me, in easier terms (like what is a tubing and needless canula, etc). Thank you so much!

[suzanne4, RN]

The tubing that you are talking about is called "secondary"-- it is used in conjunction with primary tubing. Secondary tubing is used for giving piggy back medications such as antibiotics.

In the recent past, we used needles on the end of the secondary tubing to insert into the primary tubing at the different ports, then usually put a piece of tape around it so that it would not get pulled out. Nurses would get stuck, etc. Now they have what is called the "needleless" system, where the tubing can attach directly without the needle.

Hope that this helps and good luck with your clinicals.:)

[crb613, BSN, RN]

tlcmel said:

Thank you.

Does anyone know of any good sites where I could view the parts and details of all this.

Do you have a skills book? It should be in there. We use Clinical Nursing Skills & Techniques 5th ed. by Perry & Potter.It's really good if you don't have one.:)

[Daytonite, BSN, RN]

Peripheral venous access devices:

• Guidelines and Measures - AHRQ - access device guidelines: recommendations for nursing practice and education.
• IHC Antibodies
• Initiate and Manage an Intravenous Infusion
• Intravenous Therapy
• Intravenous Catheter Complications

Central venous access devices (cvads):

• Central Venous Access - quick guide to central venous access; 153 page manual with extensive information
• Central venous catheter - illustration of anatomical placement of a central venous catheter
• Intravenous fluid sites - illustration of iv and central line sites used in babies

PICC lines:

• PICC Line Care and Maintenance: An Introduction

TPN (total parenteral nutrition):

• Total Parenteral Nutrition (TPN) - indications, nutritional content, solutions, monitoring and complications - includes a table of the basic adult daily requirements for total parenteral nutrition
• Guidelines and Measures - AHRQ

IV flow rate and calculation problems:

• IV Flow Rate Calculations - practice iv flow rate quiz and answers

Blood transfusion:

• Transfusion Medicine

Table of commonly used iv solutions

• Most commonly used iv solutions; includes tonicity, ph, the ingredients of the solutions, its uses and complications

Table of Commonly Used IV Solutions.doc

[carlita]

Does anyone know any good website that explains about syringes and how to mix and dilute different types of drugs? I am having my test-off in four days and I have no clue how to proceed. I'd really appreciate any help.

[Daytonite, BSN, RN]

Hope this is what you are looking for. The only drugs I can think of that you want to dilute would be iv drugs. You can find some of that information on the chart I've linked you into below. If you are looking for the re-constitution directions for some of the antibiotics and steroids you can get that information from www.drugs.com by looking up the professional's information about a specific drug at their site.

[Daytonite, BSN, RN]

Tracheostomy/Tracheostomy Care:

• Aaron's Tracheostomy Page
• Tracheostomy Care Guidelines
• Tracheostomy - Medscape
• Tracheostomy

Mechanical Ventilation/Intubation:

• Mechanical Ventilation - Medscape

Smoking Cessation:

• Smoking Cessation - The Eeconomic Benefits

• https://www.innovations.ahrq.gov/taxonomy-terms/smoking-cessation

[VickyRN, MSN, DNP, RN]

Pediatric skills and procedures

http://www.delmarlearning.com/companions/content/1401897118/skillscklists/index.asp?isbn=1401897118

A goldmine of information from delmar.

Skills Checklists

• Assessment/monitoring
  • Vital signs
    • skill 1. temperature
    • skill 2. pulse
    • skill 3. respiration
    • skill 4. blood pressure
    • skill 5. pulse oximetry

  Specimen collection

  • blood draws
    • skill 6. capillary blood draw (heel and finger stick)
    • skill 7. venipuncture
    • skill 8. blood draw from a central venous catheter

    Nasopharyngeal

    • skill 9. nasopharyngeal swab
    • skill 10. throat culture

    Dtool specimens

    • skill 11. collection of stool specimen

    Urine specimens

    • skill 12. collection of urine specimen on infant or young child
    • skill 13. collection of a midstream, clean catch urine specimen on older child

  Diagnostic tests

  • bone marrow
    • skill 14. assisting with child during bone marrow aspiration and biopsy

    Lumbar puncture

    • skill 15. assisting with child during lumbar puncture
    • skill 16. assisting with collection of cerebrospinal fluid

  Fever & Hyperthermia

  • fever and hyperthermia management
  • skill 17. sponge bath

  Intravenous access

  • skill 18. insertion of a peripheral iv line
  • skill 19. dressing change central venous line (tunneled, percutaneous, and implanted)

  Gastrointestinal

  • NG and nj tubes
    • skill 20. insertion of a nasogastric tube
    • skill 21. management of gastrointestinal suction
    • skill 22. nasogastric tube irrigation
    • skill 23. nasogastric tube lavage

    Enteral feeding

    • skill 24. administration of a bolus feeding (ng, nj, gastrostomy)
    • skill 25. administration of ng, nj, and gastrostomy continuous feeding

    Ostomies

    • skill 26. changing a fecal ostomy appliance
    • skill 27. emptying an ostomy pouch

    Eemas

    • skill 28. administration of enemas

  Genitourinary

  • skill 29. urinary catheterization

  Musculoskeletal

  • Casts
    • skill 30. petaling a cast

    Traction

    • skill 31. pin site care

    External fixation device

    • skill 32. care of the child in an external fixation device
    • skill 33. pin care, external fixation device

  Neurological

  • Extraventricular drain
    • skill 34. evd: maintaining system at correct level and functioning
    • skill 35. evd: client assessment
    • skill 36. evd: monitoring cerebrospinal fluid (csf)
    • skill 37. evd: changing the drainage bag
    • skill 38. evd: general nursing care and safety

  Respiratory

  • Chest tubes
    • skill 39. assisting with chest tube insertion
    • skill 40. preparing the chest tube drainage system
    • skill 41. care of the child with a chest tube
    • skill 42. assisting with removal of chest tube

    Oxygen therapy

    • skill 43. oxygen administration via nasal cannula, mask, hood, tent, blow-by cannula

    Respiratory suctioning

    • skill 44. bulb suctioning
    • skill 45. nasotracheal suctioning

    Tracheostomy

    • skill 46. tracheostomy monitoring
    • skill 47. tracheostomy tube change
    • skill 48. tracheostomy tube or inner cannula cleaning
    • skill 49. tracheostomy suctioning

    Endotracheal tube

    • skill 50. endotracheal tube monitoring
    • skill 51. endotracheal suctioning

    Chest physiotherapy

    • skill 52. positions for cpt

  Restraints

  • skill 53. mummy restraint
  • skill 54. modified mummy restraint
  • skill 55. elbow restraint
  • skill 56. wrist and ankle restraint
  • skill 57. jacket restraint

  Transporting

  • transporting an infant or child

  Wound care

  • skill 58. wet to dry dressing
  • skill 59. drains jackson-pratt and hemovac

[Daytonite, BSN, RN]

Hypotonic IV Solutions

Hypotonic solutions have an osmolality (how concentrated a solution is) of less than 240 mosm/liter. They are less concentrated than blood. They exert less osmotic pressure than the fluid in the extracellular compartment which allows water to be drawn from the extracellular fluid. Blood cells will draw these solutions into them causing the blood cells to swell and burst. There is only one hypotonic solution in common use and that is 0.45% sodium chloride (1/2 normal saline). It has an osmolality of 155, a ph of 5.6, and contains 77 meq of sodium and 77 meq of chloride. Continuous infusion can cause dilution and depletion of electrolytes because of the small amount of sodium in this particular mixture resulting in hyponatremia. Because there are no calories in the solution, the patient is going to become calorie depleted as well if it is infused for a long period.

There is only one hypotonic solution: 0.45% sodium chloride.

Isotonic IV Solutions

Isotonic solutions have the same tonicity as plasma so that when they are infused into a vein, water neither enters or leaves the cells. They have the same concentration as blood. These kinds of iv solutions are used to expand the extracellular fluid volume and do not cause any fluid to move from into or out of the blood cells. Isotonic solutions have an osmolality of 240 to 340 mosm/liter.

Isotonic solutions include 0.9% sodium chloride, dextrose 5% in water, dextrose 5% and 2.5% saline, dextrose 5% in water and 0.45% saline, lactated ringer's, dextrose 2.5% in 1/5 strength lactated ringers, 6% dextran and and 0.9% saline, 10% dextran and 0.9% saline and a number of formulated electrolyte solutions (I.E., normosol r, isolyte e, plasmalyte r).

Hypertonic IV Solutions

A hypertonic solution is one that has an osmolality greater than 340 mosm/kg. They are more concentrated than blood. Hypertonic solutions exert more osmotic pressure than the extracellular fluid so when these solutions are infused, fluid gets pulled into the vascular system. You want to monitor patients receiving any hypertonic solutions for fluid overload, particularly if they are being given at a rapid rate of infusion.

There are many hypertonic iv solutions. Most common ones you will see used are 5% dextrose in 0.45 sodium chloride, 5% dextrose in 0.9% sodium chloride, 5% dextrose in lactated ringer's injection, dextrose 10% in water and 3% sodium chloride.

[VickyRN, MSN, DNP, RN]

Short, informative video clips from smithsmedical on a variety of topics including acapella (pep), incentive spirometry, and cassette medication delivery:

http://videos.smiths-medical.com/

[VickyRN, MSN, DNP, RN]

[*Blessed2BaNRS*]

Wow, this needs to be titled the "Daytonite and VickyRN site!!!" What a wealth of information that you two have posted. I know that I speak for everyone when I say

You ladies are the best!! What started out as a question about IV help sites has turned into a complete library of helps and aids.