Definition
Administering an intravenous infusion (IV) is a core nursing procedure used to deliver fluids, electrolytes, medications, or nutrients directly into the bloodstream. It ensures rapid absorption and precise control, especially in critical care, surgery, or dehydration management
Purposes
- To administer fluid and electrolytes to maintain the balance within the body.
- To provide glucose necessary for metabolism.
- To provide water-soluble vitamins and minerals.
- To establish a lifeline in case of emergency.
- To administer medications.
- To administer blood and blood products.
Complications
- Infiltration
- Hematoma
- Phlebitis
- Extravascular drug administration
- Air embolism
Articles
A clean try containing:
- Infusion set.
- IV fluid.
- Adhesive tape.
- Clean gloves.
- Tourniquet.
- Antiseptic swab.
- Antiseptic ointment(optional).
- IV cannula (angiocath/butterfly needle).
- Sterile gauze dressing or transparent occlusive dressing.
- Arm splint (optional).
- Towel/pad.
- Mackintosh/waterproof pad.
- Kidney tray.
Other Articles
1. IV pole
2. Electronic infusion pump (optional).
Procedure
| Nursing Actions | Rationale | |
| 1. | Before procedure Check physician’ order indicating type of solution, amount to be administered, rate of flow, etc. | Ensures that right procedure is done for right patient. |
| 2. | ldentify the patient. Assess vital signs, skin turgor, allergy to tape or povidone-iodine, bleeding tendencies, disease/injury to extremities, and status of vein. | Obtains baseline data on patient condition. |
| 3. | Check for any contraindication for venipuncture like arteriovenous fistula, arm on side of mastectomy, phlebitis, infiltration, sclerosis. | Prevents occurrence of any complication. |
| 4. | Prepare patient. Explain procedure to the patient and that the venipuncture will cause discomfort for few seconds, but once solution is initiated, there will not be any discomfort. Explain to patient how long the infusion will take to complete. Explain to the patient that movement of the extremity should be minimal (in case of children apply splints). Make sure that patient’s clothing can be removed over IV line if needed or provide with a gown. | Reduces anxiety and helps in obtaining cooperation of patient. Movement of the limb can cause needle to be dislodged. |
| 5. | During procedure Wash hands and don gloves. | Prevents infection. |
| 6. | Open and prepare infusion set. Check infusion container for sediments, turbidity, change in colour and expiry date. Remove tubing from the packet and straighten it out. Slide the roller clamp along tubing to just below the drip chamber. Close the clamp. Leave the ends of tubing covered with plastic caps until infusion is started. | Reduces risk of complication caused by solution. This will maintain sterility of the ends of tubing. |
| 7. | Spike the solution container. Remove protective cover from entry point of the IV bag/bottle. Add any medications if required using syringe and needle. Remove cap from the insertion spike. Spike the solution container. | |
| 8. | Paste a medication label on the solution container if a medication was added. A Mix the solution. Apply label upside down. | Applying label upside down will help in reading easily when container is hanging. Mixing ensures uniform distribution of the medication. |
| 9. | Paste a timing label on the solution container with the time when infusion was started and flow rate. | Helps in confirming if flow rate is correct or not. |
| 10. | Hang solution container on the pole. The pole should be adjusted so that solution container is 3 feet above patient’s head. | This height s needed to enable gravity to overcome venous pressure and facilitate flow of solution into the vein. |
| 11. | Partially fill the drip chamber by squeezing it till half full. | Prevents air from moving down the tubing. |
| 12. | Prime the tubing. Release the clamp, and let solution run through the tubing till all air bubbles are removed. Tap tubing if necessary, with finger to remove air bubbles sticking on sides of tubing. Connect IV tubing to IV cannula and set required drip rate. If an infusion pump is used, set it according to the rate prescribed. Follow manufacturers’ instructions for setting pump. | Prevents introduction of air into the vein. Maintains sterility. |
| 13. | Label IV tubing with date and time of attachment and signature. | Labelling ensures that tubing is changed every 72 hours. |
| 14. | Ensure appropriate infusion flow through pump or by adjusting roller clamp and note patient’s response. | |
| 15. | After procedure Discard all disposable items, clean and replace reusable items. | |
| 16. | Wash hands. | |
| 17. | Document relevant data like date and time of starting IV fluids, amount and type of solution used including medication, flow- rate, type and gauge of needle and patient’s response. | |
| 18. | Position patient comfortably. | |
| 19. | Assess frequently for swelling, pain, blanching, coolness of surrounding skin leaking or bleeding from site and change in inflow-rate, etc. |
Special Considerations
- Proper priming should be ensured to avoid air from entering into the blood circulation.
- Calculating the drop rate-The drop rate is calculated as, total volume divided by time in minutes, multiplied by the drop factor of 60 drops per minute.
- Use the appropriate drip set for administering the fluid, i.e. macro drip are sets which deliver larger drops (10,15,20) and macro drip are those which deliver small drops (60).
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
Stories are the threads that bind us; through them, we understand each other, grow, and heal.
JOHN NOORD
Connect with “Nurses Lab Editorial Team”
I hope you found this information helpful. Do you have any questions or comments? Kindly write in comments section. Subscribe the Blog with your email so you can stay updated on upcoming events and the latest articles.
