Component Task: Administration of Intravenous Fluids

This is an aseptic process of giving intravenous fluids with the aid of a connecting tube and age appropriate size intravenous cannula through a vein for therapeutic purposes. IV fluids are primarily used to treat and prevent fluid volume deficit in a child.

Aims

·         Maintain hydration

·         Treat dehydration

·         Maintain homeostasis

·         Manage shock

Requirements

a.      Set up a tray with the following items:

·         Appropriate IV fluids

·         Plain giving set

·         Dorsiflow

·         Syringes and needles (appropriate size)

·         Intravenous cannula (appropriate size)

·         Alcohol swab/cotton swabs and methylated spirit

·         Gallipot

·         Tourniquet

·         Receiver

·         Plaster/adhesive skin tape

b.      Pen

c.      Drip stand

d.      IV perfuser/infusion pump

e.      Manual/electronic health chart

f.        Fluid intake and output chart

g.      Observation chart/adverse drug reaction chart

h.      IVF normal saline

i.         Safety sharp box

j.         Sterile gloves

k.       IV tubing stopper/cap

l.         Padded splint (if necessary)

Steps

1.        Place/receive child in a comfortable seat/bed

2.      Perform five moments of hand hygiene as and when necessary

3.      Establish rapport (refer steps)

4.      Explain procedure to child/caregiver (refer steps)

5.      Incorporate developmentally appropriate strategies in dealing with the child

6.      Verify the medication order with the child’s medical records

7.       Ask child/caregiver about medication/allergy history and intervene as necessary

8.      Provide privacy

9.      Observe the Rights of Medication administration

·         Right intravenous fluid

·         Right dose

·         Right child

·         Right time

·         Right route

·         Right reason

·         Right of child/caregiver to refuse medication

·         Right documentation

10.    Provide age-appropriate diversional therapy

11.      Check the accuracy of the dose to be given to child

12.    Check vital signs, weigh child and record

13.    Calculate the total volume of infusion using the child’s weight

14.    Calculate the rate of infusion as prescribed

15.    Ensure quality of the infusion (check for expiry date, color, cloudiness, sediments and other particles)

16.    Place infusion stand at the bed side and prepare adhesive strips/tape (if necessary)

17.    Inspect IV site for administration and check for patency

18.    Reset IV line if extravasation (tissue infiltration) has occurred

19.    Assist child to assume the right position with caregiver’s support

20.  Support the child to stay calm and expose the body part with the IV access

21.    Insert the piercing end of plain giving set into the rubber seal of the infusion bag/bottle

22.  Hang the infusion bag/bottle on the drip stand

23.  Cap the distal end of the giving set

24.  Fill the chamber half way and open the regulator gently

25.  Run the fluid into the receiver to expel air from the giving set

26.  Re-cap the giving set

27.  Don sterile gloves and disengage the IV stopper from the IV cannula and keep secured

28.  Remove the cap from the giving set and connect to the IV cannula

29.  Remove and discard sterile gloves appropriately after setup

30.  Splint and apply adhesive tape to loosely hanging connecting tubing if necessary

31.    Regulate the flow rate as ordered with the aid of a timer if necessary

32.  Observe for desired outcome and adverse reaction during the IV fluid administration and intervene accordingly

33.  Inform child/caregiver to report any adverse reaction/disengagement/dislodgment

34.  Re-assess child after ten (10) minutes and observe closely

35.  Record type of IV fluid, time of setup, and amount on the treatment chart

36.  Maintain fluid intake and output chart

37.  Discard tray and decontaminate as appropriate

38.  Provide non pharmacological pain management to child

39.  Express appreciation to child/caregiver for their cooperation

40.  Document procedure in the nurse’s notes


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