{"id":280,"date":"2019-09-16T11:52:02","date_gmt":"2019-09-16T15:52:02","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/?post_type=chapter&p=280"},"modified":"2020-03-23T17:15:54","modified_gmt":"2020-03-23T21:15:54","slug":"8-6","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/chapter\/8-6\/","title":{"raw":"8.6 Infusing IV Fluids by Gravity or an Electronic Infusion Device (Pump)","rendered":"8.6 Infusing IV Fluids by Gravity or an Electronic Infusion Device (Pump)"},"content":{"raw":"

Critical Thinking Exercises: Questions, Answers, and Sources \/ References<\/strong><\/h2>\r\n
    \r\n \t
  1. A patient with an IV running via gravity leaves the unit frequently. Midway through your shift you notice the IV is approximately 6 hours behind. Explain possible reasons. Explain your next steps.<\/strong><\/li>\r\n<\/ol>\r\nAnswer:\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
    Factors\u00a0Influencing the Flow Rate of Infusions<\/td>\r\nAdditional Information<\/td>\r\n<\/tr>\r\n
    Tube occlusion<\/td>\r\nMay occur if the tubing is kinked or bent. Tubing may become kinked if caught under the patient or on equipment, such as beds and bed rails. Sometimes the cannula itself is kinked at the insertion site.<\/td>\r\n<\/tr>\r\n
    Vein spasms<\/td>\r\nIrritating or chilled fluids (fluids stored in the fridge) may cause a reflex action that\u00a0causes the vein to go into spasm at or near the intravenous infusion site. If fluids or medications are chilled, bring to room temperature prior to infusion.<\/td>\r\n<\/tr>\r\n
    Height of the fluid container<\/td>\r\nThe IV tubing drip chamber should be approximately 3 feet above IV insertion site.<\/td>\r\n<\/tr>\r\n
    Location\/position of IV cannula<\/td>\r\nIf the cannula is located in an area of flexion (bend of an arm), the IV flow may be interrupted when the patient moves around. To avoid this issue, replace IV cannula.<\/td>\r\n<\/tr>\r\n
    Infiltration or extravasation<\/td>\r\nIf the cannula punctures the vein, the fluid will leak into the surrounding tissue and slow or stop the flow, and swelling will develop.<\/td>\r\n<\/tr>\r\n
    Accidental touching\/bumping of the control clamp or raising arm above heart level<\/td>\r\nInstruct the patient not to touch the roller clamp and to take care not to bump the clamp, as this may accidentally change the flow rate. Instruct patient to keep hand\/arm below heart level; an elevated hand\/arm will slow or stop an infusion running by gravity.<\/td>\r\n<\/tr>\r\n
    Needle or cannula gauge\/diameter<\/td>\r\nThe smaller the needle or cannula, the slower the fluid will flow.<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\nCopied from Anderson, R. (2018).\u00a0Clinical Procedures for Safer Patient Care \u2013 <\/em>Thompson<\/em> Rivers<\/em> University<\/em> Edition<\/em>. Adapted from\u00a0Clinical Procedures for Safer Patient Care<\/em>\u00a0by G. R. Doyle and J. A. McCutcheon. Chapter 8.6\u00a0Infusing IV Fluids by Gravity or an Electronic Infusion Device (Pump).\u00a0\u00a0https:\/\/pressbooks.bccampus.ca\/clinicalproceduresforsaferpatientcaretrubscn\/chapter\/8-6-infusing-iv-fluids-by-gravity-or-an-electronic-infusion-device-pump\/<\/a>\r\n\r\n \r\n\r\nSources:\r\n\r\nFulcher, E. M., & Frazier, M. S. (2007). Introduction to intravenous therapy for health professionals<\/em>. St. Louis, MO: Elsevier.\r\n\r\nGoossens, G. (2015). Flushing and locking of venous catheters: Available evidence and evidence deficit [article ID 985686]. Nursing\u00a0 \u00a0 \u00a0 \u00a0 Research and Practice, 2015, <\/em>1-12.\u00a0http:\/\/dx.doi.org\/10.1155\/2015\/985686<\/a>.\r\n\r\nPerry, A. G., Potter, P. A., & Ostendorf, W. R. (2017). Clinical nursing skills and techniques<\/em> (9th<\/sup> ed). St. Louis, MO: Elsevier-Mosby.\r\n\r\n \r\n
    Sample Quiz Questions<\/strong><\/div>\r\nThe order states to initiate an IV 0.9% NS @ 100 cc\/ hr. The following questions relate to this.<\/strong>\r\n
      \r\n \t
    1. How long will it take a 1000 ml IV bag to infuse?<\/strong><\/li>\r\n<\/ol>\r\n\u00a0 \u00a0 Answer: 1000cc\u00a0 \u00f7 100 cc\/hr = 10 hours<\/em>\r\n\r\n \r\n\r\n2. With a tubing drop factor of 10 gtt\/cc. Calculate the drops per minute.<\/strong>\r\n\r\n \r\n\r\nAnswer: 100cc\/hr x 10gtt\/ccx1hr\/60 minutes = 16.7 <\/em>\u2192<\/em> 16 gtt\/ min<\/em>\r\n\r\n\u00a0<\/em>\r\n\r\n\u00a0<\/em>Multi lumen PICC lines allows the nurse to infuse incompatible meds simultaneously (True \/ False)<\/span>\r\n\r\n \r\n\r\nAnswer: True if the incompatible meds are infused into different lumens<\/em>\r\n\r\n ","rendered":"

      Critical Thinking Exercises: Questions, Answers, and Sources \/ References<\/strong><\/h2>\n
        \n
      1. A patient with an IV running via gravity leaves the unit frequently. Midway through your shift you notice the IV is approximately 6 hours behind. Explain possible reasons. Explain your next steps.<\/strong><\/li>\n<\/ol>\n

        Answer:<\/p>\n\n\n\n\n\n\n\n\n\n\n
        Factors\u00a0Influencing the Flow Rate of Infusions<\/td>\nAdditional Information<\/td>\n<\/tr>\n
        Tube occlusion<\/td>\nMay occur if the tubing is kinked or bent. Tubing may become kinked if caught under the patient or on equipment, such as beds and bed rails. Sometimes the cannula itself is kinked at the insertion site.<\/td>\n<\/tr>\n
        Vein spasms<\/td>\nIrritating or chilled fluids (fluids stored in the fridge) may cause a reflex action that\u00a0causes the vein to go into spasm at or near the intravenous infusion site. If fluids or medications are chilled, bring to room temperature prior to infusion.<\/td>\n<\/tr>\n
        Height of the fluid container<\/td>\nThe IV tubing drip chamber should be approximately 3 feet above IV insertion site.<\/td>\n<\/tr>\n
        Location\/position of IV cannula<\/td>\nIf the cannula is located in an area of flexion (bend of an arm), the IV flow may be interrupted when the patient moves around. To avoid this issue, replace IV cannula.<\/td>\n<\/tr>\n
        Infiltration or extravasation<\/td>\nIf the cannula punctures the vein, the fluid will leak into the surrounding tissue and slow or stop the flow, and swelling will develop.<\/td>\n<\/tr>\n
        Accidental touching\/bumping of the control clamp or raising arm above heart level<\/td>\nInstruct the patient not to touch the roller clamp and to take care not to bump the clamp, as this may accidentally change the flow rate. Instruct patient to keep hand\/arm below heart level; an elevated hand\/arm will slow or stop an infusion running by gravity.<\/td>\n<\/tr>\n
        Needle or cannula gauge\/diameter<\/td>\nThe smaller the needle or cannula, the slower the fluid will flow.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

        Copied from Anderson, R. (2018).\u00a0Clinical Procedures for Safer Patient Care \u2013 <\/em>Thompson<\/em> Rivers<\/em> University<\/em> Edition<\/em>. Adapted from\u00a0Clinical Procedures for Safer Patient Care<\/em>\u00a0by G. R. Doyle and J. A. McCutcheon. Chapter 8.6\u00a0Infusing IV Fluids by Gravity or an Electronic Infusion Device (Pump).\u00a0\u00a0https:\/\/pressbooks.bccampus.ca\/clinicalproceduresforsaferpatientcaretrubscn\/chapter\/8-6-infusing-iv-fluids-by-gravity-or-an-electronic-infusion-device-pump\/<\/a><\/p>\n

         <\/p>\n

        Sources:<\/p>\n

        Fulcher, E. M., & Frazier, M. S. (2007). Introduction to intravenous therapy for health professionals<\/em>. St. Louis, MO: Elsevier.<\/p>\n

        Goossens, G. (2015). Flushing and locking of venous catheters: Available evidence and evidence deficit [article ID 985686]. Nursing\u00a0 \u00a0 \u00a0 \u00a0 Research and Practice, 2015, <\/em>1-12.\u00a0http:\/\/dx.doi.org\/10.1155\/2015\/985686<\/a>.<\/p>\n

        Perry, A. G., Potter, P. A., & Ostendorf, W. R. (2017). Clinical nursing skills and techniques<\/em> (9th<\/sup> ed). St. Louis, MO: Elsevier-Mosby.<\/p>\n

         <\/p>\n

        Sample Quiz Questions<\/strong><\/div>\n

        The order states to initiate an IV 0.9% NS @ 100 cc\/ hr. The following questions relate to this.<\/strong><\/p>\n

          \n
        1. How long will it take a 1000 ml IV bag to infuse?<\/strong><\/li>\n<\/ol>\n

          \u00a0 \u00a0 Answer: 1000cc\u00a0 \u00f7 100 cc\/hr = 10 hours<\/em><\/p>\n

           <\/p>\n

          2. With a tubing drop factor of 10 gtt\/cc. Calculate the drops per minute.<\/strong><\/p>\n

           <\/p>\n

          Answer: 100cc\/hr x 10gtt\/ccx1hr\/60 minutes = 16.7 <\/em>\u2192<\/em> 16 gtt\/ min<\/em><\/p>\n

          \u00a0<\/em><\/p>\n

          \u00a0<\/em>Multi lumen PICC lines allows the nurse to infuse incompatible meds simultaneously (True \/ False)<\/span><\/p>\n

           <\/p>\n

          Answer: True if the incompatible meds are infused into different lumens<\/em><\/p>\n

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