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3. What I can't control is the time it takes to search medical libraries or PubMed when your question requires up-to-date clinical sources.

Intravenous (IV) Therapy

What Is IV Therapy?

Why It's Used

• Rapid restoration of circulating blood volume (e.g., shock, dehydration)
• Delivery of medications when oral route is not possible
• Correction of electrolyte and acid-base disturbances
• Nutritional support (total parenteral nutrition)
• Blood and blood product transfusion

Types of IV Fluids

1. Crystalloids

• 0.9% Normal Saline (NS) - isotonic; first-line for volume resuscitation
• Lactated Ringer's (LR) - balanced electrolyte solution; Na 130 mEq/L (avoid in hyponatremia)
• Dextrose solutions - for hypoglycemia and energy support
  • D10W for neonates and infants
  • D25W (2 mL/kg) for children
  • D50W (1 mL/kg) for adults/older children

2. Colloids

• Albumin, plasma - used when crystalloids alone are insufficient

3. Blood Products

• Packed red blood cells, fresh frozen plasma, platelets

Phases of IV Fluid Therapy

Emergency Resuscitation - Key Points

• Give 20 mL/kg of isotonic crystalloid IV rapidly for shock
• Reassess every 5-15 minutes - look for: normalization of BP, improved mental status, decreased heart rate, improved capillary refill, urine output
• If >60 mL/kg given without improvement - investigate for cardiogenic shock, sepsis, hemorrhage, or adrenal insufficiency
• Use intraosseous (IO) route if IV access cannot be obtained

Electrolyte Management During IV Therapy

• Daily serum electrolytes must be monitored
• Sodium, potassium, chloride replaced to maintain normal levels
• Hypokalemia - treated with IV potassium chloride (only if urine output is adequate)
• Hypocalcemia - treated with IV calcium gluconate
• Metabolic acidosis can develop - monitor with acid-base studies
• Maintain a careful fluid balance chart, including insensible losses

Hypoglycemia Management via IV

Note: D50W and D25W carry risk of tissue necrosis if they extravasate through a peripheral IV. D10W is safe at all ages.

Common IV Access Sites

• Peripheral IV - forearm, antecubital fossa, hand veins (most common)
• Central venous catheter (CVC) - subclavian, internal jugular, femoral veins (for long-term use, vasopressors, concentrated solutions)
• Intraosseous (IO) - used in emergencies when IV access fails
• PICC line - peripherally inserted central catheter (long-term therapy)

Complications of IV Therapy

Monitoring During IV Therapy

• Vital signs (BP, HR, RR, SpO2)
• Urine output (target >0.5 mL/kg/hr in adults)
• Daily fluid balance
• Serum electrolytes (Na, K, Cl, Ca, Mg)
• Blood glucose (every 30-60 min if treating hypoglycemia)
• Central venous pressure (CVP) or pulmonary artery wedge pressure in critically ill patients

• "Make it a PDF" - want me to create a PDF of the IV therapy info?
• "Too much info" - want a shorter summary?
• "Something is wrong" - what's the issue?

• Priority nursing actions (what to do FIRST)
• SATA (Select All That Apply) style content
• Safety & complications - what to assess, report, intervene
• Delegation rules - what RN can/cannot delegate
• Client education points
• Specific NCLEX buzzwords - "most important," "priority," "best action"