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Initiating Maintenance IV Fluids

Overview

Source: Madeline Lassche, MSNEd, RN and Katie Baraki, MSN, RN, College of Nursing, University of Utah, UT

Hospitalized patients frequently require the administration of intravenous (IV) fluids to maintain their fluid and electrolyte balance. Certain medical conditions that preclude oral fluid intake may necessitate IV fluid administration, with or without electrolytes, to prevent hypovolemia, dehydration, and electrolyte imbalances. Pre-surgical and pre-procedure patients who require anesthesia are often required to be NPO (i.e., nil per os; Latin for "nothing by mouth") to prevent aspiration and to maintain hydration during the procedure. Post-surgical and post-procedure patients may also require IV fluid administration to increase intravascular volume following surgical blood loss.

IV fluids can be delivered by different types of administrations sets: gravity flow infusion devices, which rely on gravitation force to push the fluid to the patient's bloodstream, or infusion pumps, which use a pump mechanism that generates positive pressure. While administering maintenance IV fluids using an infusion pump is the most common approach, facility policy; availability of infusion pump equipment; and other limitations, such as a power outage, may necessitate the use of IV gravity tubing. This video describes the approach to initiate maintenance IV fluids using gravity tubing, as well as how to calculate and set the infusion drip rates.

Procedure

1. General procedure considerations (review in the room, with the patient).

  1. Upon first entering the patient's room, wash hands with soap and warm water, applying vigorous friction for at least 20 s. Hand sanitizers may be used if the hands are not visibly soiled, but vigorous friction should also be used.
  2. At the bedside computer, log into the patient's electronic health record and review the patient's medical history, intake and output balance, vital signs, skin turgor, mucus membranes,

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Application and Summary

This video details the process for initiating maintenance IV fluids using gravity tubing. It is important to remember that maintenance IV fluids are a medication, so the five "rights" and three checks must be followed to prevent a medication error. It is also important to assess the patient's IV site and fluid status throughout the administration of the maintenance IV fluid to prevent IV site complications and iatrogenic fluid overload. Common errors associated with administration of maintenance IV fluids include: neglec

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Tags
Maintenance IV FluidsHospitalized PatientsIntravenous FluidsHydrationElectrolyte BalanceOral IntakeIntravascular VolumeBlood LossNPOAnesthesiaInfusion PumpGravity FlowPositive PressureGravitational ForcesInitiate Gravity Flow InfusionsCalculate Infusion RateHand HygieneElectronic Health Record EHRContinuous IV Fluid AdministrationMedical HistoryInput And Output BalanceVital SignsSerum Laboratory ResultsSkin TurgorMucous MembranesHydration StatusMedication Administration Record MARFluid Order

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0:00

Overview

0:55

Preparation

4:04

Administration

5:37

Calculate and Set the Drip Rate

7:34

Summary

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