| Introduction |
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1 | (6) |
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1 | (1) |
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Conventions Used in This Book |
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2 | (1) |
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3 | (1) |
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3 | (1) |
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How This Book Is Organized |
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3 | (2) |
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Part I Tapping Into IV Therapy |
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4 | (1) |
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Part II What's Your Type? Components of IV Therapy |
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4 | (1) |
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Part III Getting Down to IV Therapy Business |
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4 | (1) |
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Part IV Administering IV Therapy |
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5 | (1) |
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Part V Considering Unique Populations |
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5 | (1) |
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5 | (1) |
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5 | (1) |
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6 | (1) |
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Part I Tapping Into IV Therapy |
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7 | (62) |
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Chapter 1 Introducing IV Therapy: A Purpose-Driven Practice |
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9 | (14) |
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What's the Point? The Purpose of IV Therapy |
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9 | (3) |
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Administering emergency fluids and medications |
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10 | (1) |
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Delivering pharmacological agents |
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10 | (1) |
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Replacing blood and blood products |
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11 | (1) |
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Administering chemotherapy medications |
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11 | (1) |
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Maintaining fluid and electrolyte balance |
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12 | (1) |
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12 | (1) |
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The Main Ways to Administer IV Therapy |
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12 | (2) |
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Understanding the Important Role You Play in IV Therapy |
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14 | (4) |
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Getting down to brass tacks: Starting IVs |
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14 | (1) |
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14 | (2) |
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Monitoring infusions and managing complications |
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16 | (1) |
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Supporting your actions by keeping careful records |
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17 | (1) |
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Familiarizing Yourself with Standards of Care |
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18 | (5) |
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Understanding the importance of the Infusion Nurses Society |
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18 | (1) |
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Implementing INS standards of care in your daily practice |
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19 | (1) |
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Avoiding lawsuits by following standards of care |
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19 | (1) |
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Staying focused on ethical principles |
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20 | (1) |
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Working within your scope of practice |
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20 | (1) |
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Implementing evidence-based infusion practice |
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21 | (1) |
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Documenting informed consent |
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21 | (1) |
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Complying with your employer's policies and procedures |
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22 | (1) |
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Chapter 2 Keeping within the Letter of the Law |
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23 | (18) |
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Understanding the Legal Standard of Care |
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24 | (1) |
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Making Sense of Federal and State Regulations |
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25 | (4) |
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Seeing who's watching your back at the federal level |
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25 | (2) |
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Looking at oversight of the state |
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27 | (2) |
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Maintaining Professional Standards |
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29 | (1) |
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Defining a competent level of care: The American Nurses Association |
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29 | (1) |
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Improving the quality of healthcare: The Joint Commission |
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29 | (1) |
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Maintaining the standard of care: The Infusion Nurses Society |
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30 | (1) |
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Following facility policy |
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30 | (1) |
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When Bad Things Happen to Good People: Comprehending Malpractice |
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30 | (3) |
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Do you owe a duty of care? |
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31 | (1) |
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Has there been a breach of duty? |
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32 | (1) |
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Are there grounds for legal causation? |
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32 | (1) |
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Are the damages legally compensable? |
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33 | (1) |
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Understanding Common Areas of Malpractice and Negligence |
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33 | (3) |
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Improper administration of medications |
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33 | (1) |
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Improper use of equipment |
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34 | (1) |
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Failing to act in a timely manner |
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34 | (1) |
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Not keeping a close enough eye on your patient |
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35 | (1) |
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Causing or contributing to infection |
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35 | (1) |
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Lack of communication with the ordering doc |
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35 | (1) |
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Having joint responsibility |
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36 | (1) |
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Reducing Your Risk with Risk-Management Strategies |
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36 | (5) |
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Listening to your patient |
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37 | (1) |
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Completing an unusual occurrence report |
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37 | (2) |
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39 | (1) |
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Carrying professional liability insurance |
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40 | (1) |
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Maintaining prudent patient relations |
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40 | (1) |
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Chapter 3 Tools of the Trade |
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41 | (28) |
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42 | (7) |
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Choosing the best peripheral access device |
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42 | (3) |
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Keeping it centralized with a central vascular access device |
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45 | (4) |
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49 | (2) |
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When your infusate can't adapt: Using a glass container |
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49 | (1) |
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Being aware of the challenges of plastic containers |
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49 | (1) |
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Knowing your limitations: Alternate solution containers |
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50 | (1) |
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Saving time with ready-to-use drug delivery systems |
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51 | (1) |
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51 | (8) |
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The main event: The primary administration set |
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51 | (2) |
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Piggybacking with a secondary administration set |
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53 | (1) |
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Limiting fluids with a metered-volume chamber set |
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54 | (1) |
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Isn't that special? Considering a specialty set |
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55 | (1) |
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Characteristics of administration sets |
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56 | (3) |
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59 | (3) |
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Relying on the manual method: Gravity |
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59 | (1) |
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The pressure is on: Adding pressure with a pressure bag |
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59 | (1) |
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Relying on its own power: The mechanical infusion pump |
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60 | (1) |
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Pumping up the volume: The electronic infusion pump |
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60 | (1) |
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Characteristics of every infusion pump |
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61 | (1) |
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More to Think About When Choosing IV Equipment |
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62 | (7) |
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62 | (1) |
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Adding to your line with add-on devices |
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63 | (2) |
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65 | (1) |
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66 | (3) |
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Part II What's Your Type? Components of IV Therapy |
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69 | (100) |
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Chapter 4 Medications Made to Order: Pharmacological IV Therapy |
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71 | (22) |
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Understanding How Pharmacological IV Therapy Works |
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72 | (6) |
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Pharmacokinetics: How the body works on a drug |
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72 | (1) |
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Pharmacodynamics: How a drug works on the body |
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73 | (1) |
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What's the point? Recognizing the reasons for IV medication administration |
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74 | (4) |
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Understanding Adverse Effects |
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78 | (3) |
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Identifying Drug Incompatibilities |
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81 | (5) |
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Reconstituting IV Therapy Medications |
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86 | (4) |
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86 | (1) |
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Working with single-strength medications |
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87 | (1) |
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Working with multi-strength medications |
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87 | (1) |
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87 | (3) |
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Practicing for perfection |
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90 | (1) |
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Familiarizing Yourself with Common Classes of Pharmacological Agents |
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90 | (3) |
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Chapter 5 Beefing Up on Blood Component Therapy Basics |
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93 | (14) |
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Defining Blood Component Therapy |
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94 | (1) |
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Knowing when blood component therapy is necessary |
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94 | (1) |
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Understanding the risks involved |
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94 | (1) |
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Breaking Down Blood Composition |
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95 | (1) |
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Finding a Match: Compatibility Is Key |
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96 | (4) |
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Donor plus recipient: A match made in heaven |
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96 | (1) |
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Identifying antigens and antibodies in the blood |
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97 | (2) |
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When antigens and antibodies go to war: The hemolytic hazards of a mismatch |
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99 | (1) |
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Types of Blood Component Therapies |
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100 | (7) |
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The whole in every part: Whole blood versus individual blood components |
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100 | (4) |
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Sending them packing: Packed red blood cells |
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104 | (1) |
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Cleaning up their act: Modified packed red blood cells |
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104 | (1) |
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Skipping the leukocytes: Leukocyte-reduced packed cells |
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104 | (1) |
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Pass the platelets, please |
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105 | (1) |
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Keeping it fresh: Fresh frozen plasma |
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105 | (1) |
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Adding granules with granulocytes |
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106 | (1) |
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Chapter 6 Chemotherapy 101 |
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107 | (14) |
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Getting with the Program: The Principles of Chemotherapy |
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107 | (6) |
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108 | (1) |
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Taking a closer look at cell cycles |
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108 | (3) |
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Slowing down cancer: How chemotherapy works in the body |
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111 | (1) |
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112 | (1) |
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Determining the Goals of Treatment |
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113 | (5) |
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115 | (1) |
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115 | (2) |
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Providing comfort: The palliative side of chemotherapy |
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117 | (1) |
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It's Classified: Classifying Chemotherapy Drugs |
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118 | (3) |
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Chapter 7 Maintaining Equilibrium with Fluids and Electrolytes |
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121 | (36) |
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Getting Your Fill: Introducing Fluids and Electrolytes |
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122 | (3) |
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Appreciating your body fluids' full-time job |
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122 | (2) |
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Getting a charge out of electrolytes |
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124 | (1) |
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On the Move: Following Fluids between Compartments |
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125 | (6) |
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Catching a free ride with passive transport |
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127 | (3) |
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Going against the grain with active transport |
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130 | (1) |
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Assessing Your Patient's Fluid Requirements |
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131 | (2) |
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Taking a peek at the labs |
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131 | (1) |
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Maintenance fluids: Accounting for everyday losses |
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132 | (1) |
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Replacing existing and ongoing losses from illness or injury |
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132 | (1) |
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Restoring Volume with Crystalloids and Colloids |
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133 | (5) |
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Getting acquainted with crystalloids |
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134 | (3) |
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137 | (1) |
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Correcting Fluid and Electrolyte Imbalances |
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138 | (14) |
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Hypovolemia: Getting low on fluids |
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139 | (1) |
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Hypervolemia: Having excess fluid |
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140 | (1) |
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Simplifying sodium imbalances |
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141 | (2) |
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143 | (2) |
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Playing it safe with potassium imbalances |
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145 | (2) |
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Making calcium less complicated |
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147 | (2) |
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Picking apart phosphate imbalances |
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149 | (2) |
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Managing magnesium imbalances |
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151 | (1) |
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Acid-Base Balance Made Easy |
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152 | (5) |
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Sorting out types of acid-base imbalances |
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153 | (2) |
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Correcting acid-base imbalances |
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155 | (2) |
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Chapter 8 Serving Up Parenteral Nutrition |
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157 | (12) |
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From Soup to Nuts: Reviewing Parenteral Nutrition Basics |
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157 | (8) |
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Knowing when to use parenteral nutrition |
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158 | (2) |
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Identifying the many nutrients of PN |
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160 | (4) |
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Pointing out the two types of PN |
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164 | (1) |
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Creating a Balanced PN Recipe for Success |
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165 | (4) |
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Incorporating the main ingredients |
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165 | (2) |
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Moistening the mix with fluids |
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167 | (1) |
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Mixing in a little medication |
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168 | (1) |
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Preparing the finished product |
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168 | (1) |
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Part III Getting Down to IV Therapy Business |
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169 | (86) |
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Chapter 9 Documenting Diligently: The Backbone of Infusion Therapy |
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171 | (12) |
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Seeing Why Accurate Documentation Matters |
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172 | (2) |
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Improving communication for continuity of care |
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172 | (1) |
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Acting as your insurance policy: The importance of legal records |
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173 | (1) |
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Following protocol: Outlining steps to reach successful patient outcomes |
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173 | (1) |
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Providing info necessary for insurance reimbursement |
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174 | (1) |
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Making Your Documentation Rise above the Rest |
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174 | (3) |
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Just the facts: Keeping it accurate and focused |
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175 | (1) |
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175 | (1) |
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Ensuring it's legible and correcting writing mistakes |
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176 | (1) |
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176 | (1) |
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Making sure it's accessible and easily retrievable |
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177 | (1) |
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Putting It into Practice: Documenting IV Therapy |
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177 | (6) |
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178 | (2) |
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The insertion of a peripheral VAD |
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180 | (1) |
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The administration of the infusion |
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181 | (1) |
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The ongoing monitoring of the site |
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181 | (1) |
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The removal of the device |
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182 | (1) |
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Chapter 10 Calculation Central: Figuring Drug Dosages, Drips, and Flow Rates |
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183 | (10) |
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Calculating Correct Drug Dosages |
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183 | (6) |
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Understanding the metric system |
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184 | (1) |
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Using different calculation methods |
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185 | (2) |
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Practicing dosing calculations |
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187 | (2) |
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Going with the Flow: Calculating Drip Rates, Flow Rates, and Infusion Times |
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189 | (4) |
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Using drop factors to calculate drip rate |
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189 | (1) |
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Using two different methods to calculate flow rates |
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190 | (1) |
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Using the flow-rate formula to calculate infusion time and total volume |
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191 | (2) |
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Chapter 11 Gravity, Pumps, and Syringes: The Many Ways to Deliver IV Therapy |
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193 | (10) |
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Flowing with an Invisible Force: Gravity-Fed Infusions |
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193 | (1) |
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Optimizing Therapy with IV Pumps |
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194 | (5) |
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Administering by continuous infusion |
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195 | (1) |
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Delivering intermittent IV therapy |
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195 | (2) |
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Infusing through smart pumps |
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197 | (2) |
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Giving Infusions a Little IV Push |
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199 | (1) |
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Going Automatic with Auto-Syringe Pumps |
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200 | (1) |
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Empowering Patients with PCA Pumps |
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201 | (2) |
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Chapter 12 Going for the Hand or Arm: Peripheral IV Essentials |
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203 | (24) |
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Getting Started with a Few Peripheral IV Basics |
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203 | (1) |
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Performing an Initial Vascular Access Assessment |
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204 | (2) |
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205 | (1) |
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205 | (1) |
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205 | (1) |
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Confirming the five rights |
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206 | (1) |
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Gathering Your Equipment: Selecting the Appropriate Peripheral VAD |
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206 | (4) |
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Size does matter: Choosing the correct catheter size |
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207 | (1) |
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Considering the type of device |
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208 | (2) |
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Determining the Best Peripheral IV Site |
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210 | (1) |
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Beginning the Insertion Process |
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211 | (6) |
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212 | (1) |
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Administering an anesthetic |
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212 | (1) |
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Inserting the peripheral IV |
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213 | (1) |
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214 | (1) |
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215 | (1) |
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216 | (1) |
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Labeling the infusion bag and line |
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216 | (1) |
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Verifying and documenting your actions |
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217 | (1) |
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217 | (7) |
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Assessing the site for complications |
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217 | (1) |
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218 | (1) |
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Watching for complications |
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218 | (4) |
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222 | (2) |
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Replacing Peripherals at Regular Intervals |
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224 | (1) |
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Discontinuing the Peripheral Line |
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225 | (2) |
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Chapter 13 The ABCs of the CVAD |
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227 | (28) |
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Starting from Scratch: CVAD Basics |
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227 | (1) |
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First Things First: What to Do Before Using the CVAD |
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228 | (1) |
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228 | (1) |
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Obtaining an order to infuse |
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229 | (1) |
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Gathering the Supplies You Need to Infuse through a CVAD |
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229 | (3) |
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Choosing the right infusion device |
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230 | (2) |
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Surveying the different types of CVADs |
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232 | (1) |
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Preparing the Line and Starting the Infusion |
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232 | (1) |
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233 | (9) |
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Checking out the surroundings |
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234 | (1) |
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234 | (1) |
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235 | (1) |
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236 | (1) |
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Checking for and preventing common complications |
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237 | (5) |
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242 | (3) |
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Changing ports, access caps, and IV tubing |
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242 | (1) |
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Performing site care and dressing changes |
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243 | (2) |
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245 | (5) |
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Drawing Blood through the CVAD |
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245 | (1) |
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246 | (1) |
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246 | (1) |
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Discontinuing and Removing the CVAD |
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247 | (1) |
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Following the right procedure |
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247 | (2) |
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249 | (1) |
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Documenting your actions after the removal |
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249 | (1) |
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Using an Implanted Port Instead |
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250 | (5) |
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Applying a local anesthetic |
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251 | (1) |
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Gaining access with a non-coring needle |
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251 | (1) |
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Administering therapy through the port |
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252 | (1) |
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Communicating with your patient |
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253 | (2) |
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Part IV Administering IV Therapy |
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255 | (74) |
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Chapter 14 Practical Pharmacological IV Administration |
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257 | (12) |
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Assessing Your Pharma Patient |
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257 | (6) |
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Considering five critical safety issues |
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258 | (4) |
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Asking patients about their problems |
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262 | (1) |
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Knowing your patient's medication history from past to present |
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263 | (1) |
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Initiating Pharmacological IV Treatment |
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263 | (3) |
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Before you begin: Getting ready for the infusion |
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264 | (1) |
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Starting IV medication therapy |
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265 | (1) |
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266 | (1) |
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Recognizing and Managing Adverse Drug Events (ADEs) |
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266 | (1) |
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Discontinuing IV Medications |
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267 | (1) |
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Staying Safe: Disposing of Pharmacological Agents |
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268 | (1) |
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Chapter 15 Transfusing Blood Components |
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269 | (14) |
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Preparing for a Blood Transfusion |
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269 | (4) |
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Verifying the physician's order and the patient's blood type |
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270 | (1) |
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270 | (1) |
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271 | (1) |
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Obtaining informed consent |
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272 | (1) |
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Administering pretransfusion medications |
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272 | (1) |
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273 | (3) |
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Verifying blood at the bedside |
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273 | (2) |
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Going with the flow: Starting a blood transfusion |
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275 | (1) |
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Monitoring the transfusion |
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276 | (1) |
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Recognizing and Managing Adverse Reactions |
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276 | (5) |
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Identifying the type of reaction |
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277 | (2) |
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Managing blood transfusion reactions |
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279 | (2) |
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Discontinuing the Transfusion |
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281 | (1) |
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Safely Handling and Disposing of All Blood Products |
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282 | (1) |
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Chapter 16 Infusing Chemotherapy with Caution |
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283 | (14) |
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Preparing for Chemotherapy |
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283 | (5) |
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284 | (1) |
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285 | (1) |
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286 | (1) |
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Preparing the chemotherapy agent |
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287 | (1) |
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Handling the chemotherapy agent |
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288 | (1) |
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Administering Chemotherapy |
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288 | (2) |
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288 | (1) |
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289 | (1) |
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289 | (1) |
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Reacting to Adverse Reactions |
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290 | (3) |
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Taking action as soon as you identify a reaction |
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291 | (1) |
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Dealing with vesicant extravasation |
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291 | (2) |
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Managing Common Side Effects |
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293 | (2) |
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Dealing with nausea, vomiting, and other GI disturbances |
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293 | (1) |
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Facing hair loss and fatigue |
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294 | (1) |
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Watching for bone marrow suppression |
|
|
295 | (1) |
|
Discontinuing Chemotherapy |
|
|
295 | (1) |
|
Safely Disposing of Chemotherapy Waste |
|
|
296 | (1) |
|
Chapter 17 A Balancing Act: Administering Fluids and Electrolytes |
|
|
297 | (12) |
|
Focusing on Fluids and Electrolytes As You Assess Your Patient |
|
|
298 | (4) |
|
Taking a complete patient history |
|
|
298 | (1) |
|
Obtaining baseline assessments |
|
|
298 | (1) |
|
|
|
299 | (3) |
|
Administering IV Replacement Therapy |
|
|
302 | (3) |
|
|
|
303 | (1) |
|
|
|
304 | (1) |
|
Recognizing and Managing Adverse Reactions |
|
|
305 | (2) |
|
|
|
305 | (1) |
|
Identifying adverse reactions with some common symptoms |
|
|
306 | (1) |
|
Responding to adverse reactions |
|
|
307 | (1) |
|
Discontinuing the Replacement Infusion |
|
|
307 | (2) |
|
Chapter 18 Making Every Calorie Count: Parenteral Nutrition |
|
|
309 | (20) |
|
Planning around Your Patient's Baseline Nutritional Status |
|
|
310 | (11) |
|
Obtaining your patient's weight |
|
|
310 | (2) |
|
Reviewing your patient's blood work |
|
|
312 | (2) |
|
Assessing your patient physically |
|
|
314 | (1) |
|
Asking questions about dietary history |
|
|
315 | (1) |
|
Using a clinical scoring system |
|
|
315 | (3) |
|
Calculating your patient's energy requirements |
|
|
318 | (2) |
|
Concentrating on concentrations |
|
|
320 | (1) |
|
Administering Parenteral Nutrition Products through a CVAD |
|
|
321 | (4) |
|
|
|
322 | (2) |
|
|
|
324 | (1) |
|
Managing Common PN Complications |
|
|
325 | (1) |
|
Discontinuing Parenteral Therapy |
|
|
326 | (1) |
|
Tapering off versus stopping abruptly |
|
|
327 | (1) |
|
Considering when to withhold or withdraw |
|
|
327 | (1) |
|
Disposing of Parenteral Nutrition Products |
|
|
327 | (2) |
|
Part V Considering Unique Populations |
|
|
329 | (38) |
|
Chapter 19 A Little Dab'll Do Ya: IV Therapy for Infants and Children |
|
|
331 | (12) |
|
Understanding How Pediatric IV Therapy Is Different |
|
|
331 | (5) |
|
Making equipment modifications |
|
|
333 | (1) |
|
Dealing with fear and establishing a positive relationship |
|
|
334 | (1) |
|
Avoiding complications: Keeping a watchful eye |
|
|
335 | (1) |
|
From Preemies to Teens: Dosing for Peds |
|
|
336 | (2) |
|
Understanding the importance of age and weight |
|
|
336 | (1) |
|
Practicing your dosage calculating skills |
|
|
337 | (1) |
|
Considering alternative methods for calculating dosing |
|
|
338 | (1) |
|
Peds-Specific Peripheral IV Considerations |
|
|
338 | (3) |
|
Selecting the best venous access site |
|
|
339 | (1) |
|
Choosing the most appropriate peripheral IV |
|
|
339 | (1) |
|
Using special techniques in venipuncture |
|
|
340 | (1) |
|
Knowing what to do after a successful IV start |
|
|
340 | (1) |
|
|
|
341 | (2) |
|
The non-tunneled percutaneous CVAD |
|
|
341 | (1) |
|
|
|
342 | (1) |
|
|
|
342 | (1) |
|
|
|
342 | (1) |
|
Chapter 20 When Aging Is an Issue: IV Therapy for the Elderly |
|
|
343 | (12) |
|
Understanding How Advanced Age Impacts IV Therapy |
|
|
343 | (2) |
|
Optimizing Therapy for the Older Adult |
|
|
345 | (4) |
|
Assessing the elderly patient |
|
|
345 | (1) |
|
Obtaining informed consent |
|
|
346 | (1) |
|
|
|
347 | (1) |
|
Selecting the best venipuncture site |
|
|
347 | (1) |
|
Choosing the most effective equipment |
|
|
348 | (1) |
|
Gentleness Is Key: Following Some Basic Insertion Guidelines |
|
|
349 | (1) |
|
Prepping your elderly patient's skin |
|
|
349 | (1) |
|
|
|
349 | (1) |
|
|
|
349 | (1) |
|
Monitoring the Infusion to Prevent Complications |
|
|
350 | (4) |
|
|
|
351 | (1) |
|
Dealing with equipment issues |
|
|
351 | (1) |
|
Identifying adverse drug reactions |
|
|
352 | (1) |
|
|
|
353 | (1) |
|
Replacing and Discontinuing Peripheral IVs |
|
|
354 | (1) |
|
Chapter 21 There's No Place Like Home: IV Therapy for the Homebound Patient |
|
|
355 | (12) |
|
Ensuring Safety: Assessing the Home Environment |
|
|
356 | (2) |
|
Checking out the neighborhood |
|
|
356 | (1) |
|
Dealing with safety issues in the home |
|
|
357 | (1) |
|
Optimizing IV Therapy for a Homebound Patient |
|
|
358 | (2) |
|
Completing a patient assessment |
|
|
359 | (1) |
|
Developing a patient care plan |
|
|
360 | (1) |
|
Getting Comfortable with Home Infusion Equipment |
|
|
360 | (2) |
|
Managing Your Home Patient's Therapy |
|
|
362 | (3) |
|
Having an emergency plan in place |
|
|
362 | (1) |
|
Monitoring IV therapy in the home |
|
|
363 | (1) |
|
|
|
364 | (1) |
|
|
|
364 | (1) |
|
Properly discarding hazardous waste in the home |
|
|
365 | (1) |
|
Teaching Your Patients (And Their Families) How to Care for Themselves |
|
|
365 | (2) |
|
|
|
367 | (10) |
|
Chapter 22 Ten Things You Need to Know in IV Therapy |
|
|
369 | (4) |
|
Chapter 23 Ten Tricks of the Trade for Starting IVs |
|
|
373 | (4) |
| Index |
|
377 | |
