Plumer's Principles & Practice of Intravenous Therapy

by Weinstein, Sharon M.; Plumer, Ada Lawrence

• ISBN13: 9780397553112
• ISBN10: 0397553110
• Format: Paperback
• Copyright: 1996-11-01
• Publisher: Lippincott Williams & Wilkins

Table of Contents

Part I Practice of Intravenous Therapy	1	(46)
History of Intravenous Therapy	3	(4)
Early History	3	(1)
Twentieth-Century Advances	4	(1)
The Nursing Role	5	(2)
Risk Reduction and Quality Improvement	7	(11)
Legal Implications	7	(2)
Guidelines	9	(3)
Placement of the Peripherally Inserted Central Catheter	12	(1)
Risk Management	12	(1)
Quality Assurance	13	(2)
Quality Improvement	15	(3)
Organization of an Intravenous Department	18	(13)
Intravenous Nursing Teams	18	(1)
Leadership	19	(1)
Philosophy and Objectives	19	(1)
Functions of the Department	19	(5)
Didactic Program	24	(5)
Impact of Cost Containment on Infusion Teams	29	(2)
Nursing Role and Responsibilities	31	(11)
Standards of Practice	32	(1)
Nursing Care Plan	32	(1)
Assessment	32	(1)
Initiation	32	(1)
Site Selection	32	(1)
Cannula Selection	33	(1)
Hair Removal	33	(1)
Site Preparation	33	(1)
Cannula Placement	34	(1)
Intravenous Administration Set Change	34	(2)
Intravenous Containers	36	(1)
Dressing Changes	36	(1)
Ambulating the Patient	36	(1)
Frequent Observation	36	(3)
Monitoring	39	(1)
Documentation	39	(1)
Discontinuation of Therapy and Cannula Removal	40	(2)
Cost Factors Associated With Infusion Therapy	42	(5)
Managed Care	43	(1)
Impact of Managed Care on Infusion Therapy	43	(4)
Part II Principles of Venipuncture	47	(88)
Anatomy and Physiology Applied to Intravascular Therapy	49	(9)
Anatomy and Physiology	49	(1)
The Vascular System	50	(5)
The Skin	55	(1)
Superficial Fascia	56	(2)
Techniques of Intravenous Therapy	58	(26)
Approach to the Patient	58	(1)
Selecting the Vein	59	(3)
Selecting the Cannula	62	(2)
Securing An Appropriate Environment	64	(1)
Venous Distention	65	(1)
Preparation	65	(1)
Procedure	66	(3)
Anchoring the Device	69	(1)
Application of Dressings	70	(2)
Other Techniques	72	(3)
Hypodermoclysis	75	(1)
Phlebotomy	76	(8)
Complications	84	(27)
Local Complications	84	(4)
Systemic Complications	88	(5)
Intravenous-Associated Infections	93	(1)
Sources of Bacteria	93	(2)
Factors Influencing the Survival of Bacteria	95	(3)
Factors Contributing to Infection	98	(4)
Care of the Venous Access Device	102	(1)
Intravenous-Associated Infections	103	(1)
Particulate Matter	104	(3)
Culturing	107	(1)
Practice Setting	108	(3)
Laboratory Tests	111	(24)
Venous Sampling	112	(2)
The Vacuum System	114	(1)
Peripheral Venipunctures	114	(2)
Central Venipunctures	116	(1)
Initiating an Infusion	116	(1)
Common Laboratory Tests	117	(5)
Measurements of Electrolyte Concentration	122	(2)
Venous Blood Measurements of Acid-Base Balance	124	(1)
Enzymes	125	(2)
Transaminase	127	(1)
Liver Function Tests	127	(2)
Kidney Function Tests	129	(1)
Blood Sugar Tests	130	(1)
Blood Typing	131	(4)
Part III Principles of Equipment Selection and Clinical Applications	135	(150)
Intravenous Equipment	137	(41)
Solution Containers	137	(1)
Delivery Systems	138	(1)
Administration Sets	139	(4)
Rate of Flow	143	(6)
Intravenous Accessories	149	(1)
Final Intravenous Filters	149	(4)
Latex Injection Ports	153	(1)
Needleless Systems	153	(1)
Peripheral Vascular Access Devices	154	(5)
Catheter Materials	159	(1)
Electronic Infusion Devices	160	(2)
Ambulatory Infusion Devices	162	(1)
Therapy-Specific Devices	163	(12)
ECRI and General Purpose Infusion Pumps	175	(1)
Product Selection and Evaluation	176	(2)
Central Venous Catheterization	178	(27)
Vascular Anatomy	178	(3)
Central Venous Pressure	181	(2)
Central Venous Pressure Monitoring	183	(3)
Approach to the Patient	186	(1)
Central Venous Cannulation	187	(1)
Insertion Sites	188	(1)
Central Insertion	188	(1)
Peripherally Inserted Central Catheters	189	(5)
Peripheral Port	194	(1)
Complications of Central Venous Catheterization	195	(10)
Advanced Vascular Access	205	(55)
Devices	205	(1)
Catheter Materials	206	(1)
Bonded Catheters	207	(1)
Catheter Designs	208	(7)
Specialty Devices	215	(12)
Tunneled Catheters	227	(1)
Implanted Ports	228	(9)
Implanted Pumps	237	(4)
Intraosseous Access	241	(4)
Ventricular Reservoirs	245	(1)
Troubleshooting/Applicable Standards	246	(1)
Catheter Declotting	246	(1)
Catheter Repair	247	(2)
Catheter Site Care	249	(2)
Catheter Maintenance	251	(1)
Standards of Practice	252	(1)
Recommendations for Nursing Practice	252	(8)
Intra-arterial Therapy	260	(25)
Purpose	260	(1)
One-Time Arterial Blood Gas Sampling	261	(5)
Indwelling Arterial Catheter	266	(3)
Constant Arterial Pressure Monitoring	269	(3)
Swan-Ganz Catheters	272	(2)
Parameters	274	(4)
Primary Acid--Base Imbalances	278	(3)
Mixed Acid--Base Imbalances	281	(4)
Part IV Application of Intravenous Therapy for Homeostasis	285	(246)
Fluid and Electrolyte Balance	287	(30)
Overview of Physiology	287	(1)
Fluid Content of the Body	288	(2)
Composition of Body Fluid	290	(4)
Homeostatic Mechanisms	294	(2)
Electrolytes of Biologic Fluids	296	(4)
Objectives of Fluid and Electrolyte Therapy	300	(3)
Electrolyte and Fluid Disturbances---Patient-Specific Approaches	303	(14)
Principles of Parenteral Fluid Administration	317	(28)
Parenteral Fluids	317	(3)
Dextrose in Water	320	(3)
Isotonic Sodium Chloride Infusions	323	(1)
Isotonic Saline With Dextrose	324	(1)
Hypertonic Sodium Chloride Infusions	325	(1)
Hypotonic Sodium Chloride in Water	326	(1)
Hydrating Fluids	326	(1)
Hypotonic Multiple-Electrolyte Fluids	327	(1)
Isotonic Multiple-Electrolyte Fluids	328	(1)
Alkalizing Fluids	329	(1)
Acidifying Infusions	330	(1)
Evaluation of Water and Electrolyte Balance	331	(5)
Clinical Disturbances of Water and Electrolyte Metabolism	336	(9)
Parenteral Nutrition	345	(44)
History	345	(1)
Indications	346	(1)
Nutritional Assessment	346	(8)
Nutritional Requirements	354	(4)
Total Parenteral Nutrition Solutions	358	(4)
Vascular Access	362	(4)
Parenteral Nutrition Administration	366	(4)
Nursing Management	370	(3)
Complications	373	(9)
Home Parenteral Nutrition	382	(2)
Summary	384	(5)
Transfusion Therapy	389	(31)
Basic Immunohematology	390	(1)
Mechanism of Immune Response	391	(1)
Mechanism of Red Blood Cell Destruction	392	(1)
Blood Group Systems	392	(1)
Pretransfusion Testing	393	(1)
Anticoagulants--Preservatives	394	(1)
Whole Blood	394	(2)
Red Blood Cell Components	396	(3)
Plasma	399	(5)
Blood Administration	404	(3)
Transfusion Reactions	407	(8)
Autologous Transfusions	415	(2)
Directed Donations	417	(3)
Drug Administration	420	(19)
Advantages of the IV Route	420	(1)
Hazards	421	(1)
Pharmacokinetics	421	(2)
Therapeutic Drug Monitoring	423	(1)
Incompatibilities	424	(2)
PH and Its Role in Drug Stability	426	(1)
Vascular Irritation	426	(1)
Approved Drug Lists	427	(1)
The Physician's Responsibility	428	(1)
Admixture	428	(3)
Drug Delivery Systems	431	(2)
Important Checkpoints in IV Drug Administration	433	(1)
Drug Calculations	434	(2)
Expiration Dates	436	(1)
Administration of Investigational Drugs	436	(3)
Pain Management	439	(24)
Acute Pain	439	(2)
Chronic Pain	441	(1)
Opioids	441	(1)
Intravenous Patient--Controlled Analgesia	442	(2)
Subcutaneous Narcotic Infusions	444	(1)
Intraspinal Analgesia	445	(8)
Staff Education	453	(7)
Documentation	460	(3)
Antineoplastic Therapy	463	(68)
Education	464	(9)
Chemotherapeutic Agents	473	(38)
Controversial Issues	511	(4)
Complications	515	(16)
Part V Special Applications of Intravenous Therapy	531	(77)
Pediatric Intravenous Therapy	533	(47)
Preliminary Considerations	535	(1)
Emotional Considerations	536	(1)
Preparation for Venipuncture	537	(2)
Peripheral and Central Intravenous Access	539	(2)
Intravenous Insertion Techniques	541	(18)
Pediatric Intravenous Therapies	559	(16)
Alternative Site Pediatric IV Therapy	575	(1)
Summary of Pediatric Care	576	(4)
Intravenous Therapy in an Older Adult Patient	580	(7)
An Aging Population	580	(2)
Patient Assessment	582	(1)
Considerations in Providing Intravenous Therapy	583	(4)
Alternate Site Therapy	587	(21)
Growth of Home Care	587	(1)
Home Infusion Programs	587	(1)
Nursing Support	588	(1)
The Pharmacist	588	(1)
Policies and Procedures	589	(1)
Staff Development	590	(2)
Home Infusion Therapies	592	(3)
Candidates for Home Infusion	595	(5)
Plan of Treatment	600	(1)
Selecting a Home Infusion Provider	600	(1)
Equipment Needs	601	(3)
Compliance	604	(1)
Patient's Role in Home Care	604	(1)
Infectious Waste Management	604	(1)
Reimbursement	604	(1)
Infusion Therapy Centers	605	(3)
Appendix A Licensed Practical/Vocational Nurse-Delivered Therapies	608	(3)
Appendix B Standards of Practice: Nutrition Support Nurse	611	(5)
Appendix C Standards of Practice: Standards for Home Nutrition Support	616	(9)
Appendix D ASHP Therapeutic Position Statement on the Institutional Use of 0.9% Sodium Chloride Injection to Maintain Patency of Peripheral Indwelling Intermittent Infusion Devices	625	(4)
Glossary	629	(5)
Answers to Questions	634	(3)
Index	637