3-8. PRECAUTIONS FOR USING FLUID THERAPY

You will likely be in a position to administer or supervise administration of fluid therapy. Some precautions will be beyond your control, but most will be your responsibility. Carefully watch for the pitfalls shown below, to make sure that the intravenous infusion does the patient more good than harm.

a. Contamination. A solution intravenously administered to a patient must be free from living microorganisms. You have a responsibility for using the aseptic technique. When there is doubt about the sterility of the admixture (or intravenous solution), the product should be discarded. Microorganisms are present in the environment of the hospital room. They are on the hands of the person who will start (that is, begin the administration) the intravenous product. Therefore, this person is responsible for using care and aseptic technique to make the venipuncture.

b. Irritating Drugs. The veins are very sensitive. Therefore, any intravenous product which has an extreme pH or which is very concentrated can irritate the veins. In some cases, the physician can decide to place the drug in another intravenous solution resulting in a pH that will not irritate the veins as much. In other cases, the site can be changed frequently to allow the part of the vein just used to recover.

c. Particulate Matter. Hold a bottle or bag of intravenous solution up in front of a light. See how it is sparkling clear. Actually, small particles called particulate matter are present in the solution. Standards allow extremely small particles to be present in the solution in certain concentrations. Intravenous solutions or admixtures should never be administered to a patient when the products contain visible particulate matter. A product that is cloudy might actually be cloudy because of suspended particulate matter. Even though filters are available which can filter most particulate matter from intravenous products, do not use a cloudy solution.