NURS 225 Lecture Notes - Lecture 15: Parenteral Nutrition, Superior Vena Cava, Intravenous Therapy
4 Nov 2020
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Iv therapy using hemodilution (high osmolarity) hypertonic solutions total parenteral nutrition osmolarity no greater than 600 anything more than 10% dextrose, 5% protein or high electrolyte concentration. Large bore venous access required usually in emergent situations. Lack of alternate access e. g. extreme age groups. All catheters rest within the superior vena cava, with the exception of the femoral site. Femoral site: not used often due to increased risk of infection in the area. The tip of the cv catheter should not enter the right atrium if in right atrium, patient will present with tachycardia or arrhythmia. Highest risk of infection (due to short length) X ray required prior to internal jugular and clavicular insertion. Secured with dacron cuff (fibrous tissue grows around it) Long term use (up to 1-3 years) Inserted via peripheral vein (basilic, median cubital, brachial or cephalic) Recommended for all infusion therapies up to a year. May be inserted at the bedside or in radiology under fluoroscopy.
