(1) Certain drugs or chemicals react when they are placed in a solution.
The result is changed drugs or chemicals. This same type of chemical change can
occur when a drug is added to an intravenous solution. Remember the chemical
AgNO3 + NaCl → AgCl (↓) + NaNO3
(2) In the laboratory, silver nitrate (AgNO3) is added to sodium chloride
(NaCl) and white precipate (silver chloride, AgCl) is formed. You can actually see the
silver chloride formed. Unfortunately, one cannot see all the chemical reactions which
could happen when a drug is added to an intravenous solution. But remember, when
this type of reaction occurs, the patient is not receiving the drug(s) the physician
ordered. How can such incompatibilities be prevented? The answer is simple, the
person who prepares the admixture in the Pharmacy Sterile Products Section must use
the references available there to determine if a drug (or combination of drugs) may be
safely added to an intravenous solution. Furthermore, nursing personnel should be
cautioned never to add a drug to the contents of the intravenous product without
checking with the person in the Pharmacy Sterile Products Section.
c. 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 with a resultant pH which will not irritate the veins to a great degree. In other
cases, the site through which the irritating solution is being administered can be
changed on a frequent basis in order to allow that part of the vein to recover.
d. 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 for 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 which is cloudy in nature might actually be cloudy because of suspended
particulate matter. Remember, filters are available which can filter most particulate
matter from intravenous products, but in some cases the particulate matter is actually
COMPLICATIONS OF INTRAVENOUS FLUID THERAPY
Various complications are associated with the administration of intravenous fluid
therapy. Some of these complications are:
a. Infection. When microorganisms enter the circulatory system through the
venipuncture site, an infection can result. The microorganisms--primarily bacteria--can
be present in the intravenous solution or admixture, in the intravenous administration