Section II. PRECAUTIONS AND COMPLICATIONS ASSOCIATED
WITH INTRAVENOUS THERAPY
5-1.
INTRODUCTION
Normally, a person obtains the fluids and electrolytes needed to live by the oral
route. This route has certain built-in safeguards against bacterial invasion. When the
intravenous route of administration must be used, the material being given is injected
directly into the circulatory system through the veins. Although this route of
administration is certainly effective in terms of getting the fluid into the patient, the
intravenous route is not completely safe. Complications (e.g., infection) can arise. In
the case of infection, the fluid being administered, the intravenous administration set
(the equipment between the bottle or the bag and the patient), or the technique used to
start the fluid administration are potential sources of bacterial contamination. In short,
the intravenous administration of fluids is to be taken seriously.
5-2.
TWO BASIC CATEGORIES OF INTRAVENOUS PREPARATIONS
We have all seen intravenous solutions being administered to a patient. We
have known that the bottle or bag connected to the patient by a plastic tube means life
to many patients. For the purpose of discussion, this subcourse divided intravenous
preparations into two major categories: intravenous solutions and intravenous
admixtures. The purpose of this division is to help you understand that the pharmacy
does not prepare every intravenous product which is administered to a patient.
a. Intravenous Solutions. Intravenous solutions are products which meet
certain rigid requirements and are supplied ready for use by manufacturers. Examples
of such intravenous solutions are 5% Dextrose Injection, 0.9% Sodium Chloride
Injection, and Lactated Ringer's Injection. These solutions are ready for use as soon as
they arrive from the manufacturer. You will see the 5% Dextrose Injection and the 0.9%
Sodium Chloride Injection used as "to keep open" (TKO) solutions. That is, they are
slowly administered to a patient in order to provide fluid. In addition, they serve as a
ready and rapid way by which drugs could be given to the patient should the patient go
into shock. These solutions serve as a "base" for the category below.
b. Intravenous Admixtures. Intravenous admixtures are intravenous solutions
to which have been added one or more drugs. For example, it is common for a patient
to be administered a liter of 5% Dextrose Injection which has 20 mEq of potassium
chloride added to it. Thus, the patient received fluid, nutrients (dextrose), and
electrolytes (potassium and chloride). Typically, patients receive much more
complicated intravenous admixtures. These intravenous admixtures are prepared in the
Pharmacy Sterile Products Section by specially trained persons who use aseptic
techniques.
MD0807
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