Definition of Intravenous Injection – Nursing is a profession within the healthcare sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other healthcare providers by their approach to patient care, training, and scope of practice. Nurses practice in many specialisms with differing levels of prescriber authority.
Many nurses provide care within the ordering scope of physicians, and this traditional role has shaped the public image of nurses as care providers. However, nurses are permitted by most jurisdictions to practice independently in a variety of settings depending on training level. In the postwar period, nurse education has undergone a process of diversification towards advanced and specialized credentials, and many of the traditional regulations and provider roles are changing.
Nurses develop a plan of care, working collaboratively with physicians, therapists, the patient, the patient’s family, and other team members, that focus on treating illness to improve quality of life. Nurses may help coordinate the patient care performed by other members of an interdisciplinary healthcare team such as therapists, medical practitioners, and dietitians. Nurses provide care both interdependently, for example, with physicians, and independently as nursing professionals.
Intravenous Injection
Definition of Intravenous Injection:
Intravenous injection is the injection of liquid substances which is given directly into a vein. It is given through the vein directly, delivers the drugs directly into the bloodstream. Medications administered intravenously have an immediate effect.
Sites of Intravenous Injection:
A. Inner Arm
- Median cubital vein of the forearm
- Cephalic Vein
- Basilic Vein
- Radial Vein
B. Dorsal surface of hand:
- Superficial dorsal vein
- Dorsal venous arch
- Basilic vein
- Cephalic vein.
C. Dorsal surface of foot:
- Dorsal arch
- Dorsal plexus
- Great saphenous vein.
Advantages of Intravenous (IV) Route:
1. Intravenous route is used in emergency cases to obtain immediate effect and highly predictable blood volume
2. Large volume, unpleasant and irritant solution can be given
3. Suitable for unconscious and non-co-operative patients.
4. Drugs can be given through I.V. route in case of Diarrhea, vomiting or where the patient is unable to swallow.
5. Rapid action and accuracy of dose are ensured.
Disadvantages of Intravenous (IV) Route:
1. It is invasive painful procedure.
2. Self-medication is difficult
3. Strict aseptic measures, special, technique and skill are essential.
4. Risks: like infection, hypersensitivity reaction, pyrogenic reaction, local venous thrombosis, & hemolysis may occur.
5. Leakage of the drug outside the vein can produce severe irritation.
6. Overdose may have effects so immediate that it is impossible to reverse them.
7. Chance of injury to surrounding nerves and vessels.
8. Drugs must be water-soluble.
9. Short duration of action, as excretion is rapid.
10. Expensive.
Purposes of Injection:
1. To get the rapid and systemic effect of the drug.
2. Some medications are cannot be given by mouth. So they should be given by parenteral route. These are:
- Some medications are rendered ineffective in the gastro-intestinal tract by the action of gastric juice. E.g. Insulin.
- Some are not retained in the intestine for a sufficient period for its absorption due to diarrhea, vomiting or gastric suction.
- Some medications are poorly absorbed from gastro-intestinal tract.
- When the drug is toxic and irritating to the gastro-intestinal mucosa
3. To give required effect when the patient is unconscious or unable to swallow due to surgical or neurological problems or when the patient is not co-operative.
4. To get a local effect at the site of the injection
- For diagnostic purpose-Tuberculine Test.
- For local anaesthesia-Inj. Xylocaine.
- To test allergic condition of the drug. E.g. serum or penicilline test.
- To treat local conditions. E.g. Hydrocortisone injection into joint cavity.
5. To restore blood volume and electrolyte balance by replacing fluid e.g. in shock conditions.
6. To give nourishment when it cannot be taken by mouth
Procedure of Intravenous Injection:
1.Sterile syringe and needle of the size required according to quantity of drug is kept ready.
2. Explain the procedure to the patient to win his confidence.
3. Tactfully send the visitors out of patient’s room.
4. If the general condition allows ask the patient to wash hands with soap and water.
5. A rubber tourniquet or blood pressure cuff is tied on the upper arm to cause accumulation of blood and engorgement of veins.
6. The skin at the site of injection is cleaned with spirit swab.
7. The hand of patient is made steady by holding it with our left hand.
8. The needle is inserted at an angle of 30° or above to the skin surface.
9. When the needle pierces the vein, bloods comes out in syringe and then pushes the plunger/piston of syringe to inject the drug slowly.
10. When the needle is removed, the vein is pressed with the sponge and the forearm is flexed so as to collapse the vein and prevent bleeding.
Ways to Prevent Infection during an Injection:
1. To prevent contamination of solution, draw medication from ampoule quickly. Do not allow it to stand open.
2. To prevent needle contamination, avoid letting needle touch contaminated surface (e.g. out edges of ampoule or vial outer surface of needle cap, nurses’ hands counter top, and table surface).
3. To prevent syringe contamination, avoid touching length of plunger or inner part of barrel. Keep tip of syringe covered with needle cap.
4. To prepare skin, wash skins soiled with dirt, drainage or feces with soap and water and dry. Use friction and a circular motion while cleaning with an antiseptic swab. Swab from center of site, and move outward in a 2-inch radius.
Complication of Injection:
1. Allergic Reactions- Penicillin, sera, etc can produce allergic reactions in patients. It can be prevented by giving test dose.
2. Pain.
3. Injection Abscess- It is due to improper sterilization of injection needles and syringes and the fluids used for injection. It causes infection and leads to abscess formation.
4. Injury to nerve- Injury to sciatic and brachial nerve due to faulty technique of injection.
5. Air Embolism- It is due to introduction of air into the blood vessels.
6. Psychic trauma in children.
7. Serum hepatitis- It is due to improper disinfection of syringes and needles. Inoculation of
0.0004 ml of infected blood may transmit the serum hepatitis.
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