Risk Management and Quality Patient
Management 3
Legal and Ethical Issues in Infusion Therapy 6
Risk Management and Risk Assessment 14
Developing and Participating in Product Evaluation 19
Performance Improvement and Quality Patient
Management 21
Developing Nursing Competency Standards 27
Occupational Risks 30
2 Infection Control Measures 43
Immune System Function 46
Basic Principles of Epidemiology 50
Chain of Infection 51
Infusion-Related Infections 55
Strategies for Preventing/Treating Infection 66
3 Fundamentals of Fluid Balance 81
Body Fluid Composition 83
Fluid Distribution 85
Fluid Function 86
Homeostatic Mechanisms 91
Physical Assessment 94
Fluid Volume Imbalances 98
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4 Fundamentals of Electrolyte Balance 110
Basic Principles of Electrolyte Balance 112
Sodium (Na) 114
Potassium (K) 119
Calcium (Ca2) 126
Magnesium (Mg2) 132
Phosphorus (HPO4
–
) 137
Chloride (Cl-
) 140
Acid-Base Balance 143
Major Acid-Base Imbalances 147
Metabolic Acid-Base Imbalance 147
Respiratory Acid-Base Imbalance 151
Unit 2 Basic Infusion Practice 163
5 Parenteral Solutions 165
Rationales and Objectives of Parenteral Therapy 167
Key Elements in Parenteral Solutions 170
Osmolarity of Parenteral Solutions 173
Types of Parenteral Solutions 175
6 Equipment 197
Infusion Therapy Equipment 199
Infusion Delivery Systems 200
Administration Sets 206
Accessory Devices for Administration Sets 213
Peripheral Infusion Devices 224
Central Infusion Devices 230
Infusion Regulation Devices 235
7 Techniques for Peripheral Intravenous
Therapy 257
Anatomy and Physiology Related to I.V. Practice 259
Approaches to Venipuncture 263
Discontinuation of the I.V. Cannula 288
Intermittent Infusion Devices 289
Controversial Practices 291
Calculating the I.V. Rate 295
xvi Contents
00Phillip Manual-FM 12/06/2004 12:48 PM Page xvi
8 Phlebotomy Techniques 323
Introduction to Phlebotomy 325
Steps in Collection of Blood Specimens 326
Venipuncture Methods 340
9 Complications of Intravenous Therapy 356
Complications of I.V. Therapy 358
Local Complications 358
Systemic Complications 386
10 Special Considerations Related to
Intravenous Therapy: The Pediatric
and Geriatric Populations 406
Pediatric I.V. Therapy 408
Geriatric I.V. Therapy 428
Other Special Problems 434
Unit 3 Advanced Infusion Practice 447
11 Administration of Intravenous Medications 449
Principles of Intravenous Medication Administration 451
Intravenous Drug Safety 455
Drug Compatibility 459
Intravenous Medication Administration 461
Continuous Subcutaneous Medication Administration 468
Intraperitoneal Medication Administration 471
Intraosseous Medication Administration 471
Intraventricular Medication Administration 471
Intra-arterial Medication Administration 472
Pain Management 472
Epidural and Intrathecal Medication Administration 475
Special Drug Administration Considerations 487
12 Central Venous Access 502
Julie Eddins, RN, MSN, CRNI
Anatomy of the Vascular System 505
Choosing the Venous Access Device 508
Contents xvii
00Phillip Manual-FM 12/06/2004 12:48 PM Page xvii
Preventing Catheter-Related Infections 517
Short-Term Access Devices 518
Long-Term Access Devices 540
Management of Occluded Central Venous Access
Devices 556
Pediatric Central Venous Access 563
13 Transfusion Therapy 573
Basic Immunohematology 576
Blood Donor Collection Methods 583
Blood Component Therapy 589
Colloid Volume Expanders 603
Transfusion Alternatives 605
Blood Substitutes 605
Administration of Blood Components 608
Complications Associated with Blood Component
Therapy 620
14 Antineoplastic Therapy 647
Pamela Hockett, RN, MSN, CNS, OCN
The Role of the Clinician 650
Guidelines for Handling Hazardous Drugs (HDs) 652
Cellular Kinetics 653
Tumor Kinetics 655
Antineoplastic Agents 657
Common Side Effects of Chemotherapy 672
Chemotherapy: Routes of Administration 688
15 Nutritional Support 708
Nutritional Support 710
Concepts of Nutrition 711
Nutritional Assessment 713
Nutritional Requirements 720
Nutritional Support Candidates 730
APPENDIX A: Summary of Recommended Procedures
for Maintenance of Intravascular
Catheters, Administration Sets, and
Parenteral Fluids 767
APPENDIX B: Competency SkillChecks 771