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Types of IV BagsIV solutions are usually available in a tough, flexible, plastic bag. The bag will be of the size needed for the purpose of the IV therapy. For example, larger bags will be used for continuous hydration and smaller bags may be used for intermittent medication administration. The larger continuous IV bags are often called the main IV or primary IV. These large bags often contain 1000 milliliters or 1 liter of fluid. The intermittent IVs used to deliver medications several times a day are usually much smaller bags. These small bags may contain 50, 75 or 100 milliliters, for example.Main IV BagIV Piggy Back BagsWhen used for intermittent treatments, the smaller bags are often called IV piggy backs or IVPBs. The term "piggyback" is used because the smaller bag is plugged into, or "takes a piggyback ride" on, the established main IV line. The smaller bag is removed once the medication has been infused; the main IV remains unchanged. This "piggyback" technique means the patient does not require multiple IV sites.Main IV with IVPB IV SolutionsNow let's consider the types of fluids you will find in the IV bags. Some of these solutions may be found in either large or small IV bags.First, there are saline solutions. These fluids contain a specific percentage of the electrolytes sodium (Na+) and chloride (Cl-). The common types of plain saline solutions are:Sodium chloride 0.45%Sodium chloride 0.9%Normal Saline and Half Normal Saline IV BagsWe commonly refer to these solutions in several ways:Sometimes the abbreviations for sodium and chloride are used so you will see Na+ and Cl-.The 0.9% solution may simply be called "normal saline", abbreviated NS.The 0.45% solution may be referred to as "half normal saline" (since 0.45% is half of 0.9%) and abbreviated 1/2 NS.?Some solutions contain fluid, electrolytes and some calories in the form of carbohydrates. The carbohydrate used is dextrose, which will be abbreviated as "D". Fluid types and the abbreviations used for each inlcude: 5% dextrose in 0.45% saline: D half normal or D5 1/2NS5% dextrose in 0.9% saline: D5 normal or D5NS10% dextrose in 0.9% saline: D10 normal or D10NSD5NS IV Bag D5W IV Bag?There are also solutions which provide fluid replacement and some calories (dextrose) but no electrolytes (no Na or Cl).Examples include: 5% dextrose in water, abbreviated D5W10% dextrose in water, abbreviated D10WSome solutions have more electrolytes than the simple saline solutions. The electrolytes potassium (K) and calcium (Ca) may be added. Two types of such solutions include:Ringer's solution, simply called "Ringer's"Lactated Ringer's solution, abbreviated LRS.IV TubingIn order to connect an IV bag to a patient, tubing must be attached to the bag which is then attached to the catheter in the patient's vein. The IV bags do not come with tubing already connected. You will need to select both the bag and the tubing and assemble them.Main IV Bag and IV TubingNow look at the picture below, noticing the labeled items. We're going to investigate what each of these are.Play video of roller clamp adjusting flow rate.?Press play to view the video of slide ?The clamps on the tubing control the rate of flow for the fluid. The roller clamp will adjust the flow rate from a very slow rate to a "wide open" flow rate. The slide clamp, on the other hand, is used as an "on-off" switch. It provides an extra degree of safety if you want to be sure no fluid is moving in the IV tubing.The drip chamber is part of any IV tubing which allows visual inspection of fluid movement. Drops (gtts)of fluid can be seen falling in the drip chamber, which allows you to actually to see how fast or slow the fluid is moving. Remember you can control this rate of flow with your roller clamp. The drip chambers are purposely manufactured to allow a specific size of drop to fall; some tubing allows small drops (gtts)to fall, while others allow larger drops (gtts)to fall. The manufacturer must label the IV tubing to tell you the size of the drops for that set of tubing. The difference in the size of the drops is always expressed in terms of how many drops it takes to equal 1 mL of fluid. This is the drop factor.Examples of how the drop factor is expressed:60gtts/mL, meaning 60 small drops must fall in the drip chamber before 1 mL of fluid has moved through the tubing and into the patient.15gtts/mL meaning only 15 drops must fall before 1 mL of fluid has moved into the patient.Drop factor is 10: this means that 10 drops must fall to equal on milliliter.Because the drop factor is ALWAYS expressed in terms of how many drops equals one milliliter, the "one milliliter" may not actually be stated. For any IV tubing, you can never guess at the drop factor. You must always read this information as it is given by the manufacturer.IV TubingThe drop factor is critical to know any time you must calculate a flow rate for an IV in gtts/minute. If you know how many drops equal one milliliter, and you count how many drops fall in a minute, you will know how much fluid -how many mLs of fluid the patient has received in one minute. Next you'll view some simple IV orders and answer the questions about the orders. ................
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