Intravenous Rehydration Health Article

Definition

Intravenous rehydration is the process by which sterile water solutions containing small amounts of salt or sugar are injected into the body through a tube attached to a needle which is inserted into a vein.

Purpose

Intravenous rehydration is used to restore the fluid and electrolyte balance of the body due to illness, surgery, or accident. Electrolytes are salts (sodium, potassium, chloride, calcium, magnesium, phosphate, sulfate, and bicarbonate) that become ions when mixed with fluids in the body and blood and have the ability to conduct electricity. The body uses electrolytes to carry electrical impulses from cell to cell. Moderate to severe dehydration can interfere with the body's normal functioning. Restoration of fluids and electrolytes through intravenous means is the swiftest means to achieve fluid balance.

Description

Fever, vomiting, and diarrhea can cause a child to become dehydrated fairly quickly. Infants and children are especially vulnerable to dehydration. Athletes who have over-exerted themselves in hot weather may also require rehydration with IV (intravenous) fluids. An IV for rehydration can be in place for several hours to several days and is generally used if a patient cannot drink fluids.

Basic IV solutions are made of sterile water with small amounts of sodium (an ingredient in table salt) or dextrose (sugar) supplied in bottles or thick plastic bags that can hang on a stand mounted next to the patient's bed. Additional mineral salts such as potassium and calcium, vitamins, or medications can be added to the IV solution by injecting them into the bottle or bag with a needle or injected directly into the IV line.

Precautions

Patients receiving IV therapy need to be monitored to ensure that the IV solutions are providing the correct amounts of fluids and minerals needed. People with kidney and heart disease are at increased risk for over-hydration, so they must be carefully monitored when receiving IV therapy.

Preparation

The doctor orders the IV solution and any additional nutrients or medications to be added to it. The doctor also specifies the rate at which the IV will dispense the solution.

The IV solutions are prepared under the supervision of a pharmaceutical company, using sanitary techniques that prevent bacterial contamination, and come prepackaged. Additions to the IV solutions are supervised by a doctor or nurse. Just like a prescription, the IV is clearly labeled to show its contents and the amounts of any additives.

The skin around the area where the needle for the IV catheter is inserted is cleaned and disinfected. Once the IV catheter is in place, it is taped to the skin to prevent it from being dislodged. The IV line is then attached to the IV catheter. Any other IV lines can be added to the IV catheter.

Aftercare

Patients need to take fluids by mouth before an IV solution is discontinued. After the IV needle is removed, the site should be inspected for any signs of bleeding or infection.

Risks

There is a small risk of infection at the injection site that is usually treated topically. It is also possible that the IV solution may not provide all of the nutrients needed, leading to a deficiency or an imbalance, which would need to be corrected.

If the needle becomes dislodged, the solution can flow into tissues around the injection site rather than into the vein. This is called extravasation, or infiltration, and occurs in about half of pediatric IVs. In most cases, the patient reports a burning or stinging sensation at the site of the needle or IV catheter, especially when new IV fluids are started or the speed of the IV drip is increased. The tissues usually swell and become discolored, looking like a bruise. Usually, the IV catheter is removed and reinserted at another site.

If an IV has been in place for a long time or the child has had a medical condition that weakens the veins, the child may experience vein collapse. This occurs when the vein is not able to receive anymore intravenous fluid and forces the IV solution into the surrounding tissues. It can also occur if a thrombosis, or blood clot, forms in the vein at the IV catheter site.

A collapsed vein feels and looks much like a dislodged IV catheter. This can sometimes happen when the nurse has inserted a needle or IV catheter that is too big for the size of the vein. This isn't a misjudgement on the nurse's part. Standard sized needles are used and only rarely are extremely thin needles necessary. They may be needed in adult patients as well as children. If vein collapse occurs, the IV catheter should be removed and reinserted into a different vein, usually in another part of the body. For example, if a vein in the left arm collapses, the nurse can put a new IV catheter into the right arm.

Treatment for an extravasation or a collapsed vein are similar. A warm compress is usually applied to the injection site to reduce swelling. If there is sufficient injury at the injection site, general wound care is done to prevent infection and speed healing.