Pumps, infusion

Vapor Pressure. The Shiley Infusaid implantable infusion pump utilizes energy stored in a two-phase fluorinated hydrocarbon fluid. The pump consists of a refillable chamber that holds the dmg and a chamber that holds the fluid. The equiUbrium vapor pressure of the fluid, a constant 60 kPa (450 mm Hg), compresses the bellows, pumping the dmg through a bacterial filter, a capillary flow restrictor, and an infusion cannula to the target body site (56,116). 

Electronic infusion devices are classided as either infusion controllers or infusion pumps. The primary difference between die two is diat an infusion pump adds pressure to die infusion, whereas an infusion controller does not. An infusion pump may be used to deliver the desired number of drops per minute. An alarm is set to sound if the IV is more than or less dian the preset rate... 

Many postoperative patients require less narcotics when they are able to self-administer a narcotic for pain. Because the self-administration system is under the control of the nurse, who adds the drug to die infusion pump and sets the time interval (or lockout interval) between doses, the patient cannot receive an overdose of the drug. 

Mr. Talley, a 64-year-old retired schoolteacher, has cancer and is to receive morphine through a PCA infusion pump. His wife is eager to help, but Mr. Talley is very independent and refuses any assistame from her. Formulate a teaching plan for Mr. Talley that includes the use of PCA, adverse reactions to expect, and what adverse reactions to report. Discuss what methods the nurse might use to include Mrs. Talley in the care of her husband. 

Use an electronic infusion pump to administer these drug . 

The nurse can give some of these drug (for example, aminophylline or theophylline) IV, either direct IV or as an IV infusion. When giving theophylline or aminophylline IV, the nurse monitors die patient for hypotension, cardiac arrhythmias, and tachycardia. If a bronchodilator is given IV, the nurse administers it through an infusion pump. The nurse checks die IV infusion site at frequent intervals because these patients may be extremely restless, and extravasation can occur. 

An infusion pump must be used for the safe administration of heparin by continuous IV infusion. The nurse checks die infusion pump every 1 to 2 hours to ensure diat it is working properly. The needle site is inspected for signs of inflammation, pain, and tenderness along... 

Most antineoplastic dragp have specific recommended administration techniques. For example, an infusion pump is recommended for the administration of cisplatin, and plicamycin (Mithracin) is administered by slow IV infusion during a period of 4 to 6 hours. If administration guidelines are not provided by the primary health care provider or the hospital, the nurse checks with the appropriate authorities (physician, pharmacist) regarding the administration of a specific antineoplastic drug. 

Promoting an Optimal Response to Therapy Fhtients receiving an IV fluid should be made as comfortable as possible, although under some circumstances this may be difficult. The extremity used for administration should be made comfortable and supported as needed by a small pillow or other device An IV infusion pump may be ordered for the administration of these solutions. The nurse sets the alarm of the infusion pump and checks the functioning of the unit at frequent intervals. 

The primary health care provider orders the dose of tiie potassium salt (in mEq) and the amount and type of IV solution, as well as the time interval during which tiie solution is to be infused. After the drug is added to tiie IV container, tiie container is gently rotated to ensure mixture of tiie solution. A large vein is used for administration tiie veins on tiie back of tiie hand should be avoided. An IV containing potassium should infuse in no less than 3 to 4 hours. This necessitates frequent monitoring of the IV infusion rate, even when an IV infusion pump is used. 

Opioids maybe administered in a variety of routes including oral (tablet and liquid), sublingual, rectal, transdermal, transmucosal, intravenous, subcutaneous, and intraspinal. While the oral and transdermal routes are most common, the method of administration is based on patient needs (severity of pain) and characteristics (swallowing difficulty and preference). Oral opioids have an onset of effect of 45 minutes, so intravenous or subcutaneous administration maybe preferred if more rapid relief is desired. Intramuscular injections are not recommended because of pain at the injection site and wide fluctuations in drug absorption and peak plasma concentrations achieved. More invasive routes of administration such as PCA and intraspinal (epidural and intrathecal) are primarily used postoperatively, but may also be used in refractory chronic pain situations. PCA delivers a self-administered dose via an infusion pump with a preprogrammed dose, minimum dosing interval, and maximum hourly dose. Morphine, fentanyl, and hydromorphone are commonly administered via PCA pumps by the intravenous route, but less frequently by the subcutaneous or epidural route. 

Mechanical complications of PN are related to catheter placement and the system and equipment used to administer PN. A central venous catheter must be placed by a trained professional, and risks associated with placement include pneumothorax, arterial puncture, bleeding, hematoma formation, venous thrombosis, and air embolism.1,20 Over time, the catheter may require replacement. Problems with the equipment include malfunctions of the infusion pump, intravenous tubing sets, and filters. 

The mechanical pump approach employs miniature mechanical devices, such as implantable and portable infusion pumps and percutaneous infusion catheters, to deliver drugs into appro priate blood vessels or to a discrete site in the body. When compared with the... 

Although infusion pumps can go some way towards mimicking normal control of blood insulin levels, transplantation of insulin-producing pancreatic cells should effectively cure the diabetic patient, and research aimed at underpinning this approach continues. 

Intermittent EN is similar to bolus EN except that the feeding is administered over 20 to 60 minutes, which improves tolerability but requires more equipment (e.g., reservoir bag and infusion pump). Like bolus EN, intermittent EN mimics normal eating patterns. As compared with continuous EN, bolus or intermittent EN minimizes the development of cholestatic liver disease. 

PN solutions should be administered with an infusion pump. 

Drug delivery pump and/or catheter infusion pump for implantation iontophor-eses device. 

Medicated IV drips are solutions that have potent medications added. When administered, these infusions require extreme care and meticulous observation so that exactly the prescribed amount of medication in solution is administered to the patient. Generally, infusion pump or a controlled volume chamber and a microdrip set are used to administer medicated IV drips. 

Fig. 5.9 Design of the chip-based enzyme ESI-MS assay. MS instrument Ion-trap mass spectrometer (LCQ Deca, Thermo Electron). I Sample components/inhibitors injected by flow injection or eluting from capillary HPLC column. E Infusion pump delivering the enzyme cathepsin B. S infusion pump delivering the substrate Z-FR-AMC. Micro-chip design Vrije Universiteit Amsterdam. Micro-chip production Micronit Microfluidics BV (Enschede, The Netherlands).

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