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Intravenous Therapy: Introduction and Legal Considerations

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What is the goal of IV therapy?

The goals of IV Therapy are to:

  • maintain and prevent fluid and electrolyte imbalances
  • administer parenteral medications or solutions
  • replenish blood volume
Regulating an IV drip
Adapted from DepositPhotos.com

Can IV therapy be delegated?

Starting IV therapy through IV insertion is an invasive procedure that cannot be delegated by the nurse unless other licensed personnel has been certified and trained to perform the procedure.

In case of delegation, the nurse must instruct the delegated personnel to report the following:

  • IV site related complications: pain, redness, swelling, bleeding
  • IV dressing becomes wet
  • low fluid in the IV bag or the electronic infusion device (EID) alarms

What are the legal considerations prior to IV therapy?

Consent is required before a nurse can start IV therapy.

The consent can either be oral and written.

What are the situations when the client is incapacitated to give a consent?

Client is incapacitated to give a consent when he or she is:

  • a minor
  • unconscious
  • mentally incompetent

From whom can the nurse obtain a consent when the client is incapacitated?

If the client is unable to give consent, the nurse may obtain consent from any of the following:

  • guardian appointed and authorized by court to make healthcare decisions
  • a person with a “power of attorney for personal care”
  • an appointed representative by the Consent and Capacity Board
  • legal spouse
  • parent
  • brother or sister of legal age
  • a relative of legal age

In what situations can IV therapy be initiated without consent?

IV insertion can be initiated without consent from client or representative during life threatening or emergency situations.

In such cases, it is considered an implied consent.

What happens when the client revokes consent?

Any time during the procedure, the client can revoke his or her consent. The healthcare provider or nurse must then stop the procedure immediately.

When is consent valid?

Consent is considered valid when it meets minimum standards required by law. Client must understand:

  • facts of the procedure
  • its implications
  • future consequences and complications

Key Points:

  • Consent is needed before a nurse can start IV therapy.
  • Initiating IV therapy is an invasive procedure that can be delegated by the nurse only to trained and certified personnel.
  • The goals of initiating IV therapy are to: 1) maintain and prevent fluid and electrolyte imbalances; 2) administer parenteral medications or solutions and 3) replenish blood volume.