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MedSurg 2 > Complications of IV Therapy > Flashcards

Complications of IV Therapy Flashcards

1
Q

Infiltration: Causes

A
  • Catheter is through the vein
  • Inflammation causes capillary leak
  • Retrograde flow
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2
Q

Infiltration: S&S

A
  • Slow IV rate
  • Edema around site
  • Coolness
  • Burning
  • Tenderness
  • No blood return
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3
Q

Infiltration: Interventions

A
  • INS scale
  • New catheter in opposite arm
  • Cool compress
  • Warm compress
  • Remove catheter immediately
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4
Q

Infiltration: Prevention

A
  • Use smallest catheter needed
  • No restraints at IV site
  • Central venous cath- obtain brisk blood return before running anything
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5
Q

Extravasation: Causes

A
  • Catheter is through the vein
  • Inflammation causes capillary leak
  • Retrograde flow
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6
Q

Extravasation: S&S

A
  • Slow IV rate
  • Edema around site
  • Coolness
  • Burning
  • Tenderness
  • No blood return
    Blistering & tissue sloughing may occur in days, resolves in 1-4 weeks with chemo drug infiltration
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7
Q

Extravasation: Interventions

A
  • Aspirate drug from needle
  • Stop infusion
  • Leave port access needle in case antidote needed
  • Cold compress EXCEPT vinca alkaloids or epipodophyllotoxins
  • Photograph site
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8
Q

Extravasation: Prevention

A
  • Use smallest catheter needed
  • No restraints at IV site
  • Central venous cath- obtain brisk blood return before running anything
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9
Q

Phlebitis: Causes

A
  • Insertion technique
  • Catheter size
  • Lack of securement
  • pH extremes of med/fluid
  • Extended dwell time
  • Broken aseptic technique
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10
Q

Phlebitis: S&S

A
  • Pain
  • Red
  • Inflamed
  • Hard & cordlike vein
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11
Q

Phlebitis: Interventions

A
  • Remove catheter immediately
  • Warm compress
  • Phlebitis scale
  • Within first week of PICC line: Treat w/out removing catheter & use constant heat + elevate extremity
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12
Q

Phlebitis: Prevention

A
  • Avoid joint flexion areas- or use armboard
  • Nothing through peripheral IVs with pH below 5 or above 9
  • Nothing through peripheral IV with osmolarity over 500
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13
Q

Thrombosis: Causes

A
  • Traumatic venipuncture
  • Multiple attempts
  • Catheter too big for vein
  • Virchows triad
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14
Q

Thrombosis: S&S

A
  • Slow or stopped rate of infusion
  • Tender
  • Red
  • CVCs have engorged ipsilateral chest veins
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15
Q

Thrombosis: Interventions

A
  • Cold compress
  • Stop infusion
  • Remove catheter
  • Low dose thrombolytics for CVCs
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16
Q

Thrombosis: Prevention

A
  • 2 attempts at venipuncture max
  • Secure catheter
  • Armboards in flexion areas
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17
Q

Thrombophlebitis: Same as thrombosis but use what

A

Cold compress, then heat

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18
Q

Ecchymosis & hematoma: Causes

A
  • Fragile skin
  • Elderly
  • Multiple attempts
  • Vein laceration
19
Q

Ecchymosis & hematoma: S&S

A
  • Bruising
  • Swelling
  • Pain
20
Q

Ecchymosis & hematoma: Interventions

A
  • Light pressure when removing
  • Hematoma = direct pressure until bleeding stops
  • Elevate extremity
  • Ice packs
  • Warm packs after 24 hr

Prevention: No hidden veins or coagulopathy patients

21
Q

IV infection interventions

A
  • Send catheter tip for culture
  • Express drainage
  • Clean site with alcohol
  • Dry, sterile dressing
22
Q

Venous spasm: S&S

A
  • Cramping above/at insertion site
  • Numbness
  • Slowing of the rate
  • Unable to withdraw midline catheter or PICC
23
Q

Venous spasm: Interventions

A
  • Slow rate
  • Warm compress
  • Do not remove catheter
  • Drink warm fluids
  • Keep covered & dry
  • 12-24 hr before removal can happen

Prevent via running room temp fluids, allow vein to return to normal size before advancing after tourniquet removed, gently remove PICC in short segments

24
Q

Nerve damage: S&S

IV therapy

A
  • Pins & needles at/below site
  • Numb
25
Q

Nerve damage: Interventions

IV therapy

A
  • Stop insertion if reporting severe pain
  • Remove if discomfort does not improve once secured
26
Q

Nerve damage: prevention

IV therapy

A
  • Avoid cephalic vein in wrist
  • No palm veins
  • No side of the wrist
  • Secure catheter
  • Armboard
27
Q

Circulatory overload: S&S

A
  • SOB
  • Cough
  • HTN
  • Edema
  • +4 pulses
  • JVD
  • Crackles
  • Low SpO2

Diuretics, HOB high, call HCP, give O2

Monitor I&O

28
Q

Speed shock: S&S

When bolus of Rx causes toxic levels quickly

A
  • Lightheaded
  • Dizzy
  • Chest tightness
  • Flushed face
  • Irregular pulse
  • Unconscious
  • Cardiac arrest
  • Shock
29
Q

Speed shock: Interventions

A
  • Stop infusion
  • Hang isotonic (NS)
  • KVO rate
  • Call HCP
30
Q

Catheter embolism: S&S

A
  • Avoid forcefully flushing!
  • Cardiopulmonary arrest
31
Q

Catheter embolism: Interventions

A
  • Call HCP
  • Remove catheter
  • Tourniquet high on affected limb
  • X-ray
32
Q

Catheter migration: Causes

A
  • Cough
  • Sneeze
  • Lifting heavy objects
  • CHF
33
Q

Catheter migration: S&S

A
  • Neurologic complications if Rx are running
  • Azygos vein migration: Back pain between shoulder blades
  • Jugular migration: Gurgling or running stream sound on the side of catheter insertion

Stop all infusions & flush catheter

CXR needed

34
Q
A
34
Q

Catheter dislodgment: Causes

A
  • Excess activity with PICC
  • Inadequately secured
35
Q

Catheter dislodgment: S&S

A
  • external length of catheter changes
  • May be no sx
36
Q

Catheter dislodgment: Interventions

A
  • Stop infusions
  • Flush
  • Never readvance
  • Compare documented catheter length with current length
37
Q

Catheter rupture: Causes

A
  • Forcefully flushing against resistance
  • Scissors to remove dressing
  • Pinch off syndrome

Subclavian catheter pinched between clavicle & 1st rib (pinch-off synd)

38
Q

Catheter rupture: S&S

A
  • Fluid leaking from insertion site
  • Pain & swelling during infusion
  • Reflux of blood into catheter extension tubing
  • Unable to aspirate blood
39
Q

Lumen occlusion: Causes

A
  • Precipitate from phenytoin, calcium, diazepam
  • Long-term fat emulsion sludge
  • Blood clots
  • Fibrin sheath
  • Allowing administration set to remain connected for long periods after Rx has infused
40
Q

Lumen occlusion: S&S

A
  • Infusion stops
  • Unable to start fluids
  • Cannot draw blood
  • Flushing resistance
  • Sudden: Incompatible meds
  • Gradual: Clot
  • Precipitate: Hydrochloric acid for acidic drug, bicarb for alkaline
  • Clot: Use alteplase

Flush catheters before, after, between meds

41
Q

Catheter related bloodstream infection

CRBSI

A
  • Fever
  • Chills
  • HA
  • Malaise
  • Tachycardia
  • HOTN
  • Decreased urine output

Change entire infusion system

42
Q

Never ____ before inserting IV

A

Shave

MedSurg 2 (13 decks)

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