Complications & Problems: IV & Blood Transfusions

Question 1

IV flowing in too fast

Answer 1

IV bag may be too high, lower it

Question 2

IV flowing in too slow

Answer 2

IV bag is low, raise it

Question 3

IV catheter comes out before we want it to

Answer 3

Use tape to secure it in place

Question 4

Blood backs up in IV tubing

Answer 4

Flush IV tubing with saline syringe

Question 5

Bubbles present in IV tubing

Answer 5

Flick, stretch tubing

Use empty syringe & pull bubbles out from port

Question 6

Infiltration

Answer 6

Needle dislodged from vein resulting in fluid going into tissues

• S/S: cold/ swollen pale hand/arm
• Tx: Discontinue the IV & restart elsewhere
• Prevention: Tape IV catheter well to prevent movement

Question 7

Phlebitis

Answer 7

Inflammation of the vein from trauma, bacterial invasion, or irritating medication (K⁺)

• S/S: warmth, redness, streak up the arm, tenderness/pain
• Tx: Discontinue IV, apply warm pack & elevate arm, restart on other arm
• Prevention: sterile technique

Question 8

Thrombus

Answer 8

Clot in the vein

• S/S: redness, warmth, IV won’t flow
• Tx: Don’t massage or flush IV, discontinue IV & restart, apply warm compress
• Prevention: tape well & don’t let IV stop flowing too long

Question 9

Embolus

Answer 9

Clot or air bubble floating around in the blood

(thrombus when it breaks free)

• S/S: pain in lung or decreased LOC
• Tx: EMERGENCY!!! Call code GIVE OXYGEN
• Prevention: no air bubble in IV lines, prevent phebitis & thrombus

Question 10

Fluid Overload

Answer 10

Too much fluid for the body to handle

• S/S: fluid in the lungs, dyspea, increase heart & respiratory rate
• Tx: Check VS, decrease IV flow rate, have pt. SIT UP, call MD
• Prevention: Check flow rate frequently, listen to lungs, use IV pump on children, elderly, or frail

Question 11

Starting IV

Answer 11

• Find a straight vein
• Non-dominate hand/side
• Not the wrist area
• Start near or on the hand and work up (distal to proximal)

Question 12

Taping IV securely

Answer 12

• Tape the needle down so that tubing can be changed w/o disturbing the dressing
• Often a saline lock is used

Question 13

Tape “Research”

Answer 13

• Take is not sterile
• Don’t place tape near the skin puncture site
• Only cover the puncture site with Tegaderm (sterile)

Question 14

Dressing an IV

Answer 14

• Clear dressing are used (Tegaderm)
  
  • Protects from water & bacteria
  • Clear dressings don’t let air in
  • Can assess area w/o disturbing anything

Question 15

Allergic/ Febrile

Answer 15

Sensitivity to WBC or plasma proteins

• S/S: sudden chills, Temp 101, HA, hives, itching, anaphylatic shock
• Action: STOP transfusion
  
  • Keep vein open with saline
    
    • Call MD
      
      • May order Tylenol or Benadyl (antihistamine)

Question 16

Hemolytic

Answer 16

From incompatible blood products

Antibody reaction resulting in RBC destruction

• S/S: Immediate (<10 mL), lower back pain, fever, chills, shock
  
  • Kidney failure
  • Shock
• Cause: HUMAN ERROR
• Action: STOP transfusion
  
  • KVO w/ saline, monitor VS, call MD
  • Blood & urine samples must be taken
  • Blood, tubing, & filter sent to the lab for analysis

Question 17

Circulatory Overload

Answer 17

Too much fluid for heart to pump

• S/S: dry cough, dyspnea, pulmonary edema
• Action: Slow infusion rate, check VS, raise pt.’s HOB, one unit at a time