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Nursing Skills 2 > Intravenous Catheters > Flashcards

Intravenous Catheters Flashcards

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1
Q

What are some functions of IV catheters

A 
Fluid administration 
Drug administration
Blood products and transfusion medicine
Monitoring blood pressure 
Sample
Blood collection
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2
Q

What is the difference between IV fluid administration and oral/SQ

A

Oral and SQ have a limit to amount and time for absorption

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3
Q

What method of fluid administration has the fastest onset of drugs

A

IV -almost immediate

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4
Q

What are the parts of a catheter

A

Bung -cap/needle cover
Hub -usually has wings/coloured part
Flashback chamber -needle grip where you see the flash of blood
Cap -closes off the catheter

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5
Q

What are the 4 types of IV catheters

A

Indwelling
Intracath
Butterfly
Central venous

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6
Q

Describe an indwelling catheter

A

The catheter is over the needle -catheter is 2 gauges larger than the needle -needle is inside the catheter

Most common

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7
Q

Describe an intracath catheter

A

Catheter is smaller than the needle -inside the needle

Allows for a longer catheter

Used for jugulars and central lines

Sturdier than other catheters

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8
Q

Describe a butterfly catheter

A

Long hollow tube attached to a short rigid needle

For Very short term fluid administration (bolus) or blood collection

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9
Q

What is a central venous catheter

A

Used for jugular catheter placements

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10
Q

What is the equipment needed to place a catheter

A 
Clippers
4 pieces of gauze 
Surgical scrub and alcohol
Scissors 
3 pieces of tape (two 1/2 inch and one 1 inch)
2 catheters
Infusion plug or cap
3cc syringe of flush with 22g needle

For long term:
Vet wrap
Kling wrap
E collars

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11
Q

What factors should you consider when choosing a catheter size

A

Size of patient/vein
How long the catheter will be in
Rate of fluid administration

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12
Q

Longer catheters are more stable, so these are recommended for ___ term use and will reduce risk of ___

A

Long term use

Phlebitis

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13
Q

What is phlebitis

A

Inflammation of the blood vessel

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14
Q

A larger gauge catheter will allow ___ fluid rates (important in shock)

A

Faster

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15
Q

What is the general rule when choosing catheter length and gauge

A

The largest and longest catheter possible that sits comfortably in the vein

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16
Q

What is a rough estimate for catheter gauge in a <2.5 kg cat and a 4-6 kg cat

A

<2.5 kg: 24 gauge

4-6kg: 22 gauge

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17
Q

What is a rough estimate for catheter gauge in small, medium and large dogs?

A

Small: 22 gauge
Medium: 20-22 gauge
Large: 18-20 gauge

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18
Q

When should you select a smaller gauge catheter

A

Dehydration
High risk of bleeding
Friable veins (hypertension)

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19
Q

When should you choose a large gauge catheter

A

Staying in longer
High fluid rates
Veins with lots of valves

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20
Q

When should you select a shorter catheter

A

Chondrodysplastic dogs (short legs)

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21
Q

When should you select a longer catheter

A

Staying in longer

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22
Q

What is the most commonly used vein for IV catheters and why? what is one possible alternative?

A

Cephalon vein is most common: it is straight, Unbranched and easily accessed

Lateral saphenous is an alternative

23
Q

True or false

It is okay to put a catheter in a limb with pathology or a mass

A

False

Avoid these limbs

24
Q

True or false

The restrainer can be on the same side as the limb being used for IV catheter placement

A

False

Should stand on the opposite side

25
Q

How much should you shave the area for an IV catheter

A

2-3 inches by 1-2 inches -varies with size of patient

26
Q

Where should you shave the limb for catheter placement, why this area?

A

Distal 1/3 or 1/2 between the elbow and carpus

If the vein blows and you need to try again, try again above the “blow”, never below

27
Q

Why should you avoid areas on the limb like the carpus and elbow

A

Carpus has too many branches, the vein tapers and it can be Irritating to the patient

The elbow bends and the catheter may kink

28
Q

Describe how to clean the site for IV catheter placement

A

After shaving, take gauze soaked in surgical scrub and start where you will poke on the vein. Move outwards in circular motions while rotating the gauze to keep the edge touching the hair on the hair. Do this At least 3 times or until clean. Then do at least 1 gauze with alcohol using same technique or pour alcohol directly onto puncture site

29
Q

What should you do right when you open the catheter

A

Check for any damage
Loosen the moveable parts
Keep sterile with packaging

30
Q

What parts of the catheter do you not want to touch

A

Cannula
Needle/catheter
End of cap

31
Q

True or false

It is okay to have the bevel pointed any direction

A

False

Bevel is always up

32
Q

After you see a flash when placing a catheter, what do you do

A

Advance the whole unit 1-3mm then advance just the catheter until the hub meets the skin

33
Q

True or false

Once the catheter is in you can let go of the limb

A

False

Always have one hand on the patient until all the tape is placed

34
Q

How much of the hub should be kept clear when taping

A

Top 1/3 of the hub (to leave room for infusion plug or cap to be put on

35
Q

What is best practice when taping a catheter in place

A

All tape should be tabbed and wrap around the limb in the same direction

36
Q

Why do you flush a catheter after taping it in place

A

To test patency

37
Q

What can air in your flush cause

A

An air embolism

38
Q

How do you know the flush is going into the vein and that the catheter is patent

A

Smooth flow while pushing with no resistance

Can feel a steady stream when palpating the vein and can also feel a pulsed stream

39
Q

What are two ways to keep a catheter protected and clean for long term use

A

E collars

Long term wraps with kling and vet wrap

40
Q

What does a long term wrap also prevent

A

Pooling in the distal limb

41
Q

How often must you remove and replace long term wraps on catheters

A

Every 24 hours to check limb and puncture site

42
Q

If the catheter is not attached to fluid, how often should you flush the catheter and why

A

Every 4 hours to prevent clotting

43
Q

How often should you discard of bags of saline

A

Every 12-24 hours

44
Q

What are things you should check for on IV catheters

A 
Patency (flush) 
Swelling
Redness
Pain
Temperature (hot and cold)
Hematoma or adverse reactions
Discharge (infection)
Exposed catheters 
Thrombosis
45
Q

How often should catheters be changed

A

Every 72 hours

46
Q

What do you do if the bandage around a catheter is wet

A

Remove bandage and ensure patency of the catheter

Find reason for wetness: if it is because the catheter is out of the vein, replace catheter in a new area or just change the bandage

47
Q

What does swelling distal to the catheter mean

A

Tape/wrap is too tight

48
Q

What does swelling of the toes mean

A

Bandage/wrap is too tight

49
Q

What does swelling proximal to the catheter mean

A

Infiltration: fluid is escaping the vein into the SQ

Need to remove the catheter and replace elsewhere. Massage area to relieve swelling

50
Q

What is thrombosis

A

The vein stands out and has a cord like feeling (looks like it is being occluded)

Must remove the catheter

51
Q

What are some potential complications associated with IV catheters

A

Animal pulls out the catheter

Occlusion (from positioning or clotting) (common in short legs)

Catheter breakage (can cause foreign body emboli)

Phlebitis

Infiltration (if the vein is punctured or catheter goes through vein or if it is leaking into SQ at the venipuncture site)

Hemorrhage/hematoma

Air embolism

Infection or allergic reaction

52
Q

What is the rate of bacterial colonization of catheters

A

7-20%

53
Q

How long should you apply pressure on the area when removing a catheter

A

Minimum of 20 minutes

Maximum of 30 minutes (can occlude blood flow to the limb)

Nursing Skills 2 (5 decks)

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