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intravenous therapy Flashcards

1
Q

why is IV therapy used?

A

for fluids, medication administration, blood administration, and/or hemodynamic monitoring.

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2
Q

where can IV therapy be used?

A

at a medical facility, at a patents home

reduces cost and time associated with medical facilities

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3
Q

types of needles

Angiocaths

(short peripherl)

A
  • most commonly used
  • short
  • goes into the peripheral system
  • used for intermediate use
  • used for a short duration of time
  • IV fluids, medications, and blood transfusions are used for these.
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4
Q

14G orange

largest in diameter

A

used for large amounts of fluids like in a trauma situation

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5
Q

gauge of an IV catheter needle

16G grey

A

used for large amounts of fluids like in a trauma situation

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6
Q

gauge of an IV catheter needle

18G green

A

great for blood admin

18 holes on a green golf course

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7
Q

gauge of an IV catheter needle

20G pink

A

good for most needs concerning the adult population

20G for age 20

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8
Q

gauge of an IV catheter needle

22G blue

A

avoid use during blood admin because it can destroy blood cells during the infusion

bid it a do

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9
Q

gauge of an IV catheter needle

24G yellow

A

used for ages 2-4

little fellows or elderly with poor vein access

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10
Q

types of needles

butterflys

A
  • used for phlebotomy
  • one time use for medication administration
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11
Q

When using a butterfly needle it can pose a risk of what towards the patient?

A

phlebitis

the inflammation of the veins creating swelling, redness

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12
Q

types of neeedles

central vascular access devices

CVADs

A
  • implanted: hubuer portacath
  • external tunneled (hickman, Broviac, Groshong)
  • central venous catheter
  • peripherally inserted central catheter

types of CVADs

to prevent infusion related complications, solutions and medications with an osmolarity greater than 900 mOsm/L are infused through one of the following CVADs.

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13
Q

type of CVAD

implanted huber portacath

A
  • implanted into the skin and a non coring needle is used
  • requires surgery for venous implantaion
  • used for chemo/cancer patients and/or drawing blood
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14
Q

type of CVADexternal tunneled (hickman, broviac, groshong)

A
  • inserted surgically into the subclavian or jugular vein
  • used for permanent use
  • goes into the heart that has ports to give meds or fluids
  • give fluids, medication, nutrition
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15
Q

type of CVAD

central venous catheter

A
  • used for several weeks
  • short term
  • placed by HCP at bedside, nurse assist
  • pt is placed in trangelenburg position for insertion
  • sutured at insertion site
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16
Q

type of CVAD

peripherally inserted central catheter

(picc line)

A
  • long term antibiotic use
  • pts may go home with this
  • inserted in the anticubital fossa or the upper arm where the basilic
  • it is advanced up till catheter tip reaches central vena cava
  • dacron cuff coated in antimicrobial solution to prevent infections
  • requies dressing changes
17
Q

intraosseous access

A
  • effective route for fluid resuscitation, drug drlivery
  • into the bone
  • most often used as a last resort in emergencies (trauma)
  • physician or flight RN initiated, EMS
  • 24 hour use
18
Q

equipment needed for inserting an angiocath as a Saline Lock

A

-Angiocath(determine size needed)
-Start kit (tourniquet, tape, transparent dressing, antiseptic chlorhexidine sln,2x2 gauze, label)
-clean gloves
-J-loop with needless connector
-5 to 10mL prefilled syringe
-Stat-lock(stabilization device) if available and policy

19
Q

Procedure: inserting an angiocath as a Saline Lock

A
  1. Verify the order
  2. Gather equipment
  3. Prepare Equipment with Saline infused J-Loop ready for connection with access.
  4. Identify and prepare patient/educate
    • Purpose of VAD (meds, IVF, procedures)
    • Notify nurse with S/S of complications (redness, pain, tenderness, swelling, bleeding, drainage/leaking)
  5. Apply tourniquet & locate vein
  6. Release tourniquet
  7. Don gloves and eye protection if necessary
  8. Place towel or pad under area
  9. Scrub site with alcohol or chlorahexadine & let dry
  10. Reapply tourniquet
  11. Stabilize vein & instruct pt prior to stick
  12. Insert needle BEVEL UP 10-30 deg. Angle
  13. Observe flashback & advance ¼ in
  14. Thread cannula into vein
  15. Release tourniquet & stabilize hub and apply pressure
  16. Connect iv tubing or j-loop to hub of cannula while stabilizing the device and flush
    Some place a 2x2 under the hub in this process to catch any potential blood with the connection process. If used, the 2x2 is removed prior to dressing change.
  17. Secure site with tape & drsg
    • transparent dressing over hub (not J-loop) with insertion site covered and visible
    • Label: Date, time, initials
    • Statlock securement device or tape (5-7 days)
  18. Document
20
Q

why should a nurse always start distally and move proximally when inserting a catheter?

A

when possible, place IVs at the most distal site. using a distal site first allows for the use of proximal sites later if the patient would need a venipuncture site change.

21
Q

common sites to use for angiocath insertion

A
  • hands
  • arms
    these sites utilize the cephalic, basilic, and median cubital veins.
  • head/scalp of newborns
22
Q

sites that are last resorts for angocath insertion

A
  • foot
  • legs (increases risk of thrombocitis)
  • neck

the use of the foot for an IV site is common with children but is contraindicated in adults because of the danger of thrombophlebitis.

23
Q

things to look for when assesing an insertion site

A
  • redness
  • drainage
  • bleeding
24
Q

example of a documentation for inseting an angiocath as a saline lock

A

9/10/12 1522 18 gauge inserted to R forearm x 2 attempts. Remains a SL for medication needs. Patient tolerated well. Understood the purpose and therapeutics of need of IV cath insertion. Cath secured and labeled. —————–Nurse Nellie, RN

25
Q

dressing changes

A
  • changed every 5-7 days; per policy; if its wet, solied, rolled up, and/or if the integrity of the dressing is compromised.
  • always include initials, date, and time
26
Q

procedure: dressing change

A
  1. Hand hygiene and gloves
  2. ID patient
  3. Remove old IV site while securing device with nondominant hand
  4. Assess securement device’s need to be changed
  5. Cleanse site and allow to dry
  6. Apply new op-site dressing (Transparent Semipermeable Membrane-TSM)
  7. Secure hub and tubing with tape
  8. Label dressing change
27
Q

do not do of iv therapy

What are Contraindications of IV Placements?

A

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advanced foundations (13 decks)

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