Intravenous Therapy Flashcards
purpose for IV therapy
meds
fluids
blood
IV fluid is also called
Parentral fluid therapy
why are allergies more concerning when in IV
medication directly into blood and reaction can happen much quicker
where should we start an IV
start low because if an issue happens we can work proximal but we cannot work distal
some reasons we cannot use an arm for IV
shunt, mastectomy, open wound, blood clot
why give IV fluids
dehydrated, NPO, nasogastric suction
when should we check the IV
every time we are in the room
issues can happen very quickly
how do we check for patency
pull back
what are we checking the IV site for
redness, warmth, swelling, tender, cool, pain
why should we always ask for allergies
sometimes someone forgot to put it in the chart
what should we consider when preparing to administer IV therapy
type of fluid/medication and vein
age, size, and activity level
right or left handed
should we wear gloves and do hand hygine before preparing to do IV
yes, we are breaking the skin and could cause infection
why should leg veins be used or not used
rarely be used
poor circulation and if there were a complication and a wound developed we can have poor wound healing (especially in elderly and diabetic)
where else should we avoid starting an IV
veins distal to a previous IV infiltration or phlebitis area
sclerosed or thromboses veins
edema
infection
severe scaring
skin break down
Complications of IV therapy
fluid overload
air embolism
septicemia
infiltration
extravasations
phlebitis
thrombophlebitis
hematoma
clotting
obstruction
Infiltration
Unintentional administration of non vesicant solution of medication to surrounding tissue
how will an infiltration appear
edema around insertion site
Leakage of IV solution around site (dressing may appear wet)
Discomfort and coolness in the area of infiltration
what do we do if infiltration occurs
IV is stopped
IV catheter is discontinued
New site proximal to infiltration
any nursing implementations for infiltration
warm compress- isotonic/non caustic
cool compress- hypertonic/ caustic
elevated to reduce edema
how do we prevent infiltration
ongoing close monitoring of site
extravastion
inadvertent administration of a vesicant or irritant solution or medication into surrounding tissue
what are some agents that can cause extravasation
vasopressors, potassium, calcium, chemo
how will the extravasation sight feel and look
pain, burning, redness at sight
blistering, inflammation, necrosis of tissue can occur
what will we do if we notice extravasation
stop infusion immediately
contact MD
LEAVE IV IN
why would we leave the IV in for extravasation
because if there is an antidote available we can administer it directly to affected site
who are some patients and why might they be at risk for extravasation
elderly: poor wound healing
comatose/anesthized: cannot tell us what they are feeling
diabetics: poor wound healing
Peripheral vascular/cardiovascular disease: poor circulation
Where are we limited to starting an IV after extravasation
cannot use that extremity, must use another arm or leg
phlebitis
inflammation of a vein
mechanical
chemical
bacterial
chemical phlebitis
caused by irritating medication or solution
mechanical phlebitis
long periods of IV
catheters flexed
catheters are larger than vein lumen
poorly secured catheter
bacterial phlebitis
poor hand hygine
lack of aseptic technique
symptoms of phlebitis
redness, pain, tenderness at site and along the vein
what is the treatment for phlebitis
discontinue IV, restart at another site
nursing interventions for phlebitis
warm, moist compress
how do we prevent any IV complication
frequent and constant assessment
Clotting/obstruction
blood clots may form in the IV line
why might Clotting/ obstruction happen
kinked IV, very slow infusion rate, empty bag, failure to flush IV line
how do we prevent clotting or obstruction
not allowing IV solution to run dry, flushing after intermittent infusions, taping the tubing to prevent kinks, maintain adequate flow rate
What do we NOT do if clotting/obstruction occurs
do not raise the infusion rate or solution container
don not aspirate the clot
what do we do if clotting/obstruction occurs
discontinue infusion, restart at new site
Thrombophlebitis
Presence of clot plus inflammation in the vein
How does Thrombophlebitis present
redness, pain, warmth, swelling around insertion and along the path of the vein, immobility of the extremity, discomfort, swelling, fever, malaise, leukocytosis
what do we do if Thrombophlebitis occurs
discontinue IV
apply cold compress followed by warm compress
elevate extremity and restart in other extremity
Hemotoma
blood leakage into the tissues surrounding the IV insertion
how might a hematoma present
ecchymosis (bruise color)
immediate swelling at site, leakage of blood at insertion site
treatment of a hemotoma
discontinue the IV
light pressure with sterile dry dressing
apply ice for 24 hours to the site to avoid extension of hemotoma
elevlate extremity
restart IV in other extremity
who might be at risk for hemotoma
elderly and patients on blood thinners
removable of IV is associated with 2 complications
bleeding
catheter embolism
how do we prevent/ handle bleeding
dry sterile pressure dressing should be held over the site as the catheter is removed
catheter embolism
compare the length of the catheter to an actual catheter, occlude the vein above the site, notify MD
should we use scissors to remove IV
no
potenital to severe the catheter
