Intravenous Therapy

Question 1

purpose for IV therapy

Answer 1

meds
fluids
blood

Question 2

IV fluid is also called

Answer 2

Parentral fluid therapy

Question 3

why are allergies more concerning when in IV

Answer 3

medication directly into blood and reaction can happen much quicker

Question 4

where should we start an IV

Answer 4

start low because if an issue happens we can work proximal but we cannot work distal

Question 5

some reasons we cannot use an arm for IV

Answer 5

shunt, mastectomy, open wound, blood clot

Question 6

why give IV fluids

Answer 6

dehydrated, NPO, nasogastric suction

Question 7

when should we check the IV

Answer 7

every time we are in the room
issues can happen very quickly

Question 8

how do we check for patency

Answer 8

pull back

Question 9

what are we checking the IV site for

Answer 9

redness, warmth, swelling, tender, cool, pain

Question 10

why should we always ask for allergies

Answer 10

sometimes someone forgot to put it in the chart

Question 11

what should we consider when preparing to administer IV therapy

Answer 11

type of fluid/medication and vein
age, size, and activity level
right or left handed

Question 12

should we wear gloves and do hand hygine before preparing to do IV

Answer 12

yes, we are breaking the skin and could cause infection

Question 13

why should leg veins be used or not used

Answer 13

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)

Question 14

where else should we avoid starting an IV

Answer 14

veins distal to a previous IV infiltration or phlebitis area
sclerosed or thromboses veins
edema
infection
severe scaring
skin break down

Question 15

Complications of IV therapy

Answer 15

fluid overload
air embolism
septicemia
infiltration
extravasations
phlebitis
thrombophlebitis
hematoma
clotting
obstruction

Question 16

Infiltration

Answer 16

Unintentional administration of non vesicant solution of medication to surrounding tissue

Question 17

how will an infiltration appear

Answer 17

edema around insertion site
Leakage of IV solution around site (dressing may appear wet)
Discomfort and coolness in the area of infiltration

Question 18

what do we do if infiltration occurs

Answer 18

IV is stopped
IV catheter is discontinued
New site proximal to infiltration

Question 19

any nursing implementations for infiltration

Answer 19

warm compress- isotonic/non caustic
cool compress- hypertonic/ caustic
elevated to reduce edema

Question 20

how do we prevent infiltration

Answer 20

ongoing close monitoring of site

Question 21

extravastion

Answer 21

inadvertent administration of a vesicant or irritant solution or medication into surrounding tissue

Question 22

what are some agents that can cause extravasation

Answer 22

vasopressors, potassium, calcium, chemo

Question 23

how will the extravasation sight feel and look

Answer 23

pain, burning, redness at sight

blistering, inflammation, necrosis of tissue can occur

Question 24

what will we do if we notice extravasation

Answer 24

stop infusion immediately
contact MD
LEAVE IV IN

Question 25

why would we leave the IV in for extravasation

Answer 25

because if there is an antidote available we can administer it directly to affected site

Question 26

who are some patients and why might they be at risk for extravasation

Answer 26

elderly: poor wound healing comatose/anesthized: cannot tell us what they are feeling diabetics: poor wound healing Peripheral vascular/cardiovascular disease: poor circulation

Question 27

Where are we limited to starting an IV after extravasation

Answer 27

cannot use that extremity, must use another arm or leg

Question 28

phlebitis

Answer 28

inflammation of a vein mechanical chemical bacterial

Question 29

chemical phlebitis

Answer 29

caused by irritating medication or solution

Question 30

mechanical phlebitis

Answer 30

long periods of IV catheters flexed catheters are larger than vein lumen poorly secured catheter

Question 31

bacterial phlebitis

Answer 31

poor hand hygine lack of aseptic technique

Question 32

symptoms of phlebitis

Answer 32

redness, pain, tenderness at site and along the vein

Question 33

what is the treatment for phlebitis

Answer 33

discontinue IV, restart at another site

Question 34

nursing interventions for phlebitis

Answer 34

warm, moist compress

Question 35

how do we prevent any IV complication

Answer 35

frequent and constant assessment

Question 36

Clotting/obstruction

Answer 36

blood clots may form in the IV line

Question 37

why might Clotting/ obstruction happen

Answer 37

kinked IV, very slow infusion rate, empty bag, failure to flush IV line

Question 38

how do we prevent clotting or obstruction

Answer 38

not allowing IV solution to run dry, flushing after intermittent infusions, taping the tubing to prevent kinks, maintain adequate flow rate

Question 39

What do we NOT do if clotting/obstruction occurs

Answer 39

do not raise the infusion rate or solution container don not aspirate the clot

Question 40

what do we do if clotting/obstruction occurs

Answer 40

discontinue infusion, restart at new site

Question 41

Thrombophlebitis

Answer 41

Presence of clot plus inflammation in the vein

Question 42

How does Thrombophlebitis present

Answer 42

redness, pain, warmth, swelling around insertion and along the path of the vein, immobility of the extremity, discomfort, swelling, fever, malaise, leukocytosis

Question 43

what do we do if Thrombophlebitis occurs

Answer 43

discontinue IV apply cold compress followed by warm compress elevate extremity and restart in other extremity

Question 44

Hemotoma

Answer 44

blood leakage into the tissues surrounding the IV insertion

Question 45

how might a hematoma present

Answer 45

ecchymosis (bruise color) immediate swelling at site, leakage of blood at insertion site

Question 46

treatment of a hemotoma

Answer 46

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

Question 47

who might be at risk for hemotoma

Answer 47

elderly and patients on blood thinners

Question 48

removable of IV is associated with 2 complications

Answer 48

bleeding catheter embolism

Question 49

how do we prevent/ handle bleeding

Answer 49

dry sterile pressure dressing should be held over the site as the catheter is removed

Question 50

catheter embolism

Answer 50

compare the length of the catheter to an actual catheter, occlude the vein above the site, notify MD

Question 51

should we use scissors to remove IV

Answer 51

no potenital to severe the catheter