IV Cannulation Flashcards
Start with ___________ veins and work _____________
Distal (low), proximally
Antecubital is the
Last option!
Considerations for selecting a vein
Condition of the veins?
Reason for the IV?
What solutions or meds will be used?
Vein evaluation
PALPATE!!
Suitable veins should be
Round, firm, & elastic
Best palpated when engorged
Methods of administration
Intermittent
Continuous
Bolus
Push
Intermittent
Medications on schedule dose daily or several times per day
Continuous
IV solutions continuously
Bolus
Specified amount of solution to be administered in a specific time frame through IV pump or syringe — often quickly administered
Push
Specified amount of medication to be administered in a specific time frame through IV syringe only
IVs that are being used intermittently are commonly referred to as an
I N T
Continuous can be used for
Hydration, electrolyte replacement, or both
IV medication advantages
Direct access to circulatory system —> instant action
Instant drug action and drug termination
Rapid treatment
Better control of rate
Great for those with GI tract limitations
Good for meds that irritate gastric mucosa
IV medication disadvantages
Reconstitution errors
Venous spasm
Drug incompatibilities
Impaired drug absorption
Speed shock
Chemical phlebitis
Extravasation of vesicants
Air embolism
Air embolism
Air enters central veins
Air embolism causes
Solution runs dry
Air in tubing
Loose connections
Improper removal of CVAD
Poor technique with dressing or tubing changes
Air embolism signs and symptoms
Dyspnea
Tachypnea
Lightheadedness
Palpitations
Drop in BP
Weakness
Cyanosis
Expiratory wheezes
Air embolism intervention
Call for help
Position pt in trendelenburg on left side
Administer oxygen
Monitor vital signs
Have emergency equipment ready
Complications of IV therapy
Fluid overload
Infection
Phlebitis
Infiltration
Extravasation
Fluid overload
Too much fluid overloads the circulatory system
Phlebitis
Irritation to vein
Mechanical or chemical
Infiltration
Fluid seeps into tissue
Extravasation
Infiltration of any caustic medication into tissue
Chemical phlebitis
Inflammation of a vein associated with chemical irritation
Chemical phlebitis causes
Too rapid infusion
Presence of particulate matter in solution
Improper dilution or reconstitution when preparing meds
Administration of irritating meds
Chemical phlebitis prevention
Use an in-line filter for meds that do not reconstitute completely
Increase volume of dilution
CVAD or larger peripheral veins for IV site
Slow the rate of infusion
Restart any questionable IVS
Infiltration signs and symptoms
Does not irritate the tissue
Pain or burning at IV site
Skin tightness at site
Blanching and coolness of skin
Dependent edema
Infiltration
Fluid leak into tissue around the vein
Infiltration interventions
STOP infusion
Remove IV line
Place a new IV line
Continue to monitor infiltrated site
Extravasation
Infiltration of a vesicant drug
What is the safest for administration of vesicant drugs?
CVADs
Extravasation signs and symptoms
Pain or burning at IV site
Skin tightness at site
Blanching and coolness of skin
Dependent edema
Extravasation prevention
Dilute meds as recommended
Avoid use of high-pressure pumps
Assess and monitor IV site
Teach pt what to report
Venous spasm
Sudden, brief, tightening of muscle cells inside the vein
Venous spasm causes
Viscous solutions
Too rapid administration
Cold or irritating solutions
Venous spasm symptoms
Sharp pain at the IV site
Pain radiating up the arm with the IV site
Venous spasm prevention techniques
Dilute meds as recommended
Admin solutions and meds at room temp
Admin at recommended rate
Restart questionable IVs
Consider a warm compress during infusion
IV push admin
Follow 7 rights
Verify pt and allergy status
Scan armband
Scan med vial
Hand hygiene and don clean gloves
Remove cap from IV lumen
Remove alcohol permeated cap from IV lumen and clean needle less connector access with alcohol pad for how long?
15 seconds
Use the __________ __________ included with the tubing delivery system to control the rate of admin
Roller clamp
14g or 16g
Great for trauma or surgery when needing rapid infusions
18g
Good for pts going into surgery, receiving blood or caustic meds
20g or 22g
Most common size for adult patients
24g
Most common for pediatric pts, can use for adults with small or fragile veins
