IV Complications

Question 1

Name the 8 complications of IV therapy

Answer 1

Infiltration, extravasation, phelbitis, thrombophlebitis, hematoma, catheter occlusion, fluid (circulatory) overload, air embolism

Question 2

Infiltration

Answer 2

fluid leaks out of vein to surrounding tissue

Question 3

Site assessment of infiltration

Answer 3

skin pale, puffy, emematous, cool —> progress to translucent, tight skin and pain.

Question 4

IV signs of infiltration

Answer 4

Iv flow sluggish, no blood return

Question 5

Treatment of infiltration

Answer 5

D/C IV, elevate limb (encourage fluid to return to BV), warm compress to promote comfort, vasodilation, facilitating re absorption rate

Question 6

How to prevent infiltration

Answer 6

check freq (also whole limb bc fluid may pool somewhere else), tape secure, avoid traction on tubing

Question 7

extravasation

Answer 7

Leaking of irritating or vesicant (blister-forming) type meds/solution into surrounding tissue. (Stage 4 INFILTRATION)

Question 8

site assessment of extravasation

Answer 8

redness, burning, pain-blistering, inflammation, necrosis —> amputation

Question 9

treatment of extravasation

Answer 9

STOP infusion immediately, elevate limb, notify MD, follow protocol for anitdotes, don’t use arm for further IV placement, ICE or WARM PACKS depending on drug manufacturer’s recommendation

Question 10

Prevention of extravasation

Answer 10

proper administration techniques, give vesicants last when multiple drugs ordered, give through CENTRAL LINE

Question 11

Phlebitis

Answer 11

Inflammation of vein

Question 12

site assess. of phlebitis

Answer 12

red, warm area at site/path of vein, may have pain, tenderness, swelling, palpable venous cord. (shouldn’t feel vein by IV site, stresses the vein and opens door for infection.)

Question 13

cause of phlebitis

Answer 13

irritating/not compatible meds, RAPID infusion rate, vein trauma during insertion, too large of IV cannula (elderly have smaller veins), prolonged use of same IV site, break in aseptic technique, inadequately secured site

Question 14

treatment of phlebitis

Answer 14

D/C, WARM compress (promotes circulation, body sends WBC to fight infection)

Question 15

prevention of phlebitis

Answer 15

aseptic technique, tape site securely, dilute IV meds adequately

Question 16

Thrombophlebitis

Answer 16

presence of clot PLUS inflammation in vein (phlebitis= vein inflammation, thrombo= blood clot)

Question 17

site assess for thrombophlebitis

Answer 17

same as phlebitis plus fever/malaise and sluggish infusion. D/C and restart new one in diff arm. NOTIFY MD

Question 18

Hematoma

Answer 18

blood leaking into tissues surrounding IV insertion site

Question 19

site assess of hematoma

Answer 19

bruising (ecchymosis) and immediate swelling at site, leakage of blood under skin at insertion site

Question 20

cause of hematoma

Answer 20

insertion technique, use of larger IV catheter than required, tourniquet too tight, fragile veins (elderly, immunocompromised, and blood thinner patients more at risk)

Question 21

treatment of hematoma

Answer 21

remove IV cath applying PRESSURE with dry, sterile dressing. ICE for 24 hrs, elevate

Question 22

catheter occlusion

Answer 22

formation of blood clots in IV line

Question 23

site assess of occlusion

Answer 23

blood back up in tubing, unable to flush saline lock

Question 24

cause of occlusion

Answer 24

kinked iv tubing, failure to flush IV line after intermittent med administered

Question 25

treatment of occlusion

Answer 25

remove IV catheter and restart new IV line (dislodging it will only push clot into circulatory system)

Question 26

prevention of occlusion

Answer 26

flush IV lines per policy (usually every shift and before/after med administered)

Question 27

circulatory overload

Answer 27

excess fluid volume in circulatory system

Question 28

assess of circulatory overload

Answer 28

crackles in lungs, SOB, peripheral edema, engorged neck veins, increased BP

Question 29

treatment of circulatory overload

Answer 29

STOP and notify MD, slow IV rate, raise HOB, administer O2, administer ordered diureticd

Question 30

prevention of overload

Answer 30

monitor rate carefully (qhr), never leave roller clamp wide open, free flow infusion, use IV pumps, assess positional IV sites carefully

Question 31

air embolism

Answer 31

air enters systemic circulation and travels to right ventricle and into pulmonary circulation

Question 32

assess of embolism

Answer 32

sudden severe chest pain, respiratory distress, hypotension, weak/rapid pulse, can lead to shock/death

Question 33

treatment of air embolism

Answer 33

STOP infusion, position patient on left side in trandelenburg position (feet up head down), check VS and lung sounds, administer O2, call MD

Question 34

prevention of embolism

Answer 34

DO NOT allow Iv tubing to run dry, closed system, check at least every 2 hrs