IV Complications Flashcards
Name the 8 complications of IV therapy
Infiltration, extravasation, phelbitis, thrombophlebitis, hematoma, catheter occlusion, fluid (circulatory) overload, air embolism
Infiltration
fluid leaks out of vein to surrounding tissue
Site assessment of infiltration
skin pale, puffy, emematous, cool —> progress to translucent, tight skin and pain.
IV signs of infiltration
Iv flow sluggish, no blood return
Treatment of infiltration
D/C IV, elevate limb (encourage fluid to return to BV), warm compress to promote comfort, vasodilation, facilitating re absorption rate
How to prevent infiltration
check freq (also whole limb bc fluid may pool somewhere else), tape secure, avoid traction on tubing
extravasation
Leaking of irritating or vesicant (blister-forming) type meds/solution into surrounding tissue. (Stage 4 INFILTRATION)
site assessment of extravasation
redness, burning, pain-blistering, inflammation, necrosis —> amputation
treatment of extravasation
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
Prevention of extravasation
proper administration techniques, give vesicants last when multiple drugs ordered, give through CENTRAL LINE
Phlebitis
Inflammation of vein
site assess. of phlebitis
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.)
cause of phlebitis
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
treatment of phlebitis
D/C, WARM compress (promotes circulation, body sends WBC to fight infection)
prevention of phlebitis
aseptic technique, tape site securely, dilute IV meds adequately
Thrombophlebitis
presence of clot PLUS inflammation in vein (phlebitis= vein inflammation, thrombo= blood clot)
site assess for thrombophlebitis
same as phlebitis plus fever/malaise and sluggish infusion. D/C and restart new one in diff arm. NOTIFY MD
Hematoma
blood leaking into tissues surrounding IV insertion site
site assess of hematoma
bruising (ecchymosis) and immediate swelling at site, leakage of blood under skin at insertion site
cause of hematoma
insertion technique, use of larger IV catheter than required, tourniquet too tight, fragile veins (elderly, immunocompromised, and blood thinner patients more at risk)
treatment of hematoma
remove IV cath applying PRESSURE with dry, sterile dressing. ICE for 24 hrs, elevate
catheter occlusion
formation of blood clots in IV line
site assess of occlusion
blood back up in tubing, unable to flush saline lock
cause of occlusion
kinked iv tubing, failure to flush IV line after intermittent med administered
treatment of occlusion
remove IV catheter and restart new IV line (dislodging it will only push clot into circulatory system)
prevention of occlusion
flush IV lines per policy (usually every shift and before/after med administered)
circulatory overload
excess fluid volume in circulatory system
assess of circulatory overload
crackles in lungs, SOB, peripheral edema, engorged neck veins, increased BP
treatment of circulatory overload
STOP and notify MD, slow IV rate, raise HOB, administer O2, administer ordered diureticd
prevention of overload
monitor rate carefully (qhr), never leave roller clamp wide open, free flow infusion, use IV pumps, assess positional IV sites carefully
air embolism
air enters systemic circulation and travels to right ventricle and into pulmonary circulation
assess of embolism
sudden severe chest pain, respiratory distress, hypotension, weak/rapid pulse, can lead to shock/death
treatment of air embolism
STOP infusion, position patient on left side in trandelenburg position (feet up head down), check VS and lung sounds, administer O2, call MD
prevention of embolism
DO NOT allow Iv tubing to run dry, closed system, check at least every 2 hrs
