IV complications

Question 1

non running IV can be due to?

Answer 1

prob not in the vessel

IV infusion bag too close to the heart level

bevel of the needle against the wall of the vein

tourniquet left on the arm - make sure this is OFF

infiltration

Question 2

if drop bag below heart

Answer 2

may not be effective

if blood becomes above the bag - not going to flow

Question 3

needle not a catheter

Answer 3

have bevels – probably not going to flow - can impede flow

Question 4

venospasm

Answer 4

complication

a protective mechanism

vein collapses and may be accompanied by burning sensation

unpreventable

Question 5

hematoma

Answer 5

complication
the most common complication associated with venipuncture

can occur with IV placement and also at the time when the catheter is removed

Question 6

the most common complication associated with venipuncture

Answer 6

hematoma

Question 7

infiltration

Answer 7

complication associated with venipuncture

fluid is deposited in the tissues surrounding the blood vessel

it is painless, colorless swelling that develops at the site of the needle tip when the IV is started

have to stop the infusion and remove the needle / catheter and place pressure for 5 mins

Question 8

local venous compications

Answer 8

can develop after IV sedation procedures

most common is due to chemical irritation of the vein wall from the administer medication

Question 9

air embolism

Answer 9

unlikely to occur in IV sedation

best prevented by removing air from syringes and IV tubing before the procedure and making sure the IV bag does not empty

small children at greater risk

managment - position patient on their left side in the head down position
- trendelenberg

air goes right ventrivel– air goes to lungs

Question 10

tolerate ___ weight of air in the peripheral venous circulation without adverse effect?

Answer 10

1 ml/ kg body weight

Question 11

overhydration can ocurr in who more

Answer 11

small children and pateitns with heart failure

Question 12

broad over view of local complications of drug administration

Answer 12

extravascular drug administration

intraarterial injection

local venous complications

Question 13

extravascular drug administration

Answer 13

drug is injected into the subcutaneous tissue

• pain
• delayed absorption of the drug
• tissue damage

Question 14

intraarterial injection

Answer 14

most significant complication if it occurs

medications cause spasm of the artery in the most DISTAL portions

could lead to loss of limb

Question 15

intraarterial injection prevention

Answer 15

palpate vessel before venipuncture , before placing tournaquet

as needle approaches the artery, the vessel will begin to spasm and has more intense burning sensation

if in vessel - blood return is brighter

once tourniquet is removed, the blood may pulsate in the tubing or back up

Question 16

management of intraarterial injection

Answer 16

leave needle in place

administer PROCAINE

• 1% solution slowly to a total of 2 to 10 mls
• acts as an anesthetic
• vasodilator (most vasodilating)
• pH of 5 - thus counter balances alkaline pH solutions
• diluent

hospitilize the patient
- seen by vascular surgeon

Question 17

thrombophlebitis?

can be seen with use of?

Answer 17

local venous complication
- inflammation has preceded the formation of thrombus

features

• edema, inflammation, tenderness and delayed onset
• usually 24-48 hours

seen with DIAZEPAM USE - B/C contains propylene glycol

can also be caused by improper technique , use of a large needle in a small vein
at the site of venipuncture

manage

• limit limb activity
• affected limb should be elevated
• manage with NSAIDs
• anticoagulants and antibiotics are not part of the usual regimen
• resolution in 3-4 weeks

Question 18

histamine release can be seen with which class of drugs

Answer 18

opioiods

see redness that will go up the arm

Question 19

emergence delirium with

Answer 19

ketamine

Question 20

laryngospasm

Answer 20

protective reflex

seen when the protective reflexes are compromised with CNS depressant medications

in deep sedation or ultralight GA - foreign material present in the area of the larynx may provoke a protective reflex in which the vocal cords ADDUCT in an attempt to seal off the trachea from this material

this will also prevent the passage of air into and out of the trachea and lungs

closed together

Question 21

partial laryngospasm

Answer 21

presence of stridor - hear some breathing noises - defined as an abnormal high-pitched sound

Question 22

complete larygnospasm

Answer 22

identified by the absence of sound in the presence of spontaneous respiratory efforts

Question 23

management of laryngospasm

Answer 23

remove any offending material , tonsillar suction

after suctioning - administer positive pressure of oxygen - it is possible to break the spasm by forcing air through the vocal chords

administration of meds like succinycholine - depolarizing muscle relaxer - the
20-40 mg will need to ventilate patient - have to breathe for them