IV Insertion Flashcards
What are the things that an IV order must contain?
Solution, Rate, Route, Time Frame
What are important things to review for a patient’s assessment prior to IV insertion?
Physical findings (i.e. mastectomy or fistula), lab values, age, mobility, skin, allergies
What supplies are needed to start an IV?
gloves, tape, dressing (tegaderm), drip set, gauze, tourniquet, alcohol prep, IV catheter, saline flush, connector tubing, IV fluid
When can an IV in the foot be placed on an adult patient?
When there are doctor’s orders for it
What are the 4 parts of an IV catheter?
Stylet, catheter, flash chamber, safety device
What are the 5 hand veins?
digital veins, metacarpal veins, dorsal veins, cephalic veins, basilic veins
What are the characteristics of a good vein?
superficial, smooth, bouncy, no pulsation, not close to a joint, skin is normal
What is it important to have a smooth vein when inserting an IV?
lumpy veins have more valves
What can hard veins be an indicator of?
sclerosis
What are some vein dilation techniques to use when starting an IV?
Tapping, rubbing, moist heat, gravity, fist clenching
Which hand should you use to anchor a vein?
Non-dominant hand
How should the bevel of the needle be positioned for insertion?
Bevel should be up
Steps of preparation for IV catheter insertion
Prep all supplies, identify the patients with 3 identifiers, position the patient and yourself, find vessel, use alcohol wipe to prep area, position the angiocatheter, anchor the vein
Where should a tourniquet be placed in reference to the IV site?
6 inches above site
What is the diameter of the swab site that should be wiped with prep before IV insertion?
Around 3 inches in diameter
When can a site be touched after prepping the IV site with Chlorhexidine?
never
What is an indicator that the needle has entered the vessel?
flashback in hub and “flash chamber”
4 techniques that can be used to advance the cannula
One-step technique, pushing cannula off stylet, “floating” cannula into vein, two-handed technique
What should be on the label of an IV dressing?
date, time, initial, size of catheter
What should be done after advancing the IV catheter?
hold IV catheter steady, remove stylet, attach T-connector or tubing, anchor IV with tape, cover IV with transparent dressing, Label IV dressing, Flush IV tubing and catheter
What needs to be documented following IV insertion?
time/date of insertion, location of site, gauge/length/type of catheter, Number of attempts & complications, type of dressing, States IV site, client response to procedure
What are indications that IV catheter insertion is unsuccessful?
loss of blood return, severe pain, vein puffs up during flushing (infiltrates), no blood return
What may have happened if there is a loss of blood return?
may have pierced through the vein
What may have happened if the patient is in severe pain following IV insertion?
the IV may be in surrounding tissue or it may have pierced a nerve
If there is no blood return after inserting an IV what may have happened?
the needle may have missed the vein
Why should an IV not be placed in a pulsating vessel?
The vessel may be an artery
How many IV attempts can be done before someone else needs to be brought in to start the IV?
2
What could be the cause of redness, swelling, and warmth at the IV insertion site?
phlebitis
What could be the issue if there is swelling, but it is cool around the IV site?
infiltration
What could be the issue if the IV site has no redness, no swelling, is dry, but patient has SOB, puffy feet, and palpitations?
hypervolemia
What could be the issue if the IV site has redness, patient has chills but feels hot and patient states that he/she feels yucky?
IV infection
What does extravasation refer to?
the leakage of injected drugs from blood vessels causing damage to the surrounding tissues
S/S of extravasation
pain, stinging or burning sensations, and edema around the intravenous (IV) injection site
What action should be taken with an IV site that is not WNL?
Discontinue the IV and relocate
Why might IV insertion/IV therapy be needed?
antibiotic administration, hydration, med administration
