IV Skills Flashcards
IV infusion pump
Generates the flow of IV fluids by exerting pressure on the tubing or the fluid. Overcomes peripheral resistance.
Types of electronic infusion devices
IV infusion pump, IV controller
Advantages to IV infusion pump
More precise than controllers, accurately deliver the fluid as programmed
Disadvantages to IV infusion pump
Ability to exert pressure and overcome resistance puts IV site at greater risk for infiltration
Purposes of EIDs
Regulate rate and volume of infusions, improves safety and accuracy of fluid and drug administration, not intended to replace the nurse or nurse’s responsibility for monitoring and insuring the flow rate of the therapy
IV controller
Generates flow of IV fluids by gravitational force. Container must be at least 36 inches above venipuncture site to work. Sensor system utilized
Advantages of IV controllers
Reduce the potential to rapid infusion of large amount I solutions because they maintain accurate flow rates
Disadvantages of IV controllers
Cannot detect infiltrations, not often used except in long term care agencies
Equipment prep for EID
- Obtain appropriate tubing that is compatible with the EID
- obtain ordered IV solution
- obtain EID
- prime tubing according to manufacturers instructions
- plug in EID and turn on, clear previous data
- load tubing according to manufacturers guidelines
- set controls to desired infusion rate and volume
- place electronic infusion device on same side as venipuncture
Client Assessment and Teaching Preprocedure EID
- assess patency of IV site. Note complications of phlebitis or infiltration. Presence of these complications necessitates a new IV site
- assess integrity of IV Q1. Change as needed
- teach client about EID alarm system, instruct client not to adjust alarms and call rn if alarm sounds or if pain or swelling occurs at IV site
Initiate/monitor/assess EID
- attach IV tubing to clients IV access device and begin infusion of ordered solution at prescribed rate
- document appropriate information on intake/output flow sheets, IV assessment flow sheets and/or progress notes per agency policy
- assess IV solution and change when container low, container outdated per CDC guidelines (96degrees) or when health care provider orders a different solution
- assess the EID frequently to make sure the solution is infusing properly since these devices can malfunction (check volume infused feature and correlate to ordered rate over specific time span, observe and count actual drops, observe credit of solution an correlate to ordered rate over specific time span), keep EID plugged in at all times except during ambulatory to conserve battery power
- change EID tubing per agency policy
Client Assessment During Procedure EID
- assess IV site Q 1 h, when changing IV bag or rate or prior to administering an intravenous minibag
- assess client response to infusion. Note both therapeutic response and any adverse effects
Troubleshooting EID
when EID alarm sounds immediately pause/stop pump and perform assessment. begin the assessment with the client and proceed systematically in a upward fashion
Systematic Assessment
- Client: IV site, patency, complications, position of extremity
- Assess Tubing: kinks, obstructions, roller clamps/side clamps, air in line, drip chamber correctly filled, placement of tubing within electronic infusion device
- Assess Infusion Device: on/off button, run/hold/pause button, battery power indicator/plugged into outlet, alarm indicator, rate/volume/volume to be infused buttons, drop sensor position
- Assess Solution: Solution credit, height of container (controller only)
What to do in case of Air Detection Alarm
follow systemic assessment looking for air in line. clamp tubing and remove tubing from client’s IV access device and EID. remove air by purging the line. reload electronic infusion device and attach to client’s IV access device
How to prevent Air Detection Alarm
correctly prime IV tuving, set EID at correct volume to be infused
What to do Battery Low Alarm
plug in EID
How to prevent Battery Low Alarm
keep EID plugged in at all times except during ambulation
What to do Pressure or Occlusion Alarm
follow systematic assessment looking for cause of pressure or occlusion
How to prevent Pressure or Occlusion Alarm
maintain patent IV site, open all clamps prior to beginning the infusion, correctly load EID, position client’s extremity to prevent kinking obstruction or disruption of flow
Patient Controlled Analgesia
A method of pain management that allows for self-administration of intravenous analgesics using a computer controlled infusion pump to deliver a predetermined dose of medication within set limits
Purpose of patient controlled analgesia
facilitates client involvement in pain control, provides individualized pain relief, provides client with a sense of control over the pain, decreases opioid requirements, eliminates need for IM analgesics
Contraindications for patient controlled analgesia
client inability to understand PCA teaching, client with psychomotor deficit who is unable to depress PCA button
Bolus
The amount of medication delivered either as a loading dose or as an additional supplement