IV Theory: Trouble Shooting Flashcards
What are the complications of IV therapy?
- Fluid volume deficit
- Fluid volume excess (overload)
- Trauma from IV therapy (chemical, biological, mechanical)
Which patients are more at risk for develop fluid volume overload?
- Renal failure
- Congestive Heart Failure
- Liver damage
What is chemical IV trauma?
When the chemicals in the solution damage tissue
What is biological IV trauma?
Infections, incompatibility and allergic reactions
What is mechanical IV trauma?
When a portion of the IV has broken off inside the body
What are the manifestations of circulatory overload?
- Crackles
- Dsypnea
- SOB
- Edema
- HTN
- Tachycardia
What do we do if we suscept circulatory overload?
- Notify physician
- Slow rate to TKVO (do not discontinue IV)
What is infiltration?
When fluid enters the interstitial spaces (it is outside of the vein), causing swelling (fluid has to go somewhere)
What can cause infiltration?
- Mechanical and chemical
- Displaced cannula
- Enlarged puncture wound
- Pain, swelling, cool, slow or stopped infusion
What nursing interventions do we do for an individual with infiltration?
- D/C IV (remove cannula)
- Warm compress (vaso dilate)
- Elevate arm
- Re-start elsewhere (go for a different limb)
- Document
What is extravasation?
- One step worse than infiltration
- When the drug leaks into SC tissues and causes necrosis/damage (chemical damage)
What are the S&S of extravasation?
- Swelling
- Tenderness
- Slow or stopped flow
- Eventual tissue necrosis
What are nursing interventions for extravasation?
- D/C IV unless you need to give antidote (remove cannula)
- Ice packs or warm compresses
- Elevate arm
- Notify physician/document
What happens in infection?
- Biological trauma
- Faulty aseptic technique (frequently the result of RN’s)
- Redness, warmth, tenderness **, swelling and exudate
What are nursing interventions for infection?
- D/C IV (remove cannula)
- Culture insertion site and tip of cannula
- Cleanse with normal saline
- Notify physician and document
What is Phlebitis?
- An infection contained to the vein
- Mechanical and chemical trauma
- Movement of cannula in vein and irritating meds
What are the S&S of phlebitis?
- Red, tender and warm cord
- Slow or stopped flow
- Irritation with infusion
- Increased risk of sepsis (look for manifestations)
What are nursing interventions for phlebitis?
- D/C IV (remove cannula)
- Warm compresses
- Observe for S&S of sepsis
- Take a culture swab (optional)
- Notify physician/document
What happens in a drug or fluid reaction?
- Biological trauma
- Systemic/allergic reaction
- Side effect, allergy or interaction with other drugs
What are the S&S of drug or fluid reactions?
- Tachycardia
- Tachypnea
- Subtle changes in pt (appearance/behaviour)
What are nursing interventions for drug or fluid reactions?
- Stop infusion immediately
- Do not d/c
- Notify physician and document
What is septicemia? What are the S&S of it?
- Biological trauma
- Contaminants or exceeded expiry
- Tachycardia, tachypnea, hypotension, N/V, temp
What are nursing interventions for septicemia?
- D/C IV
- Notify physician
- Obtain blood cultures
What happens with an embolism?
- Mechanical trauama
- IV catheter piece
- Air or clot
- Speciic to location
- Respiratory distress and CVS distress
- Rarely caused by nurses **
