IV Therapy 1 Flashcards
Purpose of an IV
- Maintain/correct fluid/lyte balance, nutritional state.
- Administer medication, blood or components
- TKVO in an emergency.
- To administer diagnostic agents/anesthesia.
Discuss the location of, uses and advantages of the veins in the arm and hand.
Digital- sides of fingers- small, not often used.
Metacarpal- dorsum of hand- good but may restrict movement of hand.
Cephalic- radial, Basilar-ulnar. Good- large.
Is it recommended to choose sites in the lower extremities? Why or why not
No. thrombosus more likely. i.e. superficial leg veins join deeper ones, so a thrombus at the end of the IV catheter may dislodge and cause an embolism. Also patient immobilized and that also increases risks for phlebitis due to decreased blood flow to the foot preventing adequate hemodilution of drugs and solutions.
What factors do you consider when choosing an IV site? (4)
Condition of veins
purpose, duration, suitable location,` i.e. re- comfort and performance. i.e. non-dominant hand unless there are contraindications.
When assessing the veins, are distal or proximal sites considered first? Why?
Distal. Preserve veins so can use the same vein higher up. Start low and work-up.
IV catheters come in different lengths and gauges. How does the nurse determine which to use? i.e. When would the nurse choose a 22g? a 16g?
Age of patient- younger and elderly often have smaller veins and need a smaller gauge i.e. 22 g. Look at size of vein, purpose, type of infusion, rate, age.
Blood Flashback
Blood passes through the tip of the stylet into the flashback chamber when the vein is entered.
Name 3 things the nurse does to prevent infection related to venipuncture.
Use clean or own tourniquet.
Hand washing and gloves.
Handle used equipment safely. Disinfect patient’s skin prior to venipuncture.
4 methods of dilating veins
Tourniquet (4-6” above site. Can use double tourniquet method.
Use warm compresses or packs.
Hold arm below heart level, gentle taps.
Relaxation techniques.
- Why anchor the vein prior to IV insertion?
18. At what angle is the catheter inserted into the vein (direct method).?
To get in. Prevent movement of vein and to decrease pain.
30-45 degrees, then lower.
Once the stylet is separated from the catheter, why should it not be re-introduced?
Risk of infection. Piece of plastic can break off and damage the vein or can be a catheter embolism.
Documentation
Date and time. When IV started and for how long. Purpose. Chart if it’s a saline lock or a running IV. State what is running and rate. Location, needle used, who started it and patient reaction. Signature and status,
Why IV may not be infusing
Tubing kinked, IV catheter kinked, positional, clot, no solution, phlebitis, wrong administration set, venous spasm.
How often IV should be changed
Q72 hours. Set Q72 hours. Solution Q24 hours (depending on type etc.) and prn. Dressing Q48-72 hours. Check hospital policy- may vary.
What happened if vein is cannulated
The pressure would push the blood up the tubing. Need to take out, apply pressure for 10 minutes and dressing (possible pressure dressing). Chart, report, retry etc.
