IV Therapy Flashcards
types of iv therapy
central and peripheral
what can you not chart about appearance
no Within normal limits (WNL)
insertion date
the older the more risk of complications
who can do periperal ivs?
RNs
phlebitis ***
inflammation of the vein
causes: poorly placed iv, bacteria, irritation
assessment: reddness, warmth, pain, line following irritation
treatment: disconnect iv and restart proximmaly or on different arm. dilute medications, avoid prolonged iv access and flexed joints
infiltration ***
leaks out into the surrounding tissue
assessment: swelling, coolness, discomfort, no blood return
treatment: disconnect iv and restart proximmaly or on other amr/vein, avoid joints.
extravasation ***
it and infiltration but with toxic fluids that damage the tissue
assessment: pain, redness, buring, blistering, necrosis
treatment: stop infusion, notify provider (MAY NEED AN ANTIDOTE), do nog use same extremety for new iv. do fequent neurovascular checks
bleeding/oozing ***
blood at insertion site or under dressing.
usually a connection issue
check iv system is intact, apply pressure, change dressing
change site if iv is dislodged
consider prior to any iv meds
PH of meds : phenergan ph 4. low ph can damage tissue
push it slowly and dilute it if needed
Dilantin ph 12
patency of line
compatibility of things going into iv (so they dont crystalize)
teach patient to report pain or burning of iv
central venous access devices ***
dumps meds right into the heart
placed by MD or APRN
can have single, double, triple, and quad lumens
use sterile dressing changes
placement is confirmed with chest xray
lumen ***
can be used as seperate ivs
can give incompatible drugs in seperate lumens
whose responsibility is it to confirm central line placement with a cxr? ***
RN
PICC line (peripherally inserted central catheter) ***
can remain in place for 1 week to 6 months
lower infection rate
good for:
home ABX, pt with incompatible meds, long term iv use
no b/p in picc arm and no other ivs in arm
pneumothorax ***
s/s : decreased/absent breath sounds, respiratory distress, chest pain, chest asymmetry
tx: apply o2, place in semi-fowlers, notify HCP and perpare for chest tube insertion
CLABSI
central line associated blood stream infections ***
local: redness, tenderness, purulent drainage, warmth, edema
systemic: fever, chills, malaise
CLABSI tx ***
local: culture drainage, apply warm compress, remove catheter as needed
systemic: prepare to collect blood culture, administer antibiotics and antipyretics, remove catheter. keep the tip for culture
how to prevent CLABSI ***
alcohol swab for port, hand hygiene, gloves, change dressing, CHG impregnated dressing.
patency of lumen for CVAD
ability to push fluid through
discontinuing IV
assess site
apply gauze and tape
discontinuing CVAD ***
clarify order to remove
remove sutures
have pt perform valsalva maneuver while gently removing
apply sterile dressing and pressure to prevent air embolism and bleeding
secondary. iv piggyback
secondar hangs higher than primary
connects at first Y port
when secondary is infusing you must stop primary
check for compatibilities
catheter occlusion ***
sluggish flush/aspiration or unable to flush
change pt position, raise arm and cough
flush
order for anticoagulant/thrombolytic agent
catheter migration ***
sluggish infusion, edema of chest/neck, dysrhythmias, decreased external catheter length
notify provider
prepare for cxr/fluoroscopy
prepare for removal of CVAD/ place new one
embolism ***
chest pain, resp distress, hypotension, tachycardia
apply o2
clamp catheter
notify provider
