IV Therapy

Question 1

types of iv therapy

Answer 1

central and peripheral

Question 2

what can you not chart about appearance

Answer 2

no Within normal limits (WNL)

Question 3

insertion date

Answer 3

the older the more risk of complications

Question 4

who can do periperal ivs?

Answer 4

RNs

Question 5

phlebitis ***

Answer 5

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

Question 6

infiltration ***

Answer 6

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.

Question 7

extravasation ***

Answer 7

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

Question 8

bleeding/oozing ***

Answer 8

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

Question 9

consider prior to any iv meds

Answer 9

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

Question 10

central venous access devices ***

Answer 10

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

Question 11

lumen ***

Answer 11

can be used as seperate ivs

can give incompatible drugs in seperate lumens

Question 12

whose responsibility is it to confirm central line placement with a cxr? ***

Answer 12

RN

Question 13

PICC line (peripherally inserted central catheter) ***

Answer 13

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

Question 14

pneumothorax ***

Answer 14

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

Question 15

CLABSI
central line associated blood stream infections ***

Answer 15

local: redness, tenderness, purulent drainage, warmth, edema
systemic: fever, chills, malaise

Question 16

CLABSI tx ***

Answer 16

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

Question 17

how to prevent CLABSI ***

Answer 17

alcohol swab for port, hand hygiene, gloves, change dressing, CHG impregnated dressing.

Question 18

patency of lumen for CVAD

Answer 18

ability to push fluid through

Question 19

discontinuing IV

Answer 19

assess site
apply gauze and tape

Question 20

discontinuing CVAD ***

Answer 20

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

Question 21

secondary. iv piggyback

Answer 21

secondar hangs higher than primary
connects at first Y port
when secondary is infusing you must stop primary
check for compatibilities

Question 22

catheter occlusion ***

Answer 22

sluggish flush/aspiration or unable to flush

change pt position, raise arm and cough

flush

order for anticoagulant/thrombolytic agent

Question 23

catheter migration ***

Answer 23

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

Question 24

embolism ***

Answer 24

chest pain, resp distress, hypotension, tachycardia

apply o2
clamp catheter
notify provider