IV THERAPY Flashcards
indications for IV therapy
NPO, electrolyte imbalance, to provide glucose, to provide vitamins and medications
What are the 4 types of IV access?
peripheral IV (PIV)
central venous access/catheter (CVC/CVAD)
peripherally inserted central catheter (PICC)
midline (CVC)
What are common peripheral IV sizes for adults?
20 and 22
What are some things to remember about peripheral IV placement?
choose most distal site, avoid areas of flexion, use straight soft veins, don’t use site of mastectomy, AV fistula, or major trauma
color and recommended use for 14G
orange, in massive trauma situations
color and recommended use for 16G
gray, trauma, surgeries, multiple large-volume infusions
color and recommended use for 18G
green, blood transfusion, large volume infusions
color and recommended use for 20G
pink, multi-purpose IV
color and recommended use for 22G
blue, most chemo infusions; patients with small veins; elderly or pediatric
color and recommended use for 24G
yellow, very fragile veins, elderly or pediatric
What are some vein dilation tips?
tourniquet, gravity, fist clenching, tapping vein, warm compresses, blood pressure cuff
PIV nursing care
label site and IV, dispose of equipment properly, calculate flow rates, CLEAN dressing changes with transparent dressing, educate patient, documentation
IV pump alarm: air in tubing
empty IV bag or hole in tubing
spike new bag and reprime or change tubing
IV pump alarm: low battery power
unplugged, loss of power to outlet
plug in device
IV pump alarm: downstream occlusion alarm
clotted catheter, IV dressing too tight, infiltration, kinked, extension added, viscous solution
flush, change, remove, stop
possible reasons pt has CVC
to monitor central venous pressure in critically ill, rapid admin, antibiotic therapy, cytotoxic drugs, parenteral neutrino, cardiac failure, post-op
What is a PICC line?
IV that goes through upper arm vein to vein near heart
What is a tunneled line?
IV placed in OR, tunneled under skin; removal by MD/APRN only, used when infusion therapy is frequent and prolonged
What are the advantages/disadvantages of tunneled lines?
no needle sticks
prolonged break in skin integrity
What is ordered if a tunneled line is not in use?
“dwell” heparin
What is the nurses role during a central line insertion?
gather sterile materials, assist MD/APRN/PA, assist patient, monitor for complications (pneumothorax), verify by CXR
What kind of dressing is central line?
STERILE
What is a CLABSI?
central-line associated bloodstream infection, develops within 48 hours of placement
How do you prevent CLABSI?
hand hygiene, sterile dressings, chlorhexidine, avoid dirty sites (femoral), remove CVCs ASAP
