IV Therapy, IV Fluids and Medication Administration Flashcards
Do determine what type of needle a patient needs what type of questions should you ask?
- what kind of therapy will the patient need to recive?
- what is the lenght of tx and duration of the device will remain in place?
- what does the vasculature of the patient look like?
- what is the patients age?
Why is Iv therapy so important?
patients can require various things:
- fluids
- medications
- electrolytes
Type of needle
Angi-Caths
- most commonly used to access veins
- short, goes into the peripheral system
- for intermittent use (short duration)
- blood, iv fluids, medications (IVP or piggyback antibiotics)
Iv catheter
24G - Yellow
- yellow for the little fellows ages 2 - 4
- younger / neonates, ederly with pooor vein access
Iv catheter
22G - Blue
- Blue 22 bid it a do
- try to avoid 22 with blood administration
IV Catheter
20G - Pink
- pretty in pink in age 20
- best
- good for anything in the adult population
IV Catheter
18G - Green
- there 18 holes on a green golf range
IV Cathere
16G - Gray
rarely used
- large amouts of fluid or blood
- trauma
- @ age 14-16 you think you are the biggest and the baddest, they have the largest diameters
IV Cathere
14G - Orange
rarely used
- large amouts of fluid or blood
- trauma
- @ age 14-16 you think you are the biggest and the baddest, they have the largest diameters
Type of needle
Butterflys
- phebotomy (lab draws)
- one time medication administration (higher risk for phlebitis and extravasation)
Central Vascular Access Devices
- Implanted: Huber portcath
- External Tunneled (Hickman, Broviac, Groshong)
- Peripherally inserted Centeral Catheter
- Central venous catheter
Implanted: Huber porthcath
- implanted venous port
- purple part is surgically inserted
- cancer pts or patients with long term needs
External tunneled (hickman, Broviac, Groshong)
- permanent
- in through the subclavian or the jugular
- fluids, medications, nutrition
central venous catheter
- placed by HCP, can be inseted by the beside
- the patient is placed in trendelenburg
- short term venous access
- sutured againt the chest at the insertion site
Peripherally Inserted Central Catheter (PICC)
- long term antibiotic use
- inserted into the antecubital fossa or the bacilic or cephalic vein and advanced up until the catheter reaches the superior vena cava
- pts can go home with this
dacron cuff covered in antimicrobial solution
dressing changes need to be done
Intraosseous Access
- into the bone
- used as a last resort in emergencies, trauma
- physician, EMS, or flight RN initiated
- 24 hour use
Angiocath as a saline lock
Equipment:
- correct size angiocath
- kit: tourniquet, tape, transparent dressing, antiseptic chlohexidine, 2x2 gauze, label
- clean gloves
- j-loop with deedless connector
- 5-10mL prefilled saline syringe
- stat lock (stabilization device) if avaliable and policy
- prepare equipment with saline infused J-loop ready for connection with access
- verify the oder
- gather equipment
- identify and educate patient
- purpose of VAD (meds, IVF, procedures)
- to notify nurse with s/s of complications (redness, pain, swelling, bleeding, drainage/leaking)
- apply tourniquet & locate vein
- release tourniquet
- hand hygine and DON gloves
- place towel/pad under ligament of insetion site
- scrubsite with antiseptic and let dry
- scrub for 30 secs. in a circular motion from clea to dirty.
- always begin inseting the catheter in the distal part of the vein and work proximal if needed.
- avoid dominant hand, wrist and leg and neck if possible.
- reapply the tourniquet 10-15 cm above the cleaned area
- stabilize above the vein & voice that you will stick
- insert needle bevel up
- observe for flashback and advance 1/4 in
- thread cannula into vein
- Release the tourniquet and stabalize the hub and apple pressure
- connect j-loop to hub of cannula while stabalizing the device
- flush the j-loop while securing the needle
- secure the site with tape and dressing
- transparent dressing hould be over the hub (not J-loop) with insertion site covered and visible
- label: date, time, initials
- statlock securement device or tape
- document
how long can a transparent dressing be placed and left on a stat lock?
when does it need to be changed?
every 5-7 days
or when its wet, soiled or the integrity of the dressing is compermised
dressing change
- hand hygiene and DON gloves
- ID patient
- remove old IV site while securing device with nondominant hand
- assess if securement device needs to be changed
- slean site and allow to dry
- apply new op-site dressing
- secure hub and tubing with tape
- label dressing change
DO NOT DO OF IV THERAPY
WHAT ARE CONTRAINDICATIONS OF IV PLACEMENTS?
- do not start an IV on the same side there is AV fistual, AV shunt, A mastectomy, impairment, infection, previous infiltration with edema or infection, or blood clots.
can cause clots to form, infections, rupture
IV Complications
- Infiltration or extravasation (Scales)
- Phlebitis or thrombophlebitis (Scales)
- Air Embolism
- Fluid overload
- Cellulitis
- Dislodgement
Local Infiltration
DESCR: IV fluid enters subcutaneous tissue around venipuncture site.
CAUSE: catheter dislodged or vein ruptures
AE: skin around catheter site taut, blanched, sool to touch, edematous; painful.
NI: stop Infusion. D/C IV infusion.
Extravasation
DESRC: A Vesicant fluid enters subcutaneous tissue around the venipuncture site.
CAUSE: catheter dislodged or vein ruptures
AE: Skin around catheter site taut, blanched, cool to touch, edematous; painful.
NI: stop infusion. D/C IV infusion. Give antidote if indicated. disconnect IV tubing and aspirate drug from catheter.
elevate affected extremity. avoid applying pressure over site; can force solution into contact with more tissue. contact HCP is solution contained KCL, a vasoconstrictor, or other potential vesicant. apply warm, moist or cold compress according to procedure for type of solution infiltrated. start new IV line in other extremity.
*vesicant = tissue damaging drug that will enter the tissue
example: chemotherapy
Phlebitis
DESCR: Inflammation of inner layer of vein
AF:
