IV Therapy Monitoring Flashcards
Potassium Chloride
Rate cannot exceed 10 mEq/hour in a concentration of up to 40 mEq/liter. The 24 hour total dose should not exceed 200 mEq.
Recognizing Infiltration
If your patient is receiving peripheral I.V. therapy, you’ll need to watch for signs and symptoms of complications, such as:
- hypersensitivity
- infiltration
- extravasation
- phlebitis
- infection
After giving an I.V. medication…
Stay with your patient for 5 to 10 minutes to detect early signs and symptoms of hypersensitivity, such as sudden fever, joint swelling, rash, urticaria (hives), bronchospasm, and wheezing.
If he’s receiving the drug for the first or second time, check him every 5 to 10 minutes or according to your facility’s policy. An immediate, severe reaction is life-threatening, so prompt recognition and treatment are imperative.
At the first sign of hypersensitivity…
- Discontinue the infusion and notify the health care provider immediately.
- Administer medications as ordered.
- Monitor the patient’s vital signs and provide emotional support.
Infiltration
Infiltration occurs when I.V. fluid leaks into surrounding tissue. It’s commonly caused by improper placement or dislodgment of the catheter. When the tip of the catheter is positioned near a flexion area, patient movement may cause the catheter to slip out or through the lumen of the vessel. The risk of infiltration increases in older patients because their veins are thin and fragile.
S&S of infiltration
- swelling
- discomfort
- burning
- tightness
- cool skin
- blanching
Extravasation
Extravasation, the leaking of vesicant drugs (such as antineoplastics) into surrounding tissue, can cause severe local tissue damage, resulting in delayed healing, infection, tissue necrosis, disfigurement, loss of function, and even amputation.
As soon as you spot infiltration, think of the 3 C’s…
Cut off the infusion
Counteract the effects of the drug
Contain the affected area
S&S of Extravasation include
- blanching, burning, or discomfort at the I.V. site
- cool skin around the I.V. site
- swelling at or above the I.V. site.
If you suspect extravasation…
- Stop the I.V. flow and remove the I.V. line, unless the catheter should remain in place to administer the antidote.
- Estimate the amount of extravasated solution and notify the health care provider.
- Instill the appropriate antidote according to your facility’s protocol.
- Elevate the extremity.
- Record the extravasation site, your patient’s symptoms, the estimated amount of extravasated solution, and the treatment.
Phlebitis
Phlebitis, or inflammation of a vein, is a common complication of peripheral I.V. therapy that’s associated with acidic or alkaline solutions or those that have a high osmolarity. Other factors include - vein trauma during insertion / using a vein that’s too small / using a vascular access device that’s too large / prolonged use of the same I.V. site.
Phlebitis (additional)
Phlebitis can follow any infusion, but it’s most common after continuous infusions, developing 2 to 3 days after the vein is exposed to the drug or solution. It develops more rapidly in distal veins than in veins close to the heart. Phenytoin and diazepam can produce phlebitis after one or more injections at the same I.V. site. Large doses of potassium chloride, amino acids, dextrose solutions, and multivitamins can cause phlebitis as well. Certain irritating I.V. drugs are also likely to cause phlebitis when piggybacked, including:
