IV Therapy PowerPoint Flashcards
Purposes & Uses of IV Therapy =
To sustain PT’s who are unable to ingest fluids orally.
Water, electrolyte, and nutrient replacement.
Immediate vascular access for rapid delivery, meds, or blood transfusions
The Osmolality of this type of solution is the same as body fluids =
Isotonic Solution
This type of solution can cause an increased Extracellular volume and does not enter cells =
Isotonic Solution
This type of solution is more dilute. It has a lower Osmolality than body fluids =
Hypotonic Solution
This type of solution can cause water to move into the cells via osmosis =
Hypotonic Solution
You need to administer a hypotonic solution slowly to prevent-
Cellular Edema
This type of solution is more concentrated, has a higher Osmolality than body fluids =
Hypertonic Solution
This type of solution can cause water to move from the cell into Extracellular Fluid by way of osmosis =
Hypertonic
This type of solution pulls fluid from the interstitial space to the vascular compartment =
Colloids (“Plasma Expanders”)
This type of solution increases volume rapidly.
It is used to treat hemorrhage or severe hypovolemia =
Colloids (“Plasma Expanders”)
What are seven things that you need to keep in mind when choosing the site for an IV Insertion?
Use distal veins first (The veins closest to yourself and not the patient).
Restarts should be proximal (Above) to the previous site.
Use the non-dominant arm if possible.
Select veins that are easily palpated and feel full.
Avoid veins that are in areas of flexion, highly visible, damaged, knotted, or in a compromised extremity.
Dilate the vein.
Limit your attempts to 2.
Name 5 things that you should avoid whenever it comes to IV insertion:
Avoid the Antecubital Basilic & Median Cubital Veins.
Areas of infiltration, infection, or thrombosis.
Extremities with dialysis grafts.
Extremities on the same side of a mastectomy.
Avoid vessels of compromised blood flow such as in paralysis.
Why should you avoid the Antecubital Basilic & Median Cubital Veins when inserting an IV?
These are used for blood draws, PICC lines, and for Bolus Injections of meds.
What are the 3 types of tubing?
Primary
Secondary
Extension
IV tubing should be changed how often?
Every 96 Hours
IV Catheter Sizes:
Yellow =
24 Gauge
IV Catheter Sizes:
Blue =
22 Gauge
IV Catheter Sizes:
Pink =
20 Gauge
IV Catheter Sizes:
Green =
18 Gauge
IV Catheter Sizes:
Grey =
16 Gauge
IV Catheter Sizes:
Orange =
14 Gauge
The smaller the gauge number, the larger the-
The larger the gauge number, the smaller the-
Diameter of the lumen
What are things that you should check IV solutions for?
Expiration Date
Cloudiness
Leaks
Right Solution
Evidence of Prior Opening
Correct Volume (Don’t select a volume higher than what’s ordered)
IV Solutions come in how many mL containers?
50, 100, 250, 500, or 1000 mL containers
Should you write directly on the bag with a pen?
No, it may puncture
Should you write directly on the bag with a marker instead of a pen?
Neither are good to do.
Markers may absorb through the plastic and into the solution
What should you do before the initiation of IV therapy?
Determine the type & amount of solution needed.
Determine the dosage of any meds to be added.
If any meds are to be added, check their compatibility.
Determine the flow rate or infusion time.
Verify that the solution matches the one prescribed by the provider.
Understand the purpose for the infusion.
Follow the med administration rights.
IV Bags should be changed how often?
The Primary Line should be changed how often?
The Secondary Tubing that remains attached to the primary line should be changed how often?
The IV Site itself should be changed how often?
IV Bags = Every 24 Hours
Primary Line = Every 94 Hours
Secondary Tubing = Every 94 Hours
IV Site = 72-96 Hours
Dressings are changed only if-
Soiled or not intact
How often should an IV Site be monitored?
Hourly
What should an IV Site be monitored for?
Proper Solution Infusing
Observe Flow rate Hourly
Patency.
Inspect the Site for discoloration, edema, or drainage.
Should you always educate the PT about how IV’s work when they are being given one?
Yes
When monitoring an IV site, you should document any-
Pertinent Information
What are some factors that can influence the IV Flow Rate?
Extremity Position
Tubing Patency / Position
The Height of the Solution (3ft Overhead)
Infiltration
Fluid Leakage
Size of Angiocath
The unintended administration of a nonvesicant drug or fluid into the subcutaneous tissue =
Infiltration
Caused by the puncture of a vein, a dislodged catheter, or a poorly secured infusion device =
Infiltration
Infiltration
Signs & Symptoms:
Skin is cool around the site
Skin Blanches
Tautness of the skin
Edema at/near site
Site leakage
Lack of blood return
Discomfort
The unintended administration of a vesicant drug or fluids into the subcutaneous tissue =
Extravasation
Is extravasation caused by the same thing that infiltration is caused by?
Yes
Extravasation
Signs & Symptoms:
Pain, tenderness, or discomfort at site
Edema at or near site
Skin Blanches
Temp Changes at site
Burning, stinging pain at site
Tightness below site
Redness followed by Blistering, Tissue Necrosis, and Ulceration
Inflammation of the vein =
Phlebitis
How many types of phlebitis are there? What are they called?
3
Mechanical, Chemical, Bacterial
Phlebitis
Signs & Symptoms:
Redness at the site
Warmth at the site
Edema at the site
Palpable cord along vein
Increased temp
Burning along vein
Red line along vein course
A bolus of air in the vein =
Air Embolism
What do you do if Air Embolism is suspected?
Clamp the tubing, turn the PT to their left side in Trendelenberg’s Position.
Notify the provider.
Air Embolism
Signs & Symptoms:
Tachycardia
Chest Pain
Dyspnea
Hypotension
Cyanosis
Lowered LOC
IV Catheter breaks off in the vein =
Catheter Embolism
What should you do is a Catheter Embolism is suspected?
What should you prepare for?
Tourniquet as proximally (above) to the IV site of the affected limb as possible. Notify provider asap.
Prepare for a radiograph and surgery to remove the catheter.
Catheter Embolism
Signs & Symptoms:
Lowered BP
Pain Along Vein
Weak, Rapid Pulse
Cyanosis of Nail Beds
Loss of Conciousness
What is the cause of Circulatory Overload?
Fluids being administered too rapidly
How should circulatory overload be prevented?
By assessing if the PT is at risk before fluid administration
Circulatory Overload
Signs & Symptoms:
Increased BP
JVD (Jugular Vein Distention)
Tachypnea
Dyspnea
Moist Cough
Crackles
The longer the IV therapy continues, the greater the risk for-
Infection
How should infection be prevented when administering fluids via IV?
Follow Strict Asepsis.
Follow Tubing Changes Policy.
Don’t allow solutions to hang for over a day.
Infection from an IV
Signs & Symptoms:
Edema
Redness
Warm to touch
Purulent Drainage
Your PT has drainage at their IV Site, what do you do?
Discontinue the IV, send the catheter in a sterile container to lab for culture
Your IV site should be checked how often by a nurse?
Hourly
