Lesson 2 (MIIDTERMS) Flashcards
Commonly used for short-term IV therapy in the hospital setting
Peripheral Devices
- Intravenous catheter inserted by percutaneous venipuncture into a peripheral vein and held in place with a sterile transparent dressing.
- The transparent dressing helps to keep the site sterile and allows the nurse to visualize the insertion site through the dressing
- Used for short-term infusions of fluids, medications, or blood
- Easy to monitor and can be inserted at the bedside by nurses and other trained professionals
Peripheral IV
- Refers to the use of a short extension set that allows IV access without requiring ongoing IV infusions
- When not in use, the lock is flushed with saline according to agency policy and clamped to ensure the site remains sterile and blood does not flow out of the extension tubing
Saline Lock
Enumerate contraindications for IV
- History of lumpectomy or mastectomy
- Arteriovenous fistula
- Current lymphedema
- Deep vein thrombosis (DVT)
- Fractures
Hospitalized patients may have signage or a bracelet stating “_____” to alert heath care professionals to these conditions
Limb Alert
- Larger catheters that allow for rapid infusions
- Much longer and inserted deeper than a peripheral IV
- Typically inserted into the basilic, cephalic, or brachial veins of the upper arm with the tip placed near the level of the axilla.
- Can also be used for longer duration than traditional peripheral venous access, which is ideal for patients needing extended hospital stays or IV access
Midline Peripheral Catheters
- Can be left in for longer periods of time and is useful for administering concentrated medications and fluids.
- Type of vascular access that involves the insertion of a tube into a vein in the neck, chest, or groin and threaded into a central vein and advanced until the tip of the catheter resides within the inferior vena cava, superior vena cava, or right atrium.
- Have an increased risk for the development of bloodstream infections, so strict aseptic technique is required during insertion and maintenance
Central Venous Access Devices
- Thin, flexible tube inserted into a vein in the upper arm and guided into the superior vena cava.
- It is used to give intravenous fluids, blood transfusions, chemotherapy, and other medications requiring a central line.
- May stay in place for weeks or months and helps avoid the need for repeated needlesticks
Peripheral Inserted Central Catheters
The process of IV start and vessel cannulation includes a comprehensive vein search, identification, and assessment process.
Site Selection
Site selection. Veins in the ______ (hands and arms) are typically the preferred sites for insertion.
Upper Extremities
Site selection. Should be _____ when assessing potential vessels for insertion, examining potential sites both visually and through palpation while progressing up the patient’s extremity.
Systematic
Site selection. The arms should be _____ so that vessels on the dorsal surface can be considered as well.
Rotated
Site selection. Taking time to identify the best access site will _____ the chances for successful cannulation and _____ discomfort for the patient
Increase & Decrease
Site selection. The veins of the _____ are common places to begin one’s assessment.
Hands
Site selection. Veins on the _____ of the wrist should be avoided due to potential nerve damage.
Palmar Side
Site selection. These veins on the _____ of the hand are typically easily visualized and palpated due to the proximity to the surface of the skin.
Dorsal Surface
Site selection. A limitation of using hand veins for venous access is they are _____ than the cephalic, basilic, or brachial veins in the arm
Smaller
Site selection. If no suitable veins are found on the hand, should progress ___ the arm and continue to assess for good access sites.
Up
Site selection. The brachial vein can be considered, but caution must be used due to its location near the _____ in the antecubital fossa.
Brachial Artery
Site selection. Palpating for a pulse and then avoiding the area where the _____ is located can help ensure cannulation occurs into a vein rather than the artery.
Pulse
Site selection.
- For blood sampling, should direct attention to the large veins located in the _____ because the veins are larger in size and can be accessed frequently
- However, these veins are _____ for routine IV fluid administration because every time the patient bends their elbow, a mechanical obstruction in the IV catheter may occur.
Antecubital Fossa & Not Optimal
Site selection. If a patient has several suitable venous access sites, preference should be given to establishing an access site on their _____ or arm.
Nondominant Hand
Site selection.
- Patients typically use their _____ when moving to reposition themselves, take meals or fluids, or operate the television remote.
- These movements can increase the chance of the _____ from the vein
Dominant Hand & Cannula Dislodging
Site selection. Additional considerations are avoiding extremities with _____ such as those with a previous history of mastectomy, lymph node dissection, or arteriovenous (A/V) fistula.
Restrictions
Site selection. The presence of an IV cannula in extremities with these conditions _____ the risk for localized infection and other complications
Increases
Veins that have _____ sections of straight surface are usually easily accessed.
¼- to ½-inch
Veins that _____ (divide into branches), narrow significantly, or are curved can be difficult to access and thread the cannula.
Bifurcate
Peripheral IV catheters are available in a variety of sizes, most commonly ranging from _____.
14 gauge to 24 gauge
The lower the gauge size, the _____ the diameter of the catheter.
Wider
Color coding of IV cannulas. Yellow gauge size and maximal flow rate (mL/min)
24G; 13
Color coding of IV cannulas. Blue gauge size and maximal flow rate (mL/min)
22G; 31
Color coding of IV cannulas. Pink gauge size and maximal flow rate (mL/min)
20G; 67
Color coding of IV cannulas. Green gauge size and maximal flow rate (mL/min)
18G; 103
Color coding of IV cannulas. Gray gauge size and maximal flow rate (mL/min)
16G; 236
Color coding of IV cannulas. Orange gauge size and maximal flow rate (mL/min)
14G; 270
Catheters with a _____ permit infusion of viscous fluids, such as blood products, at a faster rate with decreased opportunity for catheter occlusion.
Smaller Gauge