NUR 146 CL - IV A

Question 1

IV A: What do you double check prior to setting up the bag and tubing?

Answer 1

• Patient Allergies
• Compatibility of medication and diluent
• IV Site Abnormalities:
  Infiltration: treat with warm compress and elevate arm
  Phlebitis: Treat with cold compress
  Extravasation: Treat with warm compress and elevate arm; may require PCP antibiotics
• Inspect and palpate:
  Palpate an inch up of the vein, ask pt if pain/tenderness is present
• Check times:
  Bag: Good for 24 hours
  Tubing: Good for 72 hours
  IV Site: Good for 72 hours

Question 2

IV A: After your checks, before setting up the tubing/bag you must flush:

Answer 2

1) Scrub IV port w/ alc for 15 seconds
2) Take flush syringe; remove cap and connect to injection port
3) Open clamp
4) Aspirate to ensure blood return, then flush (verify absence of infiltration, swelling, pain and clear line)
5) Disconnect flush, discard in sharps

Question 3

IV A: After flushing IV site, set up IV bag and tubing

Answer 3

BAG:
- Check bag for punctures, crack leaks & Solution for clarity, absence of sediment
- Check exp. date
- Label solution bag: Initial, date, time
- “In this case we’re not adding medication, but we would specify on the label if the bag has medication.”
TUBING:
- Close all ports on tubing
- Spike must remain sterile
- Check entire tube for cracks, uniform color
- Label tube: Initials, date, time

Question 4

IV A: After doing your checks on the bag and tubing, prepare the administration set

Answer 4

• Unwrap tubing, ensure clamps are closed
• Remove cap from port of IV bag
• Keep spike in dominant hand, don’t let tubing drop to floor
• Invert bag
• Remove cap from spike
• Insert spike from tubing into bag; ensure length of spike is inserted into port
• Hang IV bag

Question 5

IV A: Priming

Answer 5

• Compress drip chamber until half full
• Remove cap from end of tubing
• Open clamps, ending with roller clamp (Slowly open roller into receptacle)
• Prime until all air is displaced
• Then, close roller clamp and add cap on tubing

Question 6

IV A: After priming, attach IV tubing to the patient’s IV port

Answer 6

(Roller clamp should be re-locked)
- Scrub IV port 15 seconds alcohol
- Remove cap from end of tubing
- Attach tubing to IV Port; open IV site clamp
- Slowly open roller clamp

Question 7

IV A: After attachment, infusing by:
Gravity
Pump

Answer 7

Gravity: Adjust roller clamp to regulate flow at prescribed drip rate
Pump:
- Thread tubing through pump, program pump to deliver proper rate

Question 8

IV A: Discontinuing IV Access

Answer 8

• Always verify order to discontinue
• Place protective barrier under extremity
• Close roller clamp on IV tubing
• Detach tubing from saline lock
• Remove dressing, tape, stabilization devices
• Clean catheter-skin junction with alcohol 15 seconds
• Apply 2x2 gauze pad above insertion site
• Remove catheter parallel to skin: Ensure catheter is removed and intact
• Then, immediately apply firm pressure with 2x2 gauze over insertion site. Hold for 1-3 minutes
• Dispose of catheter in sharps container