Preparing to administer IV

Question 1

What should be written on the label of any bag or bottle of IV liquid>

Answer 1

the type of solution hung, date, time, and nurse’s initials. Write only on the label, not the bag or bottle. Do not use a marker.

Question 2

What should be included on the label on iv TUBING?

Answer 2

Apply a label to IV tubing that indicates either when tubing was hung or when tubing should be changed, per agency policy.

Question 3

Avoid vein selection in…

Answer 3

Areas with tenderness, redness, rash, pain, or infection
An extremity affected by previous cerebrovascular accident (CVA), paralysis, dialysis shunt, or mastectomy
Any site distal to a previous venipuncture site, sclerosed or hardened veins, a site of infiltrate, areas of venous valves, or phlebitic vessels
Fragile dorsal hand veins in older adults

Question 4

Signs of fluid volume deficiency

Answer 4

decreased urine output, dry mucous membranes, decreased capillary refill, a disparity in central and peripheral pulses, tachycardia, hypotension, shock

Question 5

signs of fluid volume excess

Answer 5

crackles in the lungs, shortness of breath, edema

Question 6

signs of electrolyte imbalance

Answer 6

abnormal serum electrolyte levels, changes in mental status, alterations in neuromuscular function, cardiac arrhythmias, changes in vital signs

Question 7

signs of infiltration

Answer 7

swelling and pitting edema, pallor, coolness, pain at insertion site, decrease in flow rate

Question 8

signs of phlebitis

Answer 8

pain, increased skin temperature, erythema along path of vein

Question 9

signs of bloodstream infection

Answer 9

change in vital signs such as fever, positive blood cultures, elevated white blood cell counts

Question 10

what should be documented after implementing venipuncture and starting an infusion?

Answer 10

date, time, site, gauge, method of infusion (gravity or electronic infusion device); type and rate of infusion; device identification number (if you are using an electronic infusion device); size, length, and brand of catheter; when the infusion began; infusion pump type, # of venipuncture attempts required, and the patient’s response to the insertion (including pain), RN signature. Use an infusion therapy flowsheet when available.

Question 11

What should be reported to oncoming nurse for patients with IV therapy?

Answer 11

the type of fluid, flow rate, status of the vascular access device, amount of solution remaining in the infusion bag, expected time for completion of infusion and need to hang subsequent IV containers, and the patient’s condition.

Question 12

In general, IV tubing is usually changed every ___ _____

Answer 12

7 days. Some agencies may require every 4 days.

Question 13

Tubing used for blood, blood products, or fatty emulsions should be changed after __ _____.

Answer 13

24 hours after initiating infusion.

Question 14

Central line tubing is usually changed every __ ____

Answer 14

every 4 days (96 hours)

Question 15

Central line tubing used for TPN or lipids should be changed every __ ____.

Answer 15

every 24 hours.

Question 16

IV site dressings should be changed when…

Answer 16

they become soiled, wet, or loose, or otherwise every 24-48hrs.

Question 17

signs of phlebitis

Answer 17

PAIN & REDNESS ALONG VEIN
reduced flow rate
purulent discharge
PALPABLE CORD long vein

Question 18

signs of infiltration (leakage of non-irritating solution)

Answer 18

edema surrounding insertion site, with coolness.

Question 19

signs of extravasation (leakage of irritating solution)

Answer 19

pain and burning with edema and coolness surrounding iv site.

Question 20

signs of septicemia

Answer 20

fluctuating fever, cold sweat, N/V/D, tachycardia, hypotension, elevated WBCs

Question 21

signs of AIR EMBOLISM

Answer 21

weak rapid pulse
cyanosis
respiratory distress
change in mental status
loss of consciousness
iv container has run dry or pump wheel is making loud churning sound.

Question 22

signs of circulatory overload

Answer 22

increased weight
edema
intake much greater than output
shortness of breath, crackles
jugular vein distention

Question 23

how often should you flush an IV/saline lock?

Answer 23

once per shift when not in use.

if in use, before and after each use.