Week 4+5 IV therapy

Question 1

What 3 components should be included in a doctor’s order for insertion of an IV catheter?

Answer 1

1. physicians name and date
2. type of infusion
3. rate of infusion

Question 2

IV solutions are classified as hypotonic, isotonic, or hypertonic depending on what property of the solution?

Answer 2

Depending on the osmolality of the solution.

Question 3

Give an example of a isotonic solution.

Answer 3

Normal saline 0.9%, RL

Question 4

Give an example of a hypotonic solution.

Answer 4

2.5% dextrose in water

Question 5

Give an example of a hypertonic solution.

Answer 5

Dextrose 5% in NS

Question 6

What complication may occur when an excessive amount of isotonic solution is infused?

Answer 6

Circulatory overload

Question 7

What may allow the catheter to move inside the vein and cause phlebitis?

Answer 7

Placing the IV catheter in an area of flexion/inadequate catheter securement/chemical irritation.

Question 8

Give 2 reasons why an IV may fail to infuse.

Answer 8

1. IV is occluded by precipitation of meds

2. infiltration

Question 9

Give 3 reasons why an IV site may be painful.

Answer 9

1. phlebitis
2. infiltration/extravasation
3. Infection
4. IV catheter too far in vein, lodged in

Question 10

Give 4 reasons why a hematoma may occur with insertion/

Answer 10

1. angle too great, punctured back wall of vein.
2. tourniquet may be applied too tightly for fragile veins
3. fragile veins d/t age, medical condition, steroid use, etc
4. catheter to vein ratio, PIV gauge too large for chosen vein.

Question 11

list 4 ways of dilating a vein.

Answer 11

1. warm compress
2. dangling the patients arm
3. gentle rubbing/stroking
4. applying a tourniquet

Question 12

Leaving the tourniquet on for longer than ____ minutes can cause what to occur?

Answer 12

1-2 minutes; vein fatigue

Question 13

Why is it essential to anchor the vein before and during venipuncture?

Answer 13

stabilizes vein for needle insertion; prevents vein from rolling; and stretches skin tout; decreasing drag during insertion for anchoring vein; minimizes discomfort

Question 14

At what angle is the catheter inserted directly into the vein?

Answer 14

10-30 degrees

Question 15

What indicates that the catheter is in the vein?

Answer 15

flash of blood in catheter.

Question 16

What size of catheter meets most adult patients needs?

Answer 16

BLUE 22

Question 17

Which vein is located along the radial surface of the forearm?

Answer 17

cephalic vein

Question 18

Which vein is located along the ulnar surface of the forearm?

Answer 18

basilic vein

Question 19

When selecting an IV site, what 4 key factors should be considered?

Answer 19

1. condition of the vein
2. purpose of the infusion
3. duration of the therapy
4. Suitable location (don’t use arm on side of a mastectomy; AV shunt; CVA)

Question 20

Which layer inside the vein forms valves?

Answer 20

Tunica intima

Question 21

Name 2 reasons why the lower extremities are undesirable for IV cannulation.

Answer 21

1. increased risk of phlebitis
2. tissue damage
   (could also be: thrombophlebitis/ ulceration/immobility or decreased blood flow to fetus)

Question 22

Name a cause of catheter embolism.

Answer 22

part of the catheter released into the blood stream

Question 23

After an IV is initiated, what information should be documented?

Answer 23

Signature, site location, catheter gauge, date and time, all attempts.

Question 24

How often should a nurse inspect an IV site?

Answer 24

Q1H

Question 25

Why should an antecubital fossa not be used as a primary source of IV therapy?

Answer 25

D/t it being an area of flexion