week 8 changing infusion tubing and d/c catheter

Question 1

administration set vs secondary set re their uses

Answer 1

• Administration sets are the primary method to carry a solution or med to a pt
• Secondary sets may be used to admin antibiotics or other additional meds in conjunction w primary soln

Question 2

if you change the short peripheral set or rotate sites what do w admin set

Answer 2

• When the short peripheral set is rotated the admin set should be changed

Question 3

should you use reg admin set for blood, blood products and parenteral nutrition

Answer 3

• There are special admin sets for blood, blood products and parenteral nutrition

Question 4

when could you leave IV tubing for 7 days

Answer 4

• If antiinfective CVAD is being used and if fluids that enhance microbial gowth aren’t admined (less than 10% dextrose solutions then it may be extended to 7 days

Question 5

for a 2’ or 1’ continuous infusion how often do you change tubing and an exception to this

Answer 5

• Every 72-96hrs for fluids other than lipid blood or blood products

Question 6

• If secondary set is removed from primary set the 2’ set is considered an intermittent set when should you change it

Answer 6

• If secondary set is removed from primary set the 2’ set is considered an intermittent set and should be changed every 24hrs

Question 7

considerations for primary intermittent infusions

change how often?
what should be done to promote asepsis?
dont attach the exposed ends to?

Answer 7

Primary intermittent ifusions
• Change every 24hrs d/t in risk of infection w repeatedly disconnecting and reconnecting admin sets
• Aseptically attach a covering device to the end of the admin set after each intermittent use
• Avoid attaching the exposed end of the admin set to port on the same set eg looping

Question 8

are add on devices encouraged

Answer 8

no
Use of add on device
• Should be minimized since each is a potential source of contamination and disconnection
• Use of admin sets with devices as part of the set is preferred
• Aseptically change w insertion of new short peripheral catheter or w each administration

Question 9

how to change IV tubing

Answer 9

note date ad time when IV tubing was last changed (eg every 72-96hrs for most fluids but blood)
-assess tubing
-edu pt
try to coordinate w solution changes (to dec number of times the system is open)
-hand hygiene, open new set, secure all connections
-gloves
-get pts IV cannula hub in view
-prep infusion tubing w new bag
-turn off roller clamp, slow IV rate to KVO on old tubing
-take out tubing after squeezing out drip chamber
-place insertion spike of new tubing in old bag, prime
-place end of adapter near IV site
-stop EID or turn roller clamp off
-prep tubing w extension set or saline lock if nec
-reestablish infusion by disconnecting old tubing and quickly inseting new tubing
-attach label w date and time of tubing change onto tubing below drip chamber
-may need to apply new drsg

Question 10

how to d/c IV

Answer 10

• If catheter break off could cause emboli
• Supplies: gloves, sterile 2x2 or 4x4 inh gauze sponge, antiseptic swab, tape
• Observe site for signs and symptoms of IV related complications
• Is pt on anticoagulants or has hx?
• Review order
• Assess pt understanding of the need to remove IV
• Turn IV tubing to off position
• Remove IV site drsg and stabilize IV device then remove tape securing catheter
• W gauze above insetion site withdraw slowly in line w vein. Keep hub parallel to skin
• Apply pressure to site for minimum 30 seconds until bleeding has stopped. IF pt is on anticoagulants apply pressure for 5-10minutes
• Note catheter for intactness after removal
-apply clean folded gauze drsg over site and secure w tape
-document