Card Set Information
What are FOUR reasons we might use IVs?
Fluid and electrolyte maintenance and balance
Nutritional support for NPO status
Administer diagnostic reagents
What is an affect of hydration using an IV?
Expands intravascular volume
What are THREE reasons we might use a PICC line?
Put them in for long term IV therapy.
Less likely to get infection.
Also good for antibiotics especially on long term therapy.
Why don't we use lower extremity veins?
Thromboses and varicosities
Blood becomes stagnant
What sites should we avoid when inserting an IV?
Legs, feet and ankles
Below a previous IV infiltration
Below a phlebitic area
Sclerosed or thrombosed veins
Areas of skin inflammation, disease, bruising or breakdown
Arm affected by a radical mastectomy, edema, blood clot or infection
Arm with an AV shunt or fistula
Areas of Flexion
Below a PICC or midline
What are things to consider in assessing a site for an IV?
Is the vein straight
Distal to proximal
Firm, round in appearance or feel when palpated
Avoid crossing joints
What are the two main types of IVF?
What is crystalloid IVF?
Crystalloid-cross semipermeable membrane bc small
Mostly give crystalloid
What is a colloid IVF?
Colloid-usually proteins, so large, don’t cross membrane (blood, albumin)
What are the FOUR types of infusions?
What is a bolus infusion?
large amt of fluid all at once.
Can increase vascular volume before surgery
What is a push?
Push-medication over a short period of time.
Usually is diluted.
Need to know how long to push it.
Check drug reference book to see how fast to push it. Usually 2-4 minutes**********
Where do you apply the tourniquet?
6-12 inches above IV site
What do you document following an IV?
Date and time of insertion
Gauge and type of catheter
Number of attempts
Blood return in catheter; whether the IV flushes.
Method of securing or stabilizing
Type and rate of the IV fluid
What should you do if you are unsuccessful after 2-3 sticks?
Take off the tourniquet
Cover the site with gauze
What are common mistakes in IV insertion?
Improper tourniquet placement
Failure to release the tourniquet
A tentative “stop and start” approach
Inadequate vein stabilization
Failure to recognize that the cannula has gone “through” the vein
Stopping too soon after insertion
Inserting the cannula too deep
Failure to penetrate the vein wall
How often do you change the site or tubing?
Most facilities the site needs to be changed every 72 hours – or when no longer patent
Tubing every 72-96 hours – check the policy
What do you do if there isn't any fluid hooked up to site?
The site may be temporarily not hooked up to fluid
A “buff cap” is applied – may be called a hep lock
What is best practice in monitoring the site and cath site?
Monitor catheter site
Check for signs or symptoms of infiltration or infection
Change catheter site and tubing Q 72 hours or per hospital policy
Change IV fluid bags Q 24 hours or per hospital policy
When do you flush catheters?
Always flush catheters before and after medication administration
If incompatible, looks like snow. Pushing crystals into patient.
What do you do if there are complications with the IV site?
Caused by catheter not placed properly or dislodged. Stop IV fluids.
Put on a cool or warm compress.
Elevate heart bc of edema.
Check pulses for peripheral vascular damage.
Start IV in other arm
What do you do if phlebitis occurs?
People can have allergic rx to cathrter
Can be allergic to whatever you’re injecting
Long red chord
Maybe introduced bacteria
Send iv tip to lab to culture to see what happened
What is pulmonary edema?
Pulmonary edema=fine crackles->coarse crackles->foaming
What is my responsibility in IV insertion as a nurse?
What do you do when you discontinue the IV?
Utilize standard precautions
Peel tape towards IV site
Stabilize catheter and remove remaining tape
Place gauze over site and slide catheter out
Use direct pressure as you are pulling out the catheter
You will document the dressing applied and the time you applied pressure