Card Set Information

2012-06-24 11:42:21
Foundations IVs

IVs Foundations
Show Answers:

  1. What are FOUR reasons we might use IVs?
    • Fluid and electrolyte maintenance and balance
    • Medication/blood administration
    • Nutritional support for NPO status
    • Administer diagnostic reagents
  2. What is an affect of hydration using an IV?
    Expands intravascular volume
  3. 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.
  4. Why don't we use lower extremity veins?
    • Thromboses and varicosities
    • Blood becomes stagnant
  5. 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
  6. 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
  7. What are the two main types of IVF?
    • crystalloid
    • colloid
  8. What is crystalloid IVF?
    • Crystalloid-cross semipermeable membrane bc small
    • Mostly give crystalloid
  9. What is a colloid IVF?
    Colloid-usually proteins, so large, don’t cross membrane (blood, albumin)
  10. What are the FOUR types of infusions?
    • continuous
    • intermittent
    • bolus
    • push
  11. What is a bolus infusion?
    • large amt of fluid all at once.
    • Can increase vascular volume before surgery
  12. 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**********
  13. Where do you apply the tourniquet?
    6-12 inches above IV site
  14. What do you document following an IV?
    • Date and time of insertion
    • Gauge and type of catheter
    • Number of attempts
    • Location
    • Blood return in catheter; whether the IV flushes.
    • Dressing
    • Method of securing or stabilizing
    • Type and rate of the IV fluid
    • Patient's tolerance
    • Patient education
  15. What should you do if you are unsuccessful after 2-3 sticks?
    • Take off the tourniquet
    • Cover the site with gauze
  16. 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
  17. 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
  18. 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
  19. 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
  20. When do you flush catheters?
    • Always flush catheters before and after medication administration
    • If incompatible, looks like snow. Pushing crystals into patient.
  21. 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
  22. 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
    • Stop IV
    • Send iv tip to lab to culture to see what happened
  23. What is pulmonary edema?
    Pulmonary edema=fine crackles->coarse crackles->foaming
  24. What is my responsibility in IV insertion as a nurse?
    • Assessment
    • Maintenance
    • Education
    • Documentation
    • Liaison
    • Collaboration
  25. 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
    • Band-aid
    • You will document the dressing applied and the time you applied pressure