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localized accumulation of fluid in the tissues causing edema, pain, and coolness at the site.
Intervention for Infiltration
D/C IV, elevate extremity and put warm or cold compress on it.
How do you prevent infiltration
- secure device
- support limb
- access site frequently
- change IV site every 72 hours
- too much fluid administered in a short period of time.
- Either by too high of an infusion rate or person has renal problems or CHF
Signs of fluid overload:
- CRACKLES in the lungs
- weight gain....1 kg (2.2 lbs) equals = 1 litre of fluid
Intervention for fluid overload:
- Slow rate of infusion
- d/c but dont take out IV
- tell Dr.
- elevate head of bed to HIGH FOWLERS
- MONITOR VS q15-30 till stable
- prepare for Laxis check (K levels)
Air infusing in to an IV
Intervention when a pt has an air embolism:
- Clamp the tubing
- Turn pt on to left side
- Place in Trendelenbert so air rises to feet (not brain)
- Admin o2
- Monitor VS
- Call Dr.
How do you prevent an air embolism?
- Tight line connection
- Prime tubing of air
- Put patient in Trendelenbert when changing a central line or changing dressing
Infusing of medication in to the soft tissues
Interventions for extravasation
- Stop infusion
- Disconnect IV tubing
- Try to asperate drug
- Call Dr.....get antidote if necessary
Most important thing to remember to prevent extravasation:
Who's at risk? Cuz have small or weak vessels.
- Cancer pt
Local vs. Systemic
Local-inflammation, exudate and hot at site
Systemic-tachycardia, tachypnea, malaise, chills and WBC increase
How do you prevent infections?
- Use aseptic technique
- Change site of IV every 72 hours
- Check immunity of pt. Impaired?
Interventions of infected IV site:
- Tell Dr.
- D/c IV
- Monitor VS
- Culture & Sensitivity (Dr)
- Get right antibiotic (Dr)
inflammation of a vein with an IV in it
What causes phlebitis?
Solution being infused is either acidic, alkalitic or has a high osmolality
What does phlebitis look like?
Red and painful
Intervention for phlebitis:
- Stop IV
- Apply warm pack
- Prop arm up
- Put new IV in opposite arm
- Get a larger vein this time
- Warm and swollen
Interventions for Thrombophlebitis
- Warm compress
- Remove IV
- Get order for NSAIDS, blood thinner, maybe antibiotic
Complications of Thrombophlebitis
DVT or cellulitis
How do you prevent thrombophlebitis?
Rotate IV site....especially at the first sign of infection.
Provides sugar to patients.
What's good about D5W? Bad?
If diabetic it can cause hyperglycemia.
It cant be combined with many other solutions.
It is most like our bodies and easily combined with other IV's. Can be used with Dextrose.
What's the IV solution that can be used with blood products?
Given to pt. in acid/base imbalance by providing electrolytes and treats dehydration.
What does the Lactated Ringer label look like?
What do you assess with an IV?
- Is it clean and dry?
- Is there....
When looking at an IV what do I match with the Doctors orders?
- Infusion Rate
- Volume Remaining
Process for removing an IV:
- ID pt. and check orders for reason to remove
- Assess site for complications
- TURN OFF PUMP or CLAMP TUBING
- Use alcohol pads to loosen adhesive tape
- Use 2 x 2 to hold in place and pull it out.