Nursing IV 2

  1. What will you apply to a site with an IV infection?
    • 1. sterile drerssing
    • 2. warm moist compress
    • 3. anti-infective as ordered
  2. What are 3 ways to avoid venous spasms?
    • do not give cold infusates
    • properly dilute meds
    • do not give IV fluids too quicklly
  3. How can you treat a venous spasm?
    • apply warm compress
    • if no relief, remove IV and restart on opposite arm
  4. What can happen to an IV if it isn't secured?
    Inflammation occurs from irritation, which can cause a thrombus (clot)
  5. T or F: If a clot is formed from an IV site, you should not flush it
    true: the clot can be dislodged
  6. What do you check for if you suspect a peripheral thrombus?
    check for circulatory impairment
  7. what position will you place a patient with an air emboli?
  8. Will you administer O2 if an air embolism happens?
  9. This term means inflammation in the vein. What are the general causes?
    Phelbitis: results from mechanical, chemical or bacterial causes
  10. How can meds cause phlebitis?
    acidic or hypertonic IV solutions, rapid IV rate, or IV drugs such as KCl, vanco, and pcn can irritate the veins.
  11. List the reasons why you would stop an IV
    • 1. after infusion of prescribed amount of fluid¬†
    • 2. when infiltration, phlebitis, or local infection occurs
    • 3. if the IV infusion slows or stops, indicating a thrombus
  12. When should you change an IV site if a patient is to have one for a long duration?
  13. How do infiltrations occur?
    Occurs when an IV cath becomes dislodged or a vein ruptures and IV fluids enter the subq tissue.
  14. What is extravasation?
    when IV fluids (during an infiltration) contains additives damage tissue
  15. You should not place a cath in an area of flexion because ____ can occur?
    dislodgement of IV which can lead to infiltration
  16. How many times can you try to stick an IV at the same vein site?
    no more than 2x
  17. Do you want to use the largest appropriate cath or the smallest appropriate cath for IVs?
    smallest, shortest cath that will do the job
  18. Say how often you will assess IV site for each:

    1. Peds ____
    2. Healthy Adult ___
    3. Critically ill ___
    • 1. Q1H
    • 2. Q4H
    • 3. Q2H
  19. What scale would you give this (infiltration scale)?

    Skin blanched, Edema 8cm ,cool to touch, without pain
    2 (if edema <2.5cm, would be 1)
  20. Extravasation occurs after _____.
    Infiltration: cath dislodges from vein and IV fluids damage surrounding cells
  21. List steps of what you do if extravasation occurs
    • 1. stop iv and contact MD
    • 2. photograph
    • 3. D/C IV
    • 4. apply heat/cold compress
    • 5. elevate arm
    • 6. if ordered, give antidote
  22. What 5 main groups will you assess for all PTs with an IV?
    • 1. labs
    • 2. vs
    • 3. s/s of infection
    • 4. skin turgor
    • 5. current condition
  23. What 3 kinds of pts are high risk and need slower and/or lower volume IVs?
    • 1. very old
    • 2. renal dz
    • 3. cardio dz
  24. What can happen to IV if rate is too slow?
    • iv line clogs
    • pt not receiving full amount of rx
  25. What can happen to IV if rate is too rapid
    • 1. pulmonary edema or CHF develop
    • 2. osmotic diuresis occurs, resulting in dehydration
    • 3. irritating solutions cause phlebitis
    • 4. cardio ¬†and respiratory complications develop
  26. State if VS will raise or lower during fluid overload

    O2 sat
    • O2 sat: lower
    • weight: higher
    • HR: higher
    • RR: higher
    • BP: higher
    • (Input higher than output)
  27. What meds will you anticipate for fluid overload? 3
    • 1. loop diuretic
    • 2. vasodilator/morphine for venous dilation and improved blood flow
    • 3. Aminophylline (bronchodilator) for wheezes
  28. What nursng interventions can you provide for fluid overload?
    • 1. administer ordered meds
    • 2. O2
    • 3. semi-fowlers
    • 4. daily weight
    • 5. decrease flow rate, keep pt. warm
    • 6. swan-ganz cath
  29. This term means when a rapid infusion of medication reaches toxicity, flooding heart and brain
    speed shock
  30. what are s/s of speed shock?
    • hypotension
    • irregular pulse
    • tightness in chest
    • dizziness, facial and neck flushing
    • pounding head ache
  31. What is TKO and KVO
    • TKO: to keep open
    • KVO: keep vein open
  32. What are the flushing intervals and amounts for peds and adults?
    • Peds: q6h, 2-5Ml OF 0.9%NS
    • Adults: q8h, 5-10mL 0.9%NS
Card Set
Nursing IV 2
lecture notes