2 reasons for insertion of a PIV?
- Infusion therapy
- Hemodynamic monitoring
In pts with renal or cardiac disease, infusion therapy with isotonic solutions can pose a risk of…
…fluid volume overload.
T or F:
Hypotonic solutions can exacerbate a hypotensive state.
T
Hypertonic solutions are irritating to the vein and can increase the risk of…
…heart failure and pulmonary edema
What 3 different IV therapies are short peripheral catheters NOT recommended for?
- Continuous vesicant therapy
- Parenteral nutrition
- Infusates with an osmolarity greater than
900mOsml/L
Solutions with a high or low pH can also cause complications such as _______ and ____ are suggested instead.
- Phlebitis
- CVADs
How often should primary and secondary continuous administration sets used to administer solutions other than lipid, blood, or blood products be changed?
Every 96 hours
Where should the tourniquet be positioned for vein finding? What should you do after applying the tourniquet?
On the upper arm or at least 10cm above possible insertion site. Find the pulse distal to the tourniquet.
Most appropriate vein selection:
know at least 4
- Soft, bouncy, adequate size
- Most distal site above wrist
- Do not use areas of flexion unless emergency
- Avoid hand veins unless for short use
- Do not use a site below a failed insertion unless
completely healed - Min of 8cm or 3 fingers above the wrist
- Do not use an arm that has a fistula or a graft for
dialysis - Avoid vein in the upper extremity on the affected side
of breast surgery with axillary node dissection or
lymphedema, after radiation, or with arteriovenous
(AV) fistulas or grafts, or in an affected area from a
CVA
If you must use the ACF, how long should it be kept in that area?
48 hours
After locating an ideal vein, what should you do immediately after?
Release the tourniquet
T or F:
The tourniquet can be in place for 2-3 minutes
F, 1-2 minutes
During insertion, bevel should be…
…up
What angle should the venipuncture be preformed at?
10-15 degrees
What three components should be included in a doctor’s order for insertion of an IV catheter?
Type of solution and rate of infusion
Date
Signature
What three components should be included in a doctor’s order for insertion of an IV catheter?
- Type of solution and rate of infusion
- Date
- Signature
How quickly will blood not flushed out on the IV tubing take to form a clot?
2-3 minutes.
4 methods for enhancing vein dilation?
- Applying heat
- Tourniquet
- Gentle rubbing
- Dangle the arm below the heart
What are 2 reasons why the lower extremities are undesirable for IV cannulation?
Increased risks of phlebitis and ulceration
What should be documented after starting an IV?
4
- Date/time/Initials
- Size of device
- Location
- Number of attempts
How often should a nurse inspect an IV site?
- Infusion therapy = every hour
- Saline locked = minimum of once every shift
