Nurs 321 > IV initiation > Flashcards

IV initiation Flashcards

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1
Q

Short peripheral catheter

A

what we seen most in practice

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2
Q

midline peripheral catheter

A

in between of PIV and PICC
- allows for better flow rate and more hemodilution
- usually inserted in median cubital vein and resides at level of armpit

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3
Q

vein condition for IV insertion

A

should be straight, bouncy, and nicely palpable

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4
Q

vein collapse

A

will occur if patient is hypotensive or hypovolemic

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5
Q

Infant vein selection

A

if under 18 months then go for scalp veins due to the increased body fat

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6
Q

Elder patient vein selection

A

use BP cuff for vein dilation
- avoid metacarpal veins due to fragility

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7
Q

considerations for patients on anticoagulants

A
  • will bleed more so hold gauze for longer
  • will bruise more
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8
Q

stroke considerations

A

will have decreased circulation and increased chance of phlebitis

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9
Q

first choice for IV insertion

A

cephalic vein
- at wrist, on thumb side

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10
Q

go 8-10 cm above wrist

A
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11
Q

cephalic vein

A
  • close to radial nerve
  • first choice
  • on thumb side
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12
Q

antecubital fossa vein

A

close to tendons of bicep, brachial artery, and median nerve
- inner elbow

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13
Q

palm side of wrist vein

A

close to median nerve
- on inside of thumb

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14
Q

metacarpal veins

A

easily visualized but small and fragile
- mostly avoid

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15
Q

feet veins

A

MUST require doctor order if inserting IV in foot

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16
Q

basilic vein

A

on pinky side
- large vein but difficult to start

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17
Q

median cubital and basilic vein

A

second option if cephalic not useable

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18
Q

median antebrachial

A

not ideal because lots of nerves nearby
- pinky side close to wrist; between cephalic and basilic
- commonly used in bloodwork

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19
Q

strategies for vein distention

A
  • position extremity lower than heart
  • tourniquet
  • clench fist
  • warm compress
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20
Q

gauge

A

the SMALLER the number the BIGGER the needle

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21
Q

most common gauge

A

20-24

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22
Q

irritants gauge

A

22-24

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23
Q

16 gauge

A

gray

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24
Q

18 gauge

A

green

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25
20 gauge
pink
26
22 gauge
blue
27
24 gauge
yellow
28
26 gauge
violet
29
lab typically draws from ... and use a gauge size of...
16 (grey) or 22 (blue) gauge at median cubital vein
30
once site is prepped you cannot..
re-palpate vein
31
drying the site
must not touch, let dry on own
32
for hairy patients site prep
use clippers, do not shave
33
direct venipuncture
appropriate for small gauge needles; most commonly done - approach directly over vein
34
indirect venipuncture
can be used for all vein sites - enter skin slightly adjacent to vein and insert into side of vein
35
PLAT
pause lower advance thread
36
adult patient monitoring post insertion
every 4 hours
37
critically ill patient monitoring post insertion
every 1-2 hours
38
pediatric patient monitoring post insertion
every hour
39
mechanoreceptors
feel palpation of vein
40
thermoreceptors
sense temperature
41
chemoreceptors
process osmotic changes in blood
42
venipuncture for phlebotomy
similar to IV - insert needle and attach tube to other end of needle
43
purpose of phlebotomy
-diagnostic testing - blood donation - therapeutic reasons
44
tunica adventitia
outter most layer - connective tissue
45
tunica media
middle layer - muscular and elastic tissue
46
tunica intima
inner layer - endothelium layer
47
Evacuated tube system
most direct and efficient method - closed system
48
Syringe system for blood collection
not preferred but useful for patients with small or difficult veins
49
butterfly system
used for small or difficult veins - 23 gauge usually used
50
tube size selection criteria
age, amount of blood required, vein condition
51
tubes for blood collection
color coded and help determine order drawn in - made of unbreakable plastic
52
additives in tubes for blood collection
anticoagulants, oxalates, citrates, EDTA, heparin
53
purpose of anticoagulants in blood collection tubes
extend metabolism and life span of RBCs
54
Oxalates, citrates, EDTA function
anticoagulants - remove calcium and form calcium salts
55
oxalate
decreases calcium and regulates it
56
EDTA
decreases calcium and decreases platelet aggregation -used for CBC
57
citrate
prevents high acid levels - for coagulation study
58
heparin
prevents clotting by inhibiting conversion of prothrombin to thrombin and fibrinogen to fibrin
59
assessment data impacting blood collection
diet, stress, age, weight
60
first vein choice for phlebotomy
median cubital vein
61
second vein choice for phlebotomy
cephalic vein
62
order of collection when collecting multiple tubes of blood
blood culture --> coagulation tubes --> serum tube --> heparin tube --> EDTA tube --> oxalate tube
63
yellow tube
blood culture - invert 8 to 10 times
64
blue tube
coagulation citrate - invert 3 to 4 times
65
red tube
serum - do not invert
66
red/gray tube
clot activator - invert 5 times
67
green/gray tube
plasma separator - invert 8 to 10 times
68
green tube
heparin - invert 8 to 10 times
69
pink/purple tube
EDTA - invert 8 to 10 times
70
gray tube
oxalate - invert 8 to 10 times
71
discard method for drawing blood from CVAD
discarding first aspiration of blood to ensure no meds interfere with results
72
hematoma complication of phlebotomy and treatment
most common complication - rapid swelling - hold pressure over site for 2 min - cold compress
73
Iatrogenic anemia complication of phlebotomy
will cause decreased Hct and Hgb due to large and frequent blood sampling
74
cephalic and basilic blood flow
45-95ml/min
75
subclavian vein blood flow
150-300ml/min
76
gauge size for blood
18-20
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