Intravenous Line Preparation and Insertion

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Questions and Answers

What should be checked in the IV solution before administration to prevent patient harm?

The brand name of the solution

The packaging seal

The presence of air bubbles

Sediment or discoloration (correct)

Which component helps regulate the number of drops per minute in IV administration?

The regulator

The trocar

The drip chamber (correct)

The extension set

What is the purpose of the stopcock on an extension set?

To regulate the temperature of the solution

To facilitate IV administration without changing primary tubing (correct)

To filter the solution before it enters the patient

To connect the IV tubing to the patient

What is the optimal process to prepare the IV solution for use?

Remove air from the IV tubing Signup and view all the answers

Which type of IV catheter is most commonly used for adult patients?

Over-the-needle catheter Signup and view all the answers

What is true regarding the gauge size of IV needles and catheters?

Sizes typically range from 14 to 26 gauge Signup and view all the answers

What is a common size range for the IV catheter used in healthy adult patients?

19 to 21-gauge Signup and view all the answers

What should be done first when preparing the IV solution?

Inspect the solution for color changes Signup and view all the answers

What is one primary purpose of starting an intravenous (IV) line before anesthesia?

To replace or supplement body fluids lost around the surgical procedure. Signup and view all the answers

Why is it important to close the regulator before connecting to the patient?

To ensure a sterile connection Signup and view all the answers

Which vein is most commonly selected for IV insertion?

Metacarpal vein of the nondominant hand Signup and view all the answers

What is the primary characteristic of the IV solution containers made from plastic?

They collapse under atmospheric pressure as fluid is infused. Signup and view all the answers

In which situation would a 14-gauge catheter be most appropriately used?

For rapidly infusing fluids in hemorrhaging patients Signup and view all the answers

Which statement best describes the selection of the IV site?

It must be straight and large enough for the IV catheter while avoiding flexing areas. Signup and view all the answers

What advantage does an IV line provide while a patient receives nothing by mouth?

It enables the replacement of lost fluids and maintains fluid balance. Signup and view all the answers

What must be done to glass containers of IV solutions to ensure proper flow?

They must be air vented to allow air entry as fluid drains. Signup and view all the answers

Why is it important to avoid inserting the IV in an area that flexes, like the wrist or elbow?

Flexing can obstruct the catheter and hinder fluid flow. Signup and view all the answers

Which of the following is NOT a function of the IV line in anesthesia?

Sustaining the patient's heart rate during the surgical procedure. Signup and view all the answers

What is the result of multiplying 100 ml/hr by a drop factor of 20 drops/ml and then dividing by 60?

33.3 drops/min Signup and view all the answers

What is indicated by swelling or discoloration at the IV site?

The catheter is likely improperly positioned Signup and view all the answers

What is the first step in changing an empty IV solution container?

Slow the infusion to prevent air from entering Signup and view all the answers

What should be done if blood backs up in the IV tubing and the solution is not dripping?

Raise the IV solution container above the patient Signup and view all the answers

What method can be used to displace air bubbles in the IV tubing?

Milk the tubing by squeezing it Signup and view all the answers

What is a crucial step after discontinuing an IV?

Record the time and total fluid given Signup and view all the answers

Which type of needle insertion angle is recommended for accessing a vein?

30° to 45° Signup and view all the answers

How should the catheter be removed from the IV site?

Quickly and smoothly in the direction of the vein Signup and view all the answers

What should be done if the insertion site is very hairy before preparing the skin?

Shave the immediate insertion site Signup and view all the answers

What could be a potential consequence of attempting an IV procedure without proper training and certification?

Risk of harming the patient Signup and view all the answers

Which of the following options describes the appropriate action after catheter insertion?

Secure the catheter and remove the tourniquet Signup and view all the answers

What should be done if the IV flow is obstructed due to kinking or bending of the catheter?

Change the patient’s position or arm Signup and view all the answers

Which method is least effective for displacing air bubbles in IV tubing?

Waiting for the bubbles to dissolve naturally Signup and view all the answers

What type of dressing is used to secure the catheter to the skin?

Transparent adhesive sterile dressing Signup and view all the answers

What is critical to do once the needle has been removed from the catheter?

Connect the IV tubing Signup and view all the answers

What is the purpose of a tourniquet during IV insertion?

To occlude venous flow and distend the veins Signup and view all the answers

Which factor determines the specific methods used to start and secure an IV?

Local policy Signup and view all the answers

What should be done with the catheter package label once the catheter is inserted?

Tape it to the tubing close to the insertion site Signup and view all the answers

Which gauge needle is typically used in conjunction with a 1-3 cc syringe for local anesthetic?

26-30 gauge Signup and view all the answers

What indicates that the catheter has been properly placed after insertion?

The solution flows or drips at a set rate Signup and view all the answers

What is the primary reason for covering the patient with a warm blanket?

To keep the patient comfortable and warm Signup and view all the answers

Which action is inappropriate when assisting a patient who needs to void?

Leaving the patient unattended during the process Signup and view all the answers

What is the role of the weighted precordial stethoscope during surgery?

To constantly monitor respirations and heart tones Signup and view all the answers

Why should the solution container of an IV not be allowed to fall or run dry?

It may cause patient discomfort or complications Signup and view all the answers

What should be done if a patient feels nauseous or light-headed during preparation?

Elevate their legs and administer oxygen Signup and view all the answers

What is the importance of maintaining the patient's privacy during surgery preparation?

To respect the patient's personal dignity Signup and view all the answers

Which equipment is crucial for monitoring the patient during the induction phase?

Electrocardiogram monitor Signup and view all the answers

How should a caregiver communicate with a patient before surgery?

Calmly explaining what is happening Signup and view all the answers

Study Notes

Intravenous (IV) Line Preparation

Starting an IV is an essential first step in preparing patients for anesthesia, either performed directly or assisted by anesthesia personnel.
IV fluids are crucial for supplementing or replacing lost body fluids before, during, and after surgery.
The IV line facilitates fluid replacement while the patient is NPO (nothing by mouth) and allows for controlled administration of medications.

IV Line Selection and Insertion

Common insertion sites include the nondominant hand’s metacarpal vein, chosen for size and accessibility.
Insertions should avoid areas that may flex, such as the wrist or elbow, to prevent catheter obstruction.
Rigid steel needles, over-the-needle catheters, butterfly needles, central veins, and cutdown catheters are types of IV devices used based on the patient and procedure.

Solution Containers and Administration

IV solutions are stored in plastic bags, bottles, or occasionally glass containers; bags collapse while being infused, requiring venting in bottles.
Solutions must be inspected for sediment or discoloration prior to administration.
Sterile, disposable IV tubing connects the solution container to the patient's IV catheter, with components that help regulate flow.

IV Procedure Steps

Preparation: Position the patient comfortably, use a tourniquet to distend veins, and cleanse the site with an antiseptic. Local anesthetic may be injected for comfort.
Insertion: Insert the catheter needle at a 30° to 45° angle. Observe for blood return, indicating proper placement in the vein, then secure the catheter.
Securing the Catheter: Use a secure dressing and label the catheter site with pertinent information such as initials, date, and time.

Monitoring and Maintenance

Solution flow and rate are regulated according to physician's orders, with adjustments made based on the drop factor of the administration set.
Ensure IV site remains free from swelling or discoloration, alerting the anesthetist if issues arise.
Manage air bubbles carefully to prevent air embolism; various techniques may be used to clear bubbles from the line.

Discontinuing the IV

To discontinue, prepare by clamping the tubing, removing the dressing swiftly, and applying pressure to the insertion site to prevent bleeding.
Record the time and total fluid administered, noting any patient reactions.

Additional Preanesthetic Responsibilities

Ensure patient comfort and warmth, monitor their condition, and assist with transferring to the operating table.
Keep emergency supplies accessible, such as oxygen and emesis basin, while supporting the patient emotionally through explanations and hand-holding.
Assist with attaching monitors like blood pressure cuffs, ECG, and pulse oximeters prior to induction.

Safety and Protocols

Always follow local policies regarding IV procedures, ensuring proper training and guidelines are adhered to.
Maintain patient dignity and privacy throughout the preoperative process.

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Description

This quiz covers essential aspects of intravenous (IV) line preparation and insertion for anesthesia. It delves into the importance of IV fluids and the procedure for selecting suitable insertion sites. Assess your knowledge on how to efficiently manage IV lines to ensure patient safety during surgical procedures.