30 Questions
What is an expected nursing skill in many settings?
Performing venipuncture
What responsibility does the nurse have in IV catheter placement?
Demonstrating competency in and knowledge of IV catheter placement
What are signs and symptoms of fluid overload?
Moist crackles on auscultation of the lungs, cough, restlessness
What is a possible cause of fluid overload?
Rapid infusion of an IV solution
Who is at an increased risk of fluid overload and subsequent pulmonary edema?
Older patients with cardiac disease
What should the nurse follow in IV catheter placement?
Rules and regulations, organizational policies and procedures, and practice guidelines
What is the effect of overloading the circulatory system with excessive IV fluids?
Increased blood pressure and central venous pressure
What are the signs of thrombophlebitis?
Localized pain, redness, warmth, and swelling around the insertion site
How should thrombophlebitis be treated?
Discontinuing the IV infusion, applying cold compress followed by warm compress, and elevating the extremity
What are the signs of a hematoma?
Ecchymosis, immediate swelling at the site, and leakage of blood at the insertion site
How should a hematoma be treated?
Removing the needle or cannula, applying light pressure with a sterile, dry dressing, and applying ice for 24 hours
What can cause blood clots in the IV line?
Kinked IV tubing, very slow infusion rate, and failure to flush the IV line after intermittent medication or solution administrations
How should blood clots in the IV line be managed?
Discontinuing the infusion and restarting in another site with a new cannula and administration set
How can thrombophlebitis be prevented?
Avoiding trauma to the vein at the time the IV line is inserted, observing the site every hour, and checking medication additives for compatibility
How can a hematoma be prevented?
Carefully inserting the needle and frequently monitoring patients who have a bleeding disorder, are taking anticoagulant medication, or have advanced liver disease
How can clotting of the needle or cannula be prevented?
Not allowing the IV solution bag to run dry, taping the tubing to prevent kinking, maintaining an adequate flow rate, and flushing the line after intermittent medication or other solution administration
How can infiltration be confirmed?
By applying a tourniquet above the infusion site and observing continued dripping despite venous obstruction
What should be done if extravasation occurs?
The infusion must be stopped, and the provider should be promptly notified
What is a potential complication of extravasation?
Blistering, inflammation, and necrosis of tissues
How can infiltration be detected early?
By inspecting the site for redness, pain, edema, coolness, and IV fluid leaking
What is thrombophlebitis?
The presence of a clot plus inflammation in the vein
How can the incidence and severity of extravasation be minimized?
Careful, frequent monitoring of the IV site and using the smallest catheter possible
What should be applied if noncaustic solutions have infiltrated?
Warm compress
What are the manifestations of air embolism?
Palpitations, dyspnea, coughing, jugular venous distention, wheezing, cyanosis, hypotension, altered mental status, and pain
What is a characteristic of phlebitis?
Reddened, warm area, pain, tenderness, and swelling
How can infiltration be characterized?
Edema around the insertion site, leakage of IV fluid, discomfort, and coolness
What is a potential cause of bloodstream infections related to IV therapy?
Infection from pyogenic substances in infusion solution or IV administration set
What is a recommended treatment for air embolism?
Clamping the cannula, placing the patient on the left side in the Trendelenburg position, assessing vital signs and breath sounds, and administering oxygen
What are the signs and symptoms of infection related to IV therapy?
Abrupt temperature elevation, increased pulse and respiratory rate, nausea, vomiting, chills, shaking, and general malaise
How can phlebitis be prevented?
Using aseptic technique during insertion, appropriate-size cannula or needle, observing the site hourly, anchoring the cannula well, and changing the IV site according to agency policy
Study Notes
Intravenous Therapy Complications and Management
- Complications of circulatory overload include heart failure and pulmonary edema
- Air embolism risk is rare but associated with central vein cannulation and linked to the size of the embolus and entry rate
- Manifestations of air embolism include palpitations, dyspnea, coughing, jugular venous distention, wheezing, cyanosis, hypotension, altered mental status, and pain
- Treatment for air embolism includes clamping the cannula, placing the patient on the left side in the Trendelenburg position, assessing vital signs and breath sounds, and administering oxygen
- Infection from pyogenic substances in infusion solution or IV administration set can cause bloodstream infections
- Signs and symptoms of infection include abrupt temperature elevation, increased pulse and respiratory rate, nausea, vomiting, chills, shaking, and general malaise
- Preventing infection is essential during IV line insertion and throughout the entire infusion
- Local complications of IV therapy include phlebitis, infiltration, extravasation, thrombophlebitis, hematoma, and clotting of the needle
- Phlebitis can be chemical, mechanical, or bacterial, and is characterized by a reddened, warm area, pain, tenderness, and swelling
- The incidence of phlebitis increases with the length of time the IV line is in place, the composition of the fluid or medication infused, and other factors
- Infiltration is characterized by edema around the insertion site, leakage of IV fluid, discomfort, and coolness
- Preventing phlebitis involves using aseptic technique during insertion, appropriate-size cannula or needle, observing the site hourly, anchoring the cannula well, and changing the IV site according to agency policy
Test your knowledge of intravenous therapy complications and management with this quiz. Explore topics such as circulatory overload, air embolism, infection prevention, and local complications like phlebitis and infiltration. Assess your understanding of symptoms, treatment, and prevention strategies for various IV therapy complications.
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