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Questions and Answers
What is intravenous therapy?
Intravenous therapy is the instillation into a vein of medications, fluids, blood, or nutrient substances.
Which of the following is an indication for intravenous therapy? (Select all that apply)
What are some characteristics of a good vein for IV insertion?
Visible, straight, soft, refills when depressed, has a large lumen, well supported, bouncy, easily palpable.
Which type of veins should you avoid for venipuncture? (Select all that apply)
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What is Total Parenteral Nutrition (TPN)?
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The ______ is an ideal site for intravenous insertion.
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What equipment is needed for intravenous therapy?
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Match the vein puncture sites with their characteristics:
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Study Notes
Intravenous Therapy Definition
- Instilling medications, fluids, blood, or nutrients into a vein
- Can be intermittent or continuous administration
Indications for Intravenous Therapy
- Maintaining fluid & electrolyte balance and replacement
- Administering nutritional formulas (TPN) containing glucose, amino acids, and lipids
- Administering medications that are more effective intravenously or cannot be given by other routes
- Administering blood & blood products
- Administering chemotherapy to cancer patients
- Administering patient-controlled analgesics
- Keeping a vein open for quick access
- IV administration of radiologic contrast agents for CT, MRI, or nuclear imaging
Vein Puncture Sites
- Basilic & cephalic veins
- Hand veins: cephalic, basilic, and dorsal venous network
- Median cubital vein
- Ulnar vein
- Radial vein
- Greater saphenous vein
Peripheral IV Insertion Principles
- Select veins based on feel, not just sight
- Good veins have a bouncy feel
- Warm compresses and dependent arm positioning can help fill veins
- Latex tourniquets (if not allergic) can improve venous congestion
- Avoid areas of joint flexion
- Start distally (further from the heart)
- Use the shortest length and smallest gauge catheter possible
Characteristics of Good Veins
- Visible
- Straight
- Soft
- Above previous insertion sites
- Refills when depressed
- Has a large lumen (internal space)
- Well supported/immobile
- Bouncy/elastic
- Easily palpable (can be felt)
- Not bridging joints
Veins to Avoid
- Thrombosed/fibrosed veins (clotted or scarred)
- Inflamed veins
- Thin/fragile veins
- Mobile veins
- Veins near bony prominences
- Areas of infection, edema (swelling), or phlebitis (inflammation of a vein)
- Veins that have undergone multiple previous punctures
Intravenous Therapy Equipment
- Intravenous tray (tourniquet, alcohol swab, adhesive tape, dressing)
- Medications to be given (e.g., vials or ampoules)
- Clean gloves
- Sterile syringe of appropriate size
- Sharp container
- Patient's prescription chart and recording chart
Intravenous Therapy Procedure
- Check doctor's order
- Hand washing
- Wear gloves and prepare equipment and medications
- Explain procedures to patient
- Inspect patient's hands and forearms, selecting the venipuncture site
- Apply tourniquet 4-6 inches above the site, tight enough to impede venous return but not occlude arterial flow
- Instruct patient to open and close their fist several times
- Examine the selected vein by flicking your index finger lightly against it
- Consider using a vein viewer for vein selection
- Cleanse the site with an alcohol swab in a circular outward motion for 2 inches, allowing the area to dry
- Stretch skin towards you to stabilize the vein
- Holding the needle with the bevel up, insert it through the subcutaneous tissue at a 20-30 degree angle
- When blood return is obtained, decrease the angle to 10 degrees and carefully advance the needle and catheter
- Release the tourniquet and ask the patient to open their fist
- Inject the medication slowly and observe the skin
- Remove the needle, press with a dry sponge and plaster on the needle site
- Recollect equipment and wash hands
- Document and report the administration on the appropriate chart
Venous Blood Sample Definition
- Collecting a sample of blood from a vein for laboratory examination
Indications for Venous Blood Samples
- Assisting with diagnosis
- Confirming diagnosis
- Following the prognosis (outlook) of a diagnosis
Equipment for Venous Blood Samples
- Dry sterile syringe
- Tourniquet
- Sterile gloves
- Alcohol sponge and dry cotton sponge
- Sterile or clean, colored and coded test tubes (containing appropriate additives)
- Labels, laboratory request form, and adhesive tape
Venous Blood Sample Procedure
- Check doctor's order
- Perform hand washing and wear gloves
- Collect and prepare equipment
- Label all collection tubes with patient name, room number, date and time of collection, and signature
- Explain procedures to patient
- Inspect patient's hands and forearms, selecting the venipuncture site
- Apply tourniquet 4-6 inches (10-15 cm) above the selected site, ensuring it's tight enough to impede venous return but not occlude arterial flow
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Description
This quiz covers the essential aspects of intravenous therapy, including its definition, indications, and key principles of peripheral IV insertion. Test your knowledge on the administration of fluids, medications, and nutritional formulas through the IV route, as well as suitable vein puncture sites.
