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IV Insertion 519A
Question | Answer |
---|---|
What is essential information that a nurse needs to know to identify an appropriate IV therapy order? | Appropriate IV therapy order: Solution, Route, Rate, Time Frame |
What is essential information the nurse needs to know about Patient history before IV? | IV experience, Allergies, Comorbities, Medications |
What can you do to prepare the patient for the IV? | Educate them and provide comfort through positioning, nonpharmacologic measures, anesthetic use etc |
What do you need before you start? | Prepared patient, towel/chux, sharps disposal, gloves, tourniquet, IV site prep, IV catheter, Gauze, T-connector and flush, tape, IV dressing |
What are the sizes, colors, and use of the catheters? | 24g pediactric/frail elder, 22g Blue Smallest for adults IVF's & Abxs low flow, 20g Pink Blood products hypertonic sol., 18g Green OR,L&D, blood high flow, 16g Yellow OR, Trauma |
Where do you start when locating a vein? | Start most distal and move proximal |
What are the characteristics of a good vein? | Superficial, smooth (lumpy=multiple valves), bouncy, no pulsation, avoid vein bifurcation, not close to joint, skin is normal |
If there is no option for a peripheral IV then what? | Peripherally Inserted Central Catheter (PICC Line) |
What are the steps for preparing the IV site? | Select area for clensing, remove hair PRN, apply tourniquet ~ 6 in above site, put on gloves, swab site with appropriate prep ~3 in in diameter, let dry for 30seconds, do not touch |
What are the steps of the IV catheter insertion? | Prepare all supplies, Identify patient with 2 identifiers, Position patient and nurse, Angiocatheter in dominant hand bevel up, Anchor vein with non-dominant, Advance catheter quickly, enter vein, advance IV catheter. |
What are the steps for advancing the Cannula? | Floatin cannula into vein, advance it 1/3 to 1/2 its length or until there is flashback, release tourniquet and remove stylet, attach iv fluid and advance cannula |
What are the steps after advancing the IV catheter? | Release tourniquet, hold IV catheter stady, remove sylet, attach T connector or tubing, Anchor IV with tape, Cover IV with transparent dressing, label, flush IV tubing and catheter |
How do you properly label an IV dressing? | Date, time, initials, size of catheter |
What do you document after IV insertion? | Time & date, location of site, gauge, length of catheter, type of catheter, # of attempts & complications, type of dressing, status of IV site, client response to procedure |
What are some signs of an unsuccessful insertion? | Loss of blood return, Severe pain, During Flushing-vein puffs up, No blood return |
What do you do with an unsuccessful IV insertion? | Explain to patient, DC IV, apply pressure, and plan for next site (proximal or opposite arm). Two strikes your out |