iv therapy 2 Flashcards
Convert to a saline lock
Adequate hand hygiene removes transient microorganisms and reduces cross-contamination. It
remains the single most effective measure to prevent HAI. C
Monitor or change flow rate
The flow rate is monitored hourly or more frequently if the rate ordered is very fast (i.e., over 120 mL per hour). A flow-rate
control device (e.g., burette or volumetric pump) is used for elderly, paediatric and critically ill patients, those with a history of
cardiac or renal failure, and for any infusion that has additives
Alarms on infusion pumps signal
when drips cannot be sensed due to an empty IV bag, kinked tubing, a clotted needle,
infiltration of the IV site or a pump malfunction. Y
Some IV sites and cannulae
are positional; that is, the tip of the cannula may rest against a vein wall in some positions
and obstruct the flow
If the infusion is not being delivered at the prescribed rate:
ensure the height of the infusion is 1 m or slightly more above the IV insertion site
· ensure the drip chamber is half-full of fluid
· check the IV tubing for kinks or for large air bubbles
· check that the person is not lying on the IV tubing
· look for dependent loops and place excess tubing on the bed (dependent loops of fluid reduce the flow rate)
· check connections for leaks and for security; tighten any loose connections
· if the flow is sluggish or stopped, remove the bag of fluid from the IV stand and lower it below the level of
the insertion site. Observe the tubing
Change clothing for a person with an intravenous line
- Provide privacy and prepare the clean gown – unfolded and in the proper orientation.
- Assist the person to remove their unaffected arm and head from the original gown. Move the gown carefully over the IV
insertion site and off the hand so it is lying on the bed with the IV line still running through it. - Take the IV bag off the stand and, keeping it above the level of the insertion site, slide the gown off the line and fluid bag.
Discard the soiled gown. - Thread the clean gown over the IV bag and line, bag first, from the bottom to the armhole to the wrist of the sleeve.
- Rehang the fluid bag.
- Carefully slip the gown sleeve over the person’s hand and insertion site, and then help them to put the unaffected arm
through the other sleeve and their head through the neck of the gown. Adjust the gown for comfort.
Assist a person with an intravenous line to ambulate
The person will probably require help to get out of and back into the bed. Mind the IV insertion site and lines. Provide a
wheeled IV stand when they need to walk. Many prefer to use the IV stand to steady themselves as they walk. Assist from the
Change solutions on an established intravenous line
Prepare to change the bag when there is still about an hour’s worth of fluid remaining in the old bag. Check the IV fluid
orders and bring the selected solution to the bedside. Generally, IV fluids need to be checked by two registered healthcare
professionals These people both sign the infusion order. Check the
person’s identification (use the six rights of medication administration). Inspect the fluid and the container for turbidity,
leaks, cracks, particles and the expiry date before you commence
Do not let the old bag empty entirely
, to prevent air entering the drip chamber and line. The manufacturer provides
slightly more than 1 L in each bag. When the bag has approximately 50 mL of fluid remaining, wash your hands and, using
the roller clamp, stop the flow of solution. Remove the old bag from the IV stand. Remove the spike by firmly pulling it from
the old bag, taking care not to contaminate it or spill the remaining fluid. Pull off the protective sheath to expose the port on
the new fluid bag.
Change the dressing
Assess the IV catheter dressing at least daily. When the dressing is soiled, loose or damp it needs to be changed. A
transparent dressing should be replaced weekly
Convert to a saline lock
If no IV fluid is necessary but access to a vein is required for intermittent medication administration,
saline lock test
- Test the saline lock for patency by first cleansing the lock device with the alcowipe and friction for a minimum of 15
seconds (Moureau & Flynn, 2015). - Insert the needleless adaptor with the flush solution through the diaphragm of the lock and pull back gently on the
syringe; watch for blood return. - Inject the saline (or heparin) slowly into the lock.
- Remove the syringe/needleless adaptor. Discard the syringe/needleless adaptor into the sharps container. Do not reuse
the flush syringe
Discontinue intravenous therapy
Generally, a doctor’s order is needed to discontinue IVT. Use clean gloves and an apron. You will also require a dry sterile
gauze square and a small sterile dressing and tape
CLEAN, REPLACE AND DISPOSE OF EQUIPMENT
Empty excess solution from the discontinued IV fluid bag down the sink and place the empty bag in the garbage bin. Once
removed, dispose of the cannula into the contaminated waste bin or butterfly needle into the sharps container. Dispose of
gloves and dressing material into the contaminated waste bin. Wash the kidney basin and return it to storage. Clean the IV
pole as per the facility’s guidelines and return it to the storage area.
DOCUMENTATION
Document IV interventions on the fluid order sheet and the fluid balance chart and note solution bag changes. Note
discontinuation of the IV on the fluid order sheet, the fluid balance sheet and in the progress notes. Record the appearance of
the IV site, the amount of fluid infused, the person’s response to the procedure and any abnormal or untoward findings
