IV Insertion

Question 1

What are the things that an IV order must contain?

Answer 1

Solution, Rate, Route, Time Frame

Question 2

What are important things to review for a patient’s assessment prior to IV insertion?

Answer 2

Physical findings (i.e. mastectomy or fistula), lab values, age, mobility, skin, allergies

Question 3

What supplies are needed to start an IV?

Answer 3

gloves, tape, dressing (tegaderm), drip set, gauze, tourniquet, alcohol prep, IV catheter, saline flush, connector tubing, IV fluid

Question 4

When can an IV in the foot be placed on an adult patient?

Answer 4

When there are doctor’s orders for it

Question 5

What are the 4 parts of an IV catheter?

Answer 5

Stylet, catheter, flash chamber, safety device

Question 6

What are the 5 hand veins?

Answer 6

digital veins, metacarpal veins, dorsal veins, cephalic veins, basilic veins

Question 7

What are the characteristics of a good vein?

Answer 7

superficial, smooth, bouncy, no pulsation, not close to a joint, skin is normal

Question 8

What is it important to have a smooth vein when inserting an IV?

Answer 8

lumpy veins have more valves

Question 9

What can hard veins be an indicator of?

Answer 9

sclerosis

Question 10

What are some vein dilation techniques to use when starting an IV?

Answer 10

Tapping, rubbing, moist heat, gravity, fist clenching

Question 11

Which hand should you use to anchor a vein?

Answer 11

Non-dominant hand

Question 12

How should the bevel of the needle be positioned for insertion?

Answer 12

Bevel should be up

Question 13

Steps of preparation for IV catheter insertion

Answer 13

Prep all supplies, identify the patients with 3 identifiers, position the patient and yourself, find vessel, use alcohol wipe to prep area, position the angiocatheter, anchor the vein

Question 14

Where should a tourniquet be placed in reference to the IV site?

Answer 14

6 inches above site

Question 15

What is the diameter of the swab site that should be wiped with prep before IV insertion?

Answer 15

Around 3 inches in diameter

Question 16

When can a site be touched after prepping the IV site with Chlorhexidine?

Answer 16

never

Question 17

What is an indicator that the needle has entered the vessel?

Answer 17

flashback in hub and “flash chamber”

Question 18

4 techniques that can be used to advance the cannula

Answer 18

One-step technique, pushing cannula off stylet, “floating” cannula into vein, two-handed technique

Question 19

What should be on the label of an IV dressing?

Answer 19

date, time, initial, size of catheter

Question 20

What should be done after advancing the IV catheter?

Answer 20

hold IV catheter steady, remove stylet, attach T-connector or tubing, anchor IV with tape, cover IV with transparent dressing, Label IV dressing, Flush IV tubing and catheter

Question 21

What needs to be documented following IV insertion?

Answer 21

time/date of insertion, location of site, gauge/length/type of catheter, Number of attempts & complications, type of dressing, States IV site, client response to procedure

Question 22

What are indications that IV catheter insertion is unsuccessful?

Answer 22

loss of blood return, severe pain, vein puffs up during flushing (infiltrates), no blood return

Question 23

What may have happened if there is a loss of blood return?

Answer 23

may have pierced through the vein

Question 24

What may have happened if the patient is in severe pain following IV insertion?

Answer 24

the IV may be in surrounding tissue or it may have pierced a nerve

Question 25

If there is no blood return after inserting an IV what may have happened?

Answer 25

the needle may have missed the vein

Question 26

Why should an IV not be placed in a pulsating vessel?

Answer 26

The vessel may be an artery

Question 27

How many IV attempts can be done before someone else needs to be brought in to start the IV?

Answer 27

2

Question 28

What could be the cause of redness, swelling, and warmth at the IV insertion site?

Answer 28

phlebitis

Question 29

What could be the issue if there is swelling, but it is cool around the IV site?

Answer 29

infiltration

Question 30

What could be the issue if the IV site has no redness, no swelling, is dry, but patient has SOB, puffy feet, and palpitations?

Answer 30

hypervolemia

Question 31

What could be the issue if the IV site has redness, patient has chills but feels hot and patient states that he/she feels yucky?

Answer 31

IV infection

Question 32

What does extravasation refer to?

Answer 32

the leakage of injected drugs from blood vessels causing damage to the surrounding tissues

Question 33

S/S of extravasation

Answer 33

pain, stinging or burning sensations, and edema around the intravenous (IV) injection site

Question 34

What action should be taken with an IV site that is not WNL?

Answer 34

Discontinue the IV and relocate

Question 35

Why might IV insertion/IV therapy be needed?

Answer 35

antibiotic administration, hydration, med administration