IV Cannulation

Question 1

Start with ___________ veins and work _____________

Answer 1

Distal (low), proximally

Question 2

Antecubital is the

Answer 2

Last option!

Question 3

Considerations for selecting a vein

Answer 3

Condition of the veins?
Reason for the IV?
What solutions or meds will be used?

Question 4

Vein evaluation

Answer 4

PALPATE!!

Question 5

Suitable veins should be

Answer 5

Round, firm, & elastic
Best palpated when engorged

Question 6

Methods of administration

Answer 6

Intermittent
Continuous
Bolus
Push

Question 7

Intermittent

Answer 7

Medications on schedule dose daily or several times per day

Question 8

Continuous

Answer 8

IV solutions continuously

Question 9

Bolus

Answer 9

Specified amount of solution to be administered in a specific time frame through IV pump or syringe — often quickly administered

Question 10

Push

Answer 10

Specified amount of medication to be administered in a specific time frame through IV syringe only

Question 11

IVs that are being used intermittently are commonly referred to as an

Answer 11

I N T

Question 12

Continuous can be used for

Answer 12

Hydration, electrolyte replacement, or both

Question 13

IV medication advantages

Answer 13

Direct access to circulatory system —> instant action
Instant drug action and drug termination
Rapid treatment
Better control of rate
Great for those with GI tract limitations
Good for meds that irritate gastric mucosa

Question 14

IV medication disadvantages

Answer 14

Reconstitution errors
Venous spasm
Drug incompatibilities
Impaired drug absorption
Speed shock
Chemical phlebitis
Extravasation of vesicants
Air embolism

Question 15

Air embolism

Answer 15

Air enters central veins

Question 16

Air embolism causes

Answer 16

Solution runs dry
Air in tubing
Loose connections
Improper removal of CVAD
Poor technique with dressing or tubing changes

Question 17

Air embolism signs and symptoms

Answer 17

Dyspnea
Tachypnea
Lightheadedness
Palpitations
Drop in BP
Weakness
Cyanosis
Expiratory wheezes

Question 18

Air embolism intervention

Answer 18

Call for help
Position pt in trendelenburg on left side
Administer oxygen
Monitor vital signs
Have emergency equipment ready

Question 19

Complications of IV therapy

Answer 19

Fluid overload
Infection
Phlebitis
Infiltration
Extravasation

Question 20

Fluid overload

Answer 20

Too much fluid overloads the circulatory system

Question 21

Phlebitis

Answer 21

Irritation to vein
Mechanical or chemical

Question 22

Infiltration

Answer 22

Fluid seeps into tissue

Question 23

Extravasation

Answer 23

Infiltration of any caustic medication into tissue

Question 24

Chemical phlebitis

Answer 24

Inflammation of a vein associated with chemical irritation

Question 25

Chemical phlebitis causes

Answer 25

Too rapid infusion Presence of particulate matter in solution Improper dilution or reconstitution when preparing meds Administration of irritating meds

Question 26

Chemical phlebitis prevention

Answer 26

Use an in-line filter for meds that do not reconstitute completely Increase volume of dilution CVAD or larger peripheral veins for IV site Slow the rate of infusion Restart any questionable IVS

Question 27

Infiltration signs and symptoms

Answer 27

Does not irritate the tissue Pain or burning at IV site Skin tightness at site Blanching and coolness of skin Dependent edema

Question 28

Infiltration

Answer 28

Fluid leak into tissue around the vein

Question 29

Infiltration interventions

Answer 29

STOP infusion Remove IV line Place a new IV line Continue to monitor infiltrated site

Question 30

Extravasation

Answer 30

Infiltration of a vesicant drug

Question 31

What is the safest for administration of vesicant drugs?

Answer 31

CVADs

Question 32

Extravasation signs and symptoms

Answer 32

Pain or burning at IV site Skin tightness at site Blanching and coolness of skin Dependent edema

Question 33

Extravasation prevention

Answer 33

Dilute meds as recommended Avoid use of high-pressure pumps Assess and monitor IV site Teach pt what to report

Question 34

Venous spasm

Answer 34

Sudden, brief, tightening of muscle cells inside the vein

Question 35

Venous spasm causes

Answer 35

Viscous solutions Too rapid administration Cold or irritating solutions

Question 36

Venous spasm symptoms

Answer 36

Sharp pain at the IV site Pain radiating up the arm with the IV site

Question 37

Venous spasm prevention techniques

Answer 37

Dilute meds as recommended Admin solutions and meds at room temp Admin at recommended rate Restart questionable IVs Consider a warm compress during infusion

Question 38

IV push admin

Answer 38

Follow 7 rights Verify pt and allergy status Scan armband Scan med vial Hand hygiene and don clean gloves Remove cap from IV lumen

Question 39

Remove alcohol permeated cap from IV lumen and clean needle less connector access with alcohol pad for how long?

Answer 39

15 seconds

Question 40

Use the __________ __________ included with the tubing delivery system to control the rate of admin

Answer 40

Roller clamp

Question 41

14g or 16g

Answer 41

Great for trauma or surgery when needing rapid infusions

Question 42

18g

Answer 42

Good for pts going into surgery, receiving blood or caustic meds

Question 43

20g or 22g

Answer 43

Most common size for adult patients

Question 44

24g

Answer 44

Most common for pediatric pts, can use for adults with small or fragile veins