IV Catheter Care & Monitoring (ASAN002/12)

Question 1

Monitoring & Care of IV Catheters

Answer 1

IV catheters can be a port of entry for bacteria into the vein.\nCatheter & dressing must be checked regularly (at least 4 x day)

Question 2

IV Catheter checks include:

Answer 2

Minimum 4 x day check:\nEnsure the bandage is clean & dry at all times.\nRemove and replace bandage immediately if contaminated (dirty, wet, chewed etc).\nCheck for swelling of the distal paw.\nCheck for swelling or heat proximal to the bandage. \nEnsure the catheter is not leaking.

Question 3

Catheter insertion site check:

Answer 3

At least once a day, remove catheter bandage & visualise the insertion site.\nCheck for:\nRedness\nHeat or swelling\nDischarge (note colour & amt)\nCatheter dislodgement\nAdhesive tape or padding dislodgement\nPain on palpation of areaRe–bandage & note on cage card that catheter check was performed and any findings.

Question 4

Complications with Venous Catheterisation:

Answer 4

Phlebitis\nThrombosis\nCatheter Embolism \nFluid Infiltration\nInfection\nSwelling\nPatient Interference

Question 5

Phlebitis

Answer 5

Inflammation of the vessel wall, resulting from damage to the endothelial lining of the vein.\nMechanical damage to the vessel must be minimised to reduce the risk of phlebitis.

Question 6

Phlebitis – Signs:

Answer 6

Swelling\nTenderness on palpation\nErythema of skin over vessel (may be difficult to differentiate from cellulitis).

Question 7

Thrombosis

Answer 7

Formation of a clot from fibrin & platelets.\nCan result from endothelial trauma at the points between catheter & vessel wall.\nProper catheter selection & stabilisation ↓ risk of thrombosis.

Question 8

Thrombosis – Signs:

Answer 8

Vein stands up without being held off.\nThick, cord–like feeling to the vein.

Question 9

Catheter Embolism

Answer 9

Occurs when a fragment of catheter detaches & becomes free.\nIt enters the circulation & lodges in the heart or lungs.\nCare must be taken when catheter bandage is cut.\nNeedles should never be reinserted into a catheter while it is still in the vein.

Question 10

IMAGE – Potential Catheter complications

Answer 10

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Question 11

Fluid Infiltration

Answer 11

The diffusion of fluids into the surrounding tissues of the vein. \nUsually a result of the catheter being displaced out of the vein.\nGood stabilisation of the catheter helps to minimise the risk of infiltration.

Question 12

Fluid Infiltration – Signs:

Answer 12

Swelling\nTenderness proximal to the vein.\nSkin may feel cool to the touch if room temp fluids are administered.

Question 13

Infection

Answer 13

Insertion of IV catheter places the patient at risk of developing catheter related infections.\nIV catheters are excellent pathways for micro–organisms to enter the venous system.\nAseptic technique in catheter placement & maintenance will help ↓ the risk of infection.

Question 14

Infection – Signs:

Answer 14

Signs of infection are identical to phebitis.\nSwelling\nTenderness on palpation\nErythema of skin over vessel (may be difficult to differentiate from cellulitis). \n\nIn addition, a purulent discharge may be seen.

Question 15

Swelling

Answer 15

Swelling of the distal paw may occur if the bandage does not encompass this are & is placed too tightly.

Question 16

Patient Interference

Answer 16

Patients may chew or pull at their catheters.\nAlways check catheter is patent & not painful to the patient prior to placing e–collar.