Venipuncture PPT Flashcards Preview

Hannah RAD III > Venipuncture PPT > Flashcards

Flashcards in Venipuncture PPT Deck (34):
1

In order to access an extremity for venipuncture on a patient with a prior mastectomy, what must one have to access the extremity involved in the lymph node removal?

Physician’s order

2

What happens to the veins when a patient is apprehensive or is cold and fearful of the procedure?

The veins constrict and disappear making venipuncture more difficult

3

Vasovagal response

Reaction based on fear

4

What type of information must one obtain from a patient prior the venipuncture procedure?

-Possible allergies
-Current medications
-Prior surgeries to include mastectomy with lymph node involvement

5

Types of Syringe

Plastic disposable syringes: glass syringe

6

3 components of Syringe

-Tip: where needle attaches to syringe
(Contains a locking device to hold needle securely)
-Barrel
-Plunger: fits inside the barrel

7

Needles

Disposable; one use only

8

Needle length Measured

in inches
Varies from ½ inch to 4½ inches
Generally 1 to 1½” is used for IV injections

9

Types of needles

-Hypodermic needle
-Butterfly set
-Over-the-cannula needle

10

Butterfly sets

-Stainless steel needle with plastic appendages on both sides (wings)
-Aids in insertion and stabilization of needle 6" of tubing with a connector at the end

11

Over-the-needle cannula

-Once venipuncture is established, the catheter slips off the needle into the vein – steel needle is removed
-Recommended for long-term therapy or for rapid infusions

12

What are the components to a needle?

-Hub – part that attaches to syringe
-Cannula/shaft – length of needle
-Bevel – slanted portion of needle tip

13

What is the average range for the GFR, BUN and creatinine levels?

-GFR = 90 to 130
-BUN = 10 to 20 mg/dL
-Creatinine = 0.05 to 1.2 mg/dL

14

As the gauge of the needle increases, the diameter of the bore

decreases

15

Which is larger an 18 gauge or a 22 gauge needle?

18 gauge

16

Where are the veins typically located for IV access for use in radiologic examinations?

-Anterior forearm
-Posterior hand
-Antecubital space

17

Are you allowed to use the anterior wrist for starting an IV?

No
Could damage radial nerve

18

Feet and legs for IV access require an order on all patients

3 years and older

19

What equipment is needed for starting an IV?

Gloves
Tourniquet
Alcohol or betadine
Tape/tegaderm
Needle (22 gauge)
Syringes (3cc saline/60cc contrast)
Contrast
Extension tubing
Cotton ball/gauze
Band-aid

20

When applying the tourniquet, how far above the intended site of puncture must it be positioned?

6" to 8"

21

How much should the BP cuff be inflated if using it to secure a site for venipuncture?

60 to 80 mm/Hg

22

What is the difference between an artery and vein

- Arteries contain more pressure (If you feel a pulse you have an artery and not a vein)
- Veins lie closer to the surface

23

What is the procedure for starting an IV?

Apply tourniquet
Tight enough to distend vessels but not occlude them
One hand release technique
Locate desired vein
Open and close fist to promote venous distention
Clean surface of the skin with an antiseptic
Circular motion/NSEW direction
Don gloves
Hold the patient’s arm with the nondominant hand and use the thumb to anchor the selected vein
Anchor vein distally with finger by stretching skin against direction of insertion – taunt surface (less pain)
Place needle bevel up at a 20-30° angle to the skin’s surface
Enter just distal to site of insertion and parallel to vein – top entry not a side entry into vein
Use a quick controlled entry to enter skin and vein decreasing angle; look for return of blood in the flashback chamber
Advance needle or catheter into vein and release tourniquet
Do not touch needle or catheter – allows bacteria to enter skin
Anchor needle with tape or tegaderm

24

If both walls of the vein are punctured with the needle a hematoma will develop

Needle should immediately be removed and direct pressure is applied to the puncture site

25

If the venipuncture attempt is unsuccessful

Do not reinsert same needle; a new needle is required
Do not reinsert a stylet into the catheter once it has been removed – a new catheter is required
ONLY ONE DEVICE PER ATTEMPT
NO MORE THAN 2 ATTEMPTS – NOTIFY IV NURSE!

26

At what angle should the needle be placed when it is about to enter the skin’s surface?

20 to 30 degrees

27

How many attempts should be made before the IV team needs to be called?

No more than 3 attempts

28

What is infiltration?

A process where fluid has passed into the tissue instead of the vein

29

What is extravasation?

The most common cause is needle displacement

30

What are some symptoms associated with a mild anaphylactic reaction?

Dizziness
Shaking
Altered taste
Itching
Pallor
Flushing
Chills
Sweats
Rash/hives
Nasal stuffiness
swelling eyes/face
anxiety

31

Moderate Reactions to Contrast Media

Tachycardia
Bradycardia
Hypertension
Generalized or diffuse erythema
Dyspnea
Bronchospasm wheezing
Laryngeal edema
Mild hypotension

32

Severe Reactions to Contrast Media

Laryngeal edema
Profound hypotension
Unresponsiveness
Cardiopulmonary arrest
Clinical manifested arrhythmias
Convulsions

33

Document

Size, type and location of needle
Number of venipuncture attempts
Name of technologist who performed procedure
Indicate how patient handled contrast

34

5 rights of medication administration

Right patient
Right medication
Right route
Right amount
Right time