MUST FOLLOW OSHA STANDARDS ALWAYS
the following are:
- hand washing before &after
- wear gloves
- no artificial nails
- never reuse a needle or catheter
- injection parts must be aseptically cleansed
- *scrub the hand for 15 seconds (the end of the extension tubing)
- scrub be required
- NEVER leave any used or unused needles left unattended
when should you flush the catheter?
before and after
why is a tourniquet used?
to cause an increase pressure to make it easier to see the vein.
-always check allergies prior To know which cleaning solution to use on the patient.
-be sure to use appropriate solution for equipment
should you air dry or blow on the skin ?
always let the skin dry prior to inserting the IV! NEVER BLOW- let it air-dry to avoid getting germs onto skin.
do you need an order to start an IV?
must have an order to insert on IV
documenting on iv insertion
check your order > check date/time to start the infusion, solution, route, dose, rate, and duration
what kind of gauge should blood go into?
NEVER go into a gauge smaller than 20
proper assessment to prevent complications
never put in on a limb alert arm or one that has a fistula.
what is a preferred site ?
metacarpal veins (hand)
-chose a straight vein with normal vasculature
(T/F)
never work toward your fingers, always want the catheter go in the direction of your heart
true
-begin distal veins and work your way up.
- non dominant arm preferred but not required
dorsal digital veins (finger veins)
- small gauges
- support with board or tongue blades
metacarpal veins (hand veins)
considered primary IV site; first choice for site selection
cephalic vein (thumb side)
can accommodate large bone needles
basilic vein (pinky side)
- often used for PICC lines
- good choice for peripheral lines as well
is it okay to put iv lines in a diabetic's foot?
NO, never put iv lines in a diabetics foot
to insert an iv in the lower extremities, are you able to make that call as the nurse?
no, need DR. order in order to insert an iv in the lower extremities
If you insert an IV in a varicose vein, what can happen to your patient?
you can cause the patient to bleed
pediatric patients require what kind of tubing?
microdrop tubing, PUMPS ONLY!`
facts about older adults
- lower, slower infusions
- frequent lung assessment
- extra padding and securement to protect skin
in older adults receiving fluids, what would you want to assess?
check their lung sounds to ass for possible fluid overload
16 gauge (gray) given for :
- traumas
- emergencies
- blood products
18 gauge(green)
- traumas
- emergencies
- blood products
20 gauge (pink)
is the most commonly used
22 gauge (blue)
smaller veins
24 gauges (yellow)
- pediatrics
- elderly
- very small veins
if you are having trouble visualizing/ dilating veins?
have patient dangle their arm for several minutes
how long should a tourniquet stay on for ?
no longer than 2 minutes !
when inserting an iv, what technique should be used?
maintain aseptic technique
where should the tourniquet be placed?
4-6 inches above insertion site
if tegaderm is covering the whole band, you should:
clean the whole area to avoid trapping germs in that area
things to know when inserting:
- needle bevel up
- insert 15-30 degree angle
once you insert your iv, you wan to watch for what?
- watch for a flash of blood in the blood chamber
- if you don't see blood, your not in a vessel
-always be sure to have equipment primed and ready to go prior to inserting iv
aspirating
when you draw back and see blood
how often should you change dressing ?
Q 12 hrs; or per facility policy
- transparent dressing should be used to have visible site of the actual site
why shouldn't you use, alcohol when removing an IV?
it will prolong bleeding time
when removing catheter, what do you want to check?
always check the catheter when removed to be sure it is in tact
rapid IV fluids
use 16-18 gauge to have better flow to receive medication faster
pre op patient
18-20 gauge
site- forearm
older adult (fragile skin)
22-24 gauge
metacarpol
child requiring short- term
gauge 24, they have smaller veins/scared of needles (comfort)
school age- 22 gauge
ideal gauge for blood transfusion ?
18 gauge
patient on long term therapy
site: upper arm and peripheral/ central line
potassium
dilute it on a pump to avoid burning sensation
extravasation
leaking