must follow OSHA standards ALWAYS!

which are the following

• hand washing before and after
• wear gloves
• no artificial nails
• never reuse a needle or catheter
• injection parts must be aseptically cleansed
• scrub the hand for 15 seconds
• swab caps required
• never leave any used or unused needles left unattended

tourniquet is used to cause what?

an increase pressure to make it easier to see the vein

always check allergies prior to what?

• to know which cleaning solution to use on the patient
• be sure to use appropriate solution for equipment

always let the skin dry prior to inserting the iV

however, you NEVER do what?

never blow- let it air dry to avoid getting germs onto skin

always make sure to have supplies ready prior to getting started

T/F

true

do you need to have an order to insert an iV?

yess

when checking your order, you check for what?

date/time to start the infusion, solution, route, dose, rate, and duration

is it easier to insert an iv into a calm or anxious patient?

into a clam patient, if they are anxious it causes vasoconstriction in the veins

blood should NEVER going into a gauge smaller than what?

20 gauge

the smaller the catheter, the easier...

the easier it slows

proper assessment to prevent complications

never put in on a limb alert arm or one that has a fistula

which veins are the preferred site?

metacarpal (hard)

which direction do you want to work towards ?

never work toward your fingers, always want to working and the catheter is going in the direction of your heart

• begin with 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 blade

metacarpal veins (hand vein)

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

do you put IV lines in diabetics feet?

NEVER put IV lines in diabetics feet!

does the DR. need to order a IV insertion in the lower extremities?

yes, you as the nurse cannot make the call

knowing how long to leave on a tourniquet is very important, why?

to avoid causing damage make that call!

do you want to insert an IV in a varicosed vein?

NOOOO, NEVER! can cause patient to bleed

pediatrics require what kind of tubing?

microdrop tubing and PUMPS ONLY!

older adults facts

• lower, slower infusions
• frequent lung assessment
• extra padding and securement to protect skin

in older adults that are receiving fluids, what do you want to assess?

check the lung sounds to assess for possible fluid overload

the bigger the number the smaller the catheter

factsss or false

facts

16 gauge

GRAY

traumas, emergencies, blood products

18 gauge

green

traumas, emergencies, blood products

20 gauge

pink

most commonly used

22 gauge

blue

smaller veins

24 gauge

yellow

pediatrics, elderly, very small veins

trouble visualizing idialating veins ?

have patient dangle their arm for several minutes

how long should a tourniquet stay on for?

no more than 2 minutes

where do you want to play the tourniquet ?

4-6 inches above insertion site

Cleansing Skin

center then outward 2-3 inches with chlorahexidine (chloraprep), or alcohol, or bedtime

• allow to dry
• check allergies
• don't touch after cleansing

performing venipuncture with IV catheter

• needle bevel up
• 15-30 degree angle

when you see a ''FLASH OF BLOOD" in the cannula, after inserting the IV needle, what do you do next?

advance the catheter 1/4-1/2 inches to ensure the needle is all the way in.

-flush line to be sure its patent; may also aspirate for blood

things to remember when inserting the IV catheter

• hold the stylet in place and remove the tourniquet
• THEN remove the stylet
• attach PRIMED extension set, aspirate for blood return then flush (assess for infiltration)
• apply transparent dressing to the site (secure the extension tubing with tape)
• label the IV site with date-time-gauge-initals
• document- including site,gauge,dressing,complications,attempts, did pt tolerate &how

why do you want to check for infiltration prior to giving any medications/ IVFS

• can aspirate for blood
• flush line
• check surrounding area of IV site

factsss about flushing an iv site

• flush every shift or every day- check policy
• 3-10 ml NS
• when flushing do NOT force if you meet resistance (do further assessment)

IV site dressings

• transparent dressings should be used in order to monitor the IV site closely (tegaderm)
• change dressing as per facility policy or Q 72 hours
• change PRN if soiled or loose

when discounting an IV catheter

• LPN IS ABLE TO PERFORM
• gloves needed
• stop IV infusion if applicable & detach from IV catheter
• loosen tape
• Hold IV site with a 2x2 gauze - DO NOT USE ALCOHOL- will prolong bleeding time
• pull catheter out while holding the gauze over the catheter site
• hold pressure x 1 minute
• apply dressing/band aid
• check site
• check for intact catheter after its removed, discard and document removal
• catheter are radiopaque-can be seen on x-ray