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Exam3- IV therapy

1.

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
2.

when should you flush the catheter?

before and after

3.

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

4.

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.

5.

do you need an order to start an IV?

must have an order to insert on IV

6.

documenting on iv insertion

check your order > check date/time to start the infusion, solution, route, dose, rate, and duration

7.

what kind of gauge should blood go into?

NEVER go into a gauge smaller than 20

8.

proper assessment to prevent complications

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

9.

what is a preferred site ?

metacarpal veins (hand)

-chose a straight vein with normal vasculature

10.

(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

11.

dorsal digital veins (finger veins)

  • small gauges
  • support with board or tongue blades
12.

metacarpal veins (hand veins)

considered primary IV site; first choice for site selection

13.

cephalic vein (thumb side)

can accommodate large bone needles

14.

basilic vein (pinky side)

  • often used for PICC lines
  • good choice for peripheral lines as well
15.

is it okay to put iv lines in a diabetic's foot?

NO, never put iv lines in a diabetics foot

16.

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

17.

If you insert an IV in a varicose vein, what can happen to your patient?

you can cause the patient to bleed

18.

pediatric patients require what kind of tubing?

microdrop tubing, PUMPS ONLY!`

19.

facts about older adults

  • lower, slower infusions
  • frequent lung assessment
  • extra padding and securement to protect skin
20.

in older adults receiving fluids, what would you want to assess?

check their lung sounds to ass for possible fluid overload

21.

16 gauge (gray) given for :

  • traumas
  • emergencies
  • blood products
22.

18 gauge(green)

  • traumas
  • emergencies
  • blood products
23.

20 gauge (pink)

is the most commonly used

24.

22 gauge (blue)

smaller veins

25.

24 gauges (yellow)

  • pediatrics
  • elderly
  • very small veins
26.

if you are having trouble visualizing/ dilating veins?

have patient dangle their arm for several minutes

27.

how long should a tourniquet stay on for ?

no longer than 2 minutes !

28.

when inserting an iv, what technique should be used?

maintain aseptic technique

29.

where should the tourniquet be placed?

4-6 inches above insertion site

30.

if tegaderm is covering the whole band, you should:

clean the whole area to avoid trapping germs in that area

31.

things to know when inserting:

  • needle bevel up
  • insert 15-30 degree angle
32.

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

33.

aspirating

when you draw back and see blood

34.

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
35.

why shouldn't you use, alcohol when removing an IV?

it will prolong bleeding time

36.

when removing catheter, what do you want to check?

always check the catheter when removed to be sure it is in tact

37.

rapid IV fluids

use 16-18 gauge to have better flow to receive medication faster

38.

pre op patient

18-20 gauge

site- forearm

39.

older adult (fragile skin)

22-24 gauge

metacarpol

40.

child requiring short- term

gauge 24, they have smaller veins/scared of needles (comfort)

school age- 22 gauge

41.

ideal gauge for blood transfusion ?

18 gauge

42.

patient on long term therapy

site: upper arm and peripheral/ central line

43.

potassium

dilute it on a pump to avoid burning sensation

44.

extravasation

leaking