Intravenous (IV) Therapy Lecture Notes Flashcards

A set of 55 practice flashcards covering vocabulary, equipment, complications, and procedures related to Intravenous (IV) therapy as presented in the lecture.

Purpose of IV Therapy

Includes fluid volume replacement & maintenance, medication administration, nutrition supplement, blood draws, and special monitoring in critical care.

Peripheral Intravenous Catheter (PIV)

A vascular access device that enters veins in the AC, lower arms, or hands.

Midline Catheter

A catheter that enters a peripheral arm vein and ends at the axillary vein; it is good for up to $6$ weeks.

Peripherally Inserted Central Catheter (PICC)

A catheter that enters a peripheral arm vein and ends at the superior vena cava.

Central Venous Catheter (CVC)

A vascular access device that enters the subclavian, jugular, or femoral vein; it has a high risk of infection.

Central Venous Port (Port a cath)

A device placed under the skin in the chest that enters the subclavian vein and ends in the superior vena cava; used for long-term chronic illness and chemotherapy.

PIV Gauges $14$, $16$, and $18$

Used for trauma, surgery, rapid infusions, and increased volumes.

PIV Gauge $20$

Used for continuous and intermittent infusions.

PIV Gauges $22$ and $24$

Used for small adults and children, continuous and intermittent infusions, and fragile veins.

IV Flush Scrub Duration

Scrub all around and inside for $15$ to $30$ seconds.

IV Flush Drying Duration

Let the site dry for $15$ to $30$ seconds after scrubbing.

Flushing Technique

Flush with pulsation of $1$ to $2\,mL$ at a time for a total of $4$ to $5\,mL$.

IV Dressing Labeling

Must be labeled with the date, time, and nurse initials.

Dial-a-Flow Tubing

Used for gravity infusions and programmed by twisting a dial to the appropriate $mL/hr$.

Primary Gravity Tubing

Tubing used for gravity infusions where the flow rate is set by adjusting the roller clamp.

IV Bag Ports

Bags have two ports: one for spiking (with a pull-off tab) and one for adding medication.

IV Bag Discard Rule

Fluids and medication bags should be discarded after $24$ hours.

Continuous Infusion Tubing Change

Should be changed every $96$ hours.

Intermittent Infusion Tubing Change

Should be changed every $24$ hours.

TPN and Propofol Tubing Change

Should be changed every $12$ hours.

Blood Product Tubing Discard

Should be discarded after each use.

Assessment Frequency (Floor)

IV sites should be assessed every $4$ hours.

Assessment Frequency (ICU)

IV sites should be assessed every $2$ hours.

Infiltration

IV fluid entering subcutaneous tissue around the venipuncture site, caused by catheter dislodgement or tip penetration.

Extravasation

The infiltration of a vesicant drug into the surrounding tissue.

Vesicant

A classification of medications, such as $10-50\%$ glucose or dopamine, that can cause tissue damage if they escape the vein.

Infiltration Scale Grade $1$

Skin blanched, edema less than $1\,inch$ in any direction, and cool to touch.

Infiltration Scale Grade $2$

Skin blanched, edema $1$ to $6\,inches$ in any direction, and cool to touch.

Infiltration Scale Grade $3$

Skin blanched and translucent, gross edema greater than $6\,inches$, and possible numbness.

Infiltration Scale Grade $4$

Skin tight, leaking, discolored, or bruised; gross edema greater than $6\,inches$; deep pitting tissue edema and circulatory impairment.

Phlebitis

Inflammation of the inner layer of a vein caused by mechanical trauma, irritants, or infection.

Phlebitis Assessment Findings

Heat along vein, erythema (possible red streak), tenderness, pain, and a possible palpable cord.

Local Infection

Infection at the catheter-skin entry point; the IV must be at least $48$ hours old to meet this description.

Air Embolism

Introduction of air into the vascular system; assessment finds sudden onset of dyspnea, coughing, chest pain, and hypotension.

Trendelenburg on Left Side

The specific patient position used during an air embolism to trap air in the lower portion of the left ventricle.

Catheter Embolism

A rare complication where a piece of the catheter breaks off and travels through the vascular system.

Catheter Embolism Intervention

Apply a tourniquet above the site, notify the healthcare provider, and prepare the patient for x-ray.

Circulatory Overload

Occurs when IV solution is infused too rapidly or in too great an amount.

Circulatory Overload Assessment Findings

Dependent edema, crackles in lower lungs, pink frothy sputum, weight gain, and distended neck veins (JVD).

KVO Rate

Keep Vein Open rate, defined as $10\,mL/hr$.

IV Change Frequency

Change the IV every $72$ to $96$ hours.

Circulatory Overload Intervention

Decrease IV flow rate to KVO, raise head of bed to high Fowlers, and keep feet dependent.

Student IV Push Restriction

Students cannot give narcotics or cardiac medications.

Blood Tubing

Specific tubing with $2$ spikes and a $180\,micron$ filter.

Priming the Tubing

Gently squeeze the chamber until it is half full and slowly unclamp while holding the end over a sink; DO NOT uncap.

SmartSite Adapter

A needleless connector or injection cap used in IV tubing setups.

Hyperosmolar Vesicant Examples

Includes $10-50\%$ glucose, $3\%$ saline, and Parenteral nutrition (TPN).

Alkaline Vesicant Examples

Includes Sodium Bicarbonate, Phenytoin, and Ampicillin.

Thrombophlebitis

Inflammation of the vein associated with a clot.

Phlebitis Nursing Interventions

Stop infusion, discontinue IV, elevate affected extremity, and apply a warm, moist compress.

Infiltration Assessment Findings

Skin around site is taut (tight), blanched (pale), cool to touch, and edematous.

Late Sign of Extravasation

Blistering.

IV Dressing Cleaning Materials

Use a circular motion for alcohol and scrub with chlorhexidine.

Extension Tubing Preparation

Must be primed with a $NS$ (normal saline) flush.

Gown Change with IV

Do NOT disconnect the IV from the patient during the change.