IV Therapies & Blood Transfusions

What are some signs of phlebitis at the IV site?

• warmth

• tenderness at the IV site

• palpable venous cord

When should you change the IV site to reduce the risk of phlebitis?

the IV site should be changed every 72-96 hours

When should you change the IV tubing?

the IV tubing should be changed every 96 hours

How much cc of NS should be used to flush a PICC line?

10 cc of NS should be used to flush a PICC line

Before you can flush, hook up IV fluids, or push medications, what must you do for a central venous access IV?

there must have an x-ray verification on correct placement of the central venous access IV

When should you change the sterile dressing for a central venous access IV?

the sterile dressing should be changed every 7 days

What are isotonic solutions (0.09% NS, Lactated Ringers) used for?

• mild dehydration (vomiting/ diarrhea)

• metabolic acidosis

• burns

• surgeries

What are hypertonic solutions (D5LR, 3% NS) used for?

• severe dehydration

• significant electrolyte imbalance

What are hypotonic solutions (0.33% NS, 0.45% NS) used for?

• hypernatremia

• diabetic ketoacidosis (DKA)

What are some contraindications for hypotonic solutions?

• pt. with cerebral edema

• burn pt.

• pt. with hypotension

• trauma pt.

What are some nursing interventions for patients showing signs of phlebitis?

• discontinue IV at the site

• restart IV at different site

• put warm compression on affected site

What are some nursing interventions for patient experiencing extravasation?

• stop infusion

• administer antidot for med if possible

• elevate affected extremity

What are some nursing interventions for a patient who has a local infection at the IV site?

• use aseptic technique

• rotate IV site

• send IV to lab to get cultures done

• restart IV at different site

What are some nursing interventions for a patient experiencing an air embolism?

• properly prime IV line

• switch IV lines

How long should you stay with your patient after starting a blood transfusion and when should you do vitals?

• stay with the pt. for the first 15 minute

• do vitals every 30 minutes to an hour

What are some complications of doing peripheral parenteral nutrition (PPN)?

• phlebitis

• fluid overload

• hyper/hypoglycemia

What are some nursing interventions needed for patients that have total parental nutrition (TPN) or peripheral parenteral nutrition (PPN)?

• daily weights

• I&Os

What are some labs you need to look at for patients having total parental nutrition (TPN) or peripheral parenteral nutrition (PPN)?

• CBC

• CMP

• glucose