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IV Therapy and Complications

I. Introduction to IV Therapy

  • Overview of intravenous (IV) therapy in medical settings.
  • Importance of recognizing complications associated with IV therapy.

II. Infiltration

  • Definition: Infiltration occurs when fluid or medication leaks out of the vein into surrounding tissues.

  • Symptoms:

    • Edema around the IV site
    • Tissue feels cool to the touch.

  • Action Steps:

    • Discontinue infusion if infiltration is suspected.
    • Inform the primary nurse to assess the situation immediately.

  • Reabsorption of fluid typically occurs within twenty-four hours after infiltration.

  • Example Case: Image observation of infiltration with visible edema on the hand and constriction from dressing.

III. Extravasation

  • Definition: Extravasation is the infiltration of a vesicant, which is a medication that can cause significant damage to tissues.

  • Consequences:

    • Potential infection
    • Disfigurement or loss of function in the affected area.

  • Importance of Site Assessment: Always assess the IV site before administering medications, especially vesicants.

  • Recommended Technique: Use a saline lock and back flush to confirm blood return ensuring the IV is still patent before administering the medication.

IV. Complications of IV Therapy

A. Phlebitis

  • Definition: Phlebitis is inflammation of the vein caused by irritation from the needle, medication, or additive in IV solutions.

  • Symptoms:

    • Redness or erythema
    • Warmth at the IV site
    • Swelling and tenderness.

  • Management:

    • Discontinue the IV and establish a new site.
    • Apply warm compresses to alleviate discomfort.

  • Visual Indicator: Prolonged irritation visible along the vein post-IV.

B. Sepsis
  • Definition: Sepsis is a bloodstream infection occurred when pathogens enter the bloodstream.
  • Causes:
    • Lack of proper sterile technique or scrubbing the hub for thirty seconds before IV changes.
    • Breaks in the closed IV system during procedure changes.
  • Symptoms to Monitor:
    • Fever, chills, pain, headache, nausea, vomiting, extreme fatigue.
  • Rapid intervention required through blood cultures and aggressive antibiotic therapy.
  • Immediate discontinuation of the IV site is essential when sepsis is suspected.
C. Catheter Embolus
  • Definition: A catheter embolus occurs when a piece of the IV catheter breaks off and travels through the bloodstream, potentially lodging in the vein.
  • Cause: Incorrect insertion techniques could lead to shearing of the catheter duct.
D. Air Embolus
  • Definition: An air embolus occurs when air enters the blood vessel system.
  • Causes:
    • Usually occurs during IV line changes or when opening the line of a subclavian catheter.
  • Prevention: Keep subclavian catheters and PICC lines closed off or clamped when not in use.
  • Note: Even small amounts of air can cause concerns if injected into the heart.
E. Speed Shock
  • Definition: Speed shock occurs when fluids or medications are given too quickly, often through bolus administration.
  • Symptoms: This rapid administration can lead to shock or adverse reactions.
F. Nursing Diagnoses Related to IV Therapy
  1. Insufficient fluid volume related to the patient’s inability to ingest fluids orally.
  2. Potential for infection related to the invasive nature of IV therapy.
  3. Weight below recommended BMI resulting from inability to consume oral foods or fluids (related to Total Parenteral Nutrition).

V. Summary and Evaluation

  • Importance of identification of IV site complications to notify nursing staff.
  • Methods to confirm IV patency: Observe factors such as blood return upon drawing back before administering medication.
  • Conduct regular assessments and monitoring for effective IV therapy management.

VI. Preview for Future Topics

  • Transitioning to musculoskeletal topics in upcoming lectures.
  • Importance of reviewing anatomy and physiology related to the musculoskeletal system.
  • Overview of bone structures and classifications (long, short, flat, irregular).
  • Overview of joint types, particularly synovial joints and their structures.

VII. Assignment and Preparation

  • Review specified lab material and diagnostic tests, focusing on hematological testing and imaging.
  • Create index cards covering diagnostic tests to facilitate learning and retention of information.