Exam 3 Iv Therapy

Front 1

5 parameters against which nurse will be judged if sued for IV therapy-related malpractice:

Back 1

1. Standards of Nurse Practice Act2. CDC guidelines3. OSHA mandates4. INS (Infusion Nurses Society) standards5. Policies/procedures of employing agency

Front 2

Must have appropriate ____________ to start or d/c IV Therapy

Back 2

M.D. order

Front 3

Single most effective way to prevent spread of infection

Back 3

Hand Hygiene

Front 4

Apply 3 – 4 “above intended venipuncture siteApply so that only venous, and not arterial, blood flow is suppressed; must be able to palpate a pulse distal to tourniquetDo not leave in place >3 min

Back 4

Tourniquet Application

Front 5

1. Gravity2. Fist clenching3. Friction4. Percussion (tap vein)5. Compresses (place arm below heart level & apply warm compress X 10 min.)

Back 5

Methods to Enhance Venous Access

Front 6

apply pressure on each side of vein; if vein disappears with pressure and reappears when pressure is released, then vein is good; sclerotic vein will not blanch

Back 6

Check for Blanching

Front 7

____________ if necessary; do not shave

Back 7

clip hair

Front 8

1. Pt’s. receiving anticoagulant therapyPlace tourniquet looser, nor not at all, to avoid SC bleeding/bruising2. Pt’s. with altered skin and vesselsDo not use tourniquet with delicate, fragile skin or vessels to prevent “blowing” (breaking) of vein3. Edematous extremity or obese patientDifficult stickVeins may not be visible; will have to palpate vein; “blind stick”

Back 8

Special considerations

Front 9

AllergiesAssess for allergies to:

Back 9

iodine, tape, latex

Front 10

Check orderVerify IV additivesBlood products, chemo, etc. may require verification by 2 nurses (check facility protocol)Set up equipment away from pt. room

Back 10

Initiation of Infusion Therapy

Front 11

1. Introduce self; I.D. pt.2. Provide privacy3. Explain procedure4. Elevate bed; place pt. in semi-Fowler’s or Fowler’s position5. Protect pt. clothing & bed with towel6. Hand hygiene7. Set up supplies; select vein; prep site (allow alcohol to air dry)8. Don gloves9. Apply tourniquet 3 – 4” above site; do not leave in place >3 min.10. Start IV; with over-the-needle catheter

Back 11

Starting an infusion

Front 12

INS (Infusion Nurses Society) recommends that one nurse should not stick more than twice in event of unsuccessful sticks_____________________________________________When securing IV site, never encircle entire extremity with tape; this will cut off circulation

Back 12

never stick more than once with same cannula

Front 13

Date/Time; insertion site/appearance; size jelco; solution/rate (if applicable); type dressing; number and appearance of unsuccessful stick sites; pt. response

Back 13

Documentation

Front 14

Any pt. receiving IV therapy should be monitored/assessed at least every hourMonitor/assess both patient and IV site

Back 14

Observation/Assessment

Front 15

Good hand hygiene with site careWear gloves for dressing changesLeave dressing in place until catheter is removed or changed, or dressing becomes damp, loose, or soiled

Back 15

Site Maintenance

Front 16

In adults, replace peripheral catheters every 72 – 96 hours; may be left in place longer if there are limited access sites; but document well re: site conditionD/C catheters at first sign of problemsReplace primary/secondary tubings per facility protocol or with every new bagReplace fluids every 24 hoursBlood must be infused within 4 hours

Back 16

Equipment Protocols

Front 17

A. Adding meds to infusion containerCheck compatibilityLabel container with additiveB. IVPB (for intermittent drug infustion)C. IVP (RN must give; per hospital protocol)

Back 17

IV Medication Administration During IV Therapy

Front 18

Ex. Order may read: S.L. IV; D/C IV fluidsT-connector (T-tube) may already be in place or may need to place oneFlush SL every 8 hours with 2.5mL NS, or per facility protocolWhen IVP medication administered through SL (per RN), use S-A-S method

Back 18

Converting IV to SL (saline lock)

Front 19

S-Saline

A-Administer medication

S-Saline

Back 19

SAS Method

Front 20

Apply pressure X 1 min.Check catheter tip for intactnessDocument procedure

Back 20

Discontinuing IV

Front 21

Drugs that prevent development, growth, or proliferation of malignant cellsMost are cytotoxic: poisonous to both normal and cancer cellsAlkylating agents are the largest groupMany other classes of antineoplastic: nitrosureas, antimetabolites, plant alkaloids, etc.Strict safety guidelines with regard to preparation and administration of these drugs must be followedShould only be administered by trained personnelNormally, RN must be oncology certified

Back 21

Antineoplastic Agents

Front 22

Peripheral (extremities) and Central (central lines, mediports, PICC lines—they go directly in to the heart).

Back 22

two types of IV access