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IV Therapy Concept Map
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IV Therapy
LPN Site
Assessment
The nurse should check the site to make sure that the skin is intact and that there is no rash, edema, or any burns. The IV should not be put into an area that can be flexed (i.e the inner part of the elbow) nor should it be inserted into a limb with poor circulation.
The nurse should also check if the patient has any allergies (to the IV solution or tape).
Complications
Infiltration
Infiltration
- Occurrence of the IV solution leaking into the subcutaneous tissue
- S/S: pallor, swelling at the IV site, cold skin at the IV site, damp dressing, slowed rate of infusion
Treatment: Stop the infusion, remove the catheter, elevate the extremity, and restart the infusion in a different site
- Inflammation of the injection site
- S/S: edema, throbbing + burning + pain at the IV site, increased skin temperature, reddened skin, a red line up the arm, a palpable band at the vein site, slowed rate of infusion
- Treatment: discontinue the infusion and remove the catheter, elevate the extremity, apply warm compressed 3-4 times a day, and restart the infusion in a different site
Phlebitis
Fluid Overload
- Occurs when there is too high of a volume of fluid in the body and the fluid cannot circulate properly - hypervolemia
- S/S: dyspnea, flushed skin, hypertension, low oxygen saturation.
Treatment: Stop the infusion and have the client sit up. Diuretics may be used to lower the fluid volume.
Fluid Overload
Thrombus Formation
- Formation of a blood clot
- S/S: swelling at the IV site, pain and color change in the arm, increased edema
Treatment: Stop the infusion, alert the RN
Thrombus Formation
Pulmonary Embolism
- An artery in the lung becomes blocked by a blood clot.
- S/S: SOB, chest pain, cough.
Treatment: Breaking up the clot through the use of anticoagulants and possibly embolectomy surgery.
Pulmonary
Embolism
Air embolus
- Air emboli in the blood vessels that block the flow of blood through the body.
- S/S: SOB, dyspnea, chest pain, confusion.
Treatment: Stop the infusion, apply supplemental oxygen, alert the RN. The air may be removed surgically.
Air Embolism
Infection
Infection
- Occurrence of infection at the IV site
- S/S: pain, redness, and purulent drainage at the IV site.
Treatment: Stop the infusion, remove the catheter, and alert the RN. Antibiotics may be administered.
Indications
- Dehydration
- Medication administration
- Administration of blood products
- Total Parenteral Nutrition (TPN)
Equipment
- Tape
- IV Bag
- Infusion Pump
- Gloves
- Pre-filled syringe for
Saline Lock Flush
- IV tubing
- MAR
IV Solutions
- 5% Dextrose (D5W) is an isotonic solution that is used to treat fluid loss and dehydration
- 0.33 Sodium Chloride is a hypotonic used to hydrate cells and deplete the circulatory system for conditions such as diabetic ketoacidosis
- 5% Dextrose + Lactated Ringer's (D5LR) is a hypertonic solution used to replace electrolytes and to temporarily treat shock.
- Platelets
- Plasma Proteins
- Red blood cells (Packed cells)
- Whole blood
LPN ROLE
- Monitoring vital signs (every 15 minutes) and monitoring for adverse reactions to the blood transfusion
- If adverse reactions occur, stopping the transfusion and notifying the RN immediately