Overview
This lecture covers the differences between peripheral and central venous catheters, key IV complications, their signs, and appropriate nursing interventions.
Peripheral vs. Central Venous Catheters
- Peripheral venous catheters are inserted into small veins in the arm or hand.
- Short peripheral catheters are 3 inches or less; midline peripheral catheters are 3–8 inches, ending near or below the axilla.
- Central venous catheters (CVCs) terminate in the superior vena cava above the right atrium.
- CVCs are used for long-term IV therapy, TPN, and chemotherapy.
- Types of CVCs include tunneled/non-tunneled catheters, PICC lines, and implantable ports.
IV Complications & Nursing Interventions
Phlebitis
- Inflammation of the vein due to mechanical irritation or medication pH/osmolality.
- Symptoms: redness, warmth, pain, hard vein, red streak.
- Care: discontinue IV, elevate limb, apply warm, moist compress.
Infiltration
- Leakage of IV fluid into surrounding tissue.
- Symptoms: swelling, coolness, dampness, slowed infusion, leaking fluid.
- Care: discontinue IV, elevate limb, apply warm (normal/high pH) or cold (low pH) compress.
Extravasation
- Infiltration of a vesicant (damaging) medication.
- Symptoms: redness, pain, swelling, blisters, tissue necrosis, ulceration.
- Care: stop infusion, aspirate medication, give antidote per policy, then discontinue IV, elevate, and apply compress.
Catheter Embolus
- Fragment of catheter enters the venous system.
- Symptoms: pain along vein, weak pulse, hypotension, missing catheter tip.
- Care: place a tourniquet high on limb, prepare for surgical removal.
Air Embolus
- Air enters circulation via IV.
- Symptoms: hypotension, increased heart/respiratory rate, cyanosis.
- Care: clamp catheter, place in Trendelenburg position, give oxygen, notify provider.
Thrombosis
- Blood clot forms in the catheter.
- Sign: absent blood return from line.
- Care: use thrombolytic agent (e.g., alteplase), wait, then re-check patency.
Fluid Overload
- Excess fluid causes respiratory and circulatory symptoms.
- Symptoms: shortness of breath, crackles, hypertension, JVD, edema, tachycardia.
- Care: raise head of bed, slow infusion, monitor, give diuretics as ordered.
Key Terms & Definitions
- Peripheral Venous Catheter — IV access in small peripheral veins, typically short or midline.
- Central Venous Catheter (CVC) — IV access with tip in superior vena cava for long-term/higher-risk therapy.
- Phlebitis — Inflammation of a vein.
- Infiltration — IV fluid leaks into surrounding tissue.
- Extravasation — Vesicant medication leaks into tissue causing injury.
- Catheter Embolus — Broken catheter fragment in bloodstream.
- Air Embolus — Air in the venous circulation.
- Thrombosis — Blood clot in vessel or catheter.
- Fluid Overload — Too much fluid in circulation causing systemic symptoms.
Action Items / Next Steps
- Review flashcards for bold, red facts.
- Memorize signs, symptoms, and nursing interventions for each IV complication.
- Complete any assigned readings on IV therapy and complications.