Overview
This lecture covers key principles, procedures, safety considerations, and common complications for intravenous (IV) therapy, including types of access, site selection, maintenance, and troubleshooting.
IV Therapy Basics
- IV administration through peripheral veins is the fastest route for medications.
- Advantages: rapid absorption, consistent blood levels, less tissue damage.
- Disadvantages: risk of fluid overload, infection, infiltration, and other IV-related issues.
- IV infusions are medications and require an order specifying type, volume, and rate.
Types of IV Access
- Short-term access: Peripheral IVs for days to weeks (e.g., hand, AC, scalp in newborns).
- Long-term access: Central lines (CVCs, PICC lines) for prolonged therapy (e.g., chemo, TPN).
- CVC: Inserted near collarbone to right atrium; PICC: upper arm to superior vena cava.
- Central lines have high infection risk.
IV Site Considerations
- Avoid sites: antecubital vein with nerves/valves, paralyzed arms, arms post-mastectomy, fistulas/grafts, varicose veins, scar tissue.
- Never place peripheral IVs in limbs with lymphedema, fistula, or graft.
IV Maintenance and Safety
- Change IV tubing and site every 72 hours; change solution bags every 24 hours.
- Blood transfusion sets are single-use only.
- Never push potassium (K+ or KCl); always use a pump.
- Never add meds to blood or TPN bags.
- Check medication compatibility in multi-line setups.
Special Populations & Technique Notes
- Elderly have fragile skin; use BP cuff instead of tourniquet.
- Do not slap the extremity; use alcohol swab to apply pressure and visualize veins.
- Always use PPE and maintain aseptic technique.
IV Insertion Procedure (Summary)
- Gather supplies before bedside.
- Start IVs distally and move proximally if needed.
- Clean site thoroughly (friction removes bacteria).
- Insert catheter bevel up; confirm blood return.
- Flush, secure, and dress site with a visible window.
- Label site with date, time, and initials.
Common IV Complications & Management
- Infiltration/Extravasation: Swelling, pallor, slowed infusion, coolness; stop IV, elevate, warm compress, start new site.
- Phlebitis/Thrombophlebitis: Edema, pain, redness; stop IV, elevate, warm compress, rotate sites every 72 hours.
- Cellulitis: Pain, warmth, edema, fever/chills; stop IV, elevate, warm compress, obtain culture if drainage.
- Hematoma: Bruising/bleeding after removal; apply pressure, use cold compress, minimize tourniquet time.
Key Terms & Definitions
- Peripheral IV — Short-term intravenous access via a small vein.
- Central line (CVC/PICC) — Long-term IV access via large veins, higher infection risk.
- Infiltration — Non-vesicant fluid leaks into tissue around IV site.
- Extravasation — Vesicant (damaging) fluid leaks into tissue.
- Phlebitis — Inflammation of the vein.
- Cellulitis — Infection/inflammation of the tissue around the site.
- Hematoma — Collection of blood outside the vessel (bruise).
Action Items / Next Steps
- Study IV complication management protocols.
- Review hospital policy on IV medication compatibility.
- Take the quiz and download related study guides.
- Avoid using restricted sites for IV insertion.