Peripheral IV Therapy:
What is the definition of peripheral intravenous (IV) therapy?
The administration of fluids, electrolytes, medications, and nutrients by the IV route.
What are the main components of whole blood?
Red blood cells (RBC), white blood cells (WBC), platelets (PLT), and plasma.
Define central venous catheters.
Central venous catheters are devices inserted into large central veins, such as the subclavian or jugular vein, to administer medications, fluids, or nutrients directly into the bloodstream.
Define parenteral route.
Parenteral route refers to any route other than the oral route for administering medications or fluids, typically via injection or infusion.
Define a febrile transfusion reaction.
A febrile transfusion reaction is characterized by the development of fever during or shortly after a blood transfusion, often due to the presence of leukocytes or cytokines in the transfused blood.
What is infiltration in the context of IV therapy?
Infiltration refers to the unintentional leakage of intravenous fluid into the surrounding tissue.
Name three possible complications of IV therapy and their nursing interventions.
Complications include infiltration (stop IV & elevate arm), phlebitis (stop IV & cold compress - check circulation), and infection (local - stop - sterile dressing - antibiotic therapy if needed).
How often should type and crossmatching be done before a blood transfusion?
Every 72 hours.
What are the pros and cons of central venous catheters?
Pros include the ability to infuse highly irritating or hyperosmolar solutions and less likelihood of complications, while cons involve the need for insertion by a physician, increased infection risk, and the requirement for consent and x-ray verification of placement.
What is the primary purpose of intravenous therapy?
The primary purpose of intravenous therapy is the administration of fluids, electrolytes, medications, and nutrients directly into the bloodstream.
What is the primary nursing intervention for managing a febrile transfusion reaction?
Stop the transfusion, replace with 0.9% normal saline, and administer acetaminophen to treat fever if necessary.
What should the nurse do if infiltration occurs during IV therapy?
Stop the IV infusion, elevate the affected limb, and assess the site for swelling or pain.
List the types of solutions used in IV therapy.
Isotonic, hypotonic, and hypertonic.
What is the time limitation for initiating a blood transfusion after it is released from the blood bank?
Within 30 minutes.
Name two types of non-tunneled central venous catheters.
Triple-lumen catheters and single/double-lumen catheters.
Describe the nursing interventions for managing infiltration during IV therapy.
Stop the IV infusion, elevate the arm, and assess for any signs of complications such as swelling or pain.
Describe an allergic transfusion reaction.
An allergic transfusion reaction occurs when the recipient's immune system reacts to foreign proteins in the transfused blood, leading to symptoms such as rash, itching, or anaphylaxis.
Define phlebitis in the context of IV therapy.
Phlebitis is the inflammation of a vein, often characterized by redness, warmth, and tenderness along the vein.
What are the pros and cons of peripheral IV therapy?
Pros include suitability for brief therapy.
Cons involve fragility, dislodging easily, and limitations on the types of solutions infused.
List two pre-medications commonly given before a blood transfusion.
Acetaminophen and diphenhydramine.
What is the primary advantage of peripherally inserted central catheters (PICC) over other central access devices?
PICC lines can be used for intermediate to long-term therapy and can be inserted without surgery, allowing patients to receive treatment at home.
Explain why peripheral IV therapy may not be suitable for long-term therapy.
Peripheral IV catheters are fragile, have a higher risk of dislodgement, and are not suitable for infusing highly irritating or hyperosmolar solutions.
What is the immediate nursing action for managing an allergic transfusion reaction?
Stop the transfusion, replace with 0.9% normal saline, administer antihistamines for mild reactions, and administer epinephrine for severe reactions.
What is the primary nursing intervention for managing phlebitis during IV therapy?
Stop the IV infusion, apply a cold compress to the site, and assess for any signs of clot formation or decreased circulation.
What is the primary nursing intervention for extravasation during peripheral IV therapy?
Stop infusion immediately, apply a cold compress, and administer the appropriate antidote if available.
What type of tubing is used to administer a blood transfusion?
Y tubing.
Describe the procedure for accessing an implanted port (Mediport/Portacath).
The port is accessed through the skin using a Huber needle in a sterile procedure when needed for infusion, and it remains hidden under the skin when not in use.
What are the primary nursing interventions for managing phlebitis during IV therapy?
Stop the IV infusion, apply a cold compress, and assess circulation to the affected limb.
Explain the nursing interventions for managing a bacterial transfusion reaction.
Stop the transfusion, replace with 0.9% normal saline, and administer antibiotics as prescribed to treat the bacterial infection.
Describe thrombophlebitis in the context of IV therapy.
Thrombophlebitis is inflammation of a vein associated with the formation of a blood clot, which can impede blood flow and lead to complications such as deep vein thrombosis (DVT).
Describe the difference between infiltration and phlebitis in peripheral IV therapy.
Infiltration involves the leakage of fluid into the surrounding tissue, while phlebitis is inflammation of the vein.
Name the types of transfusion reactions.
Febrile, allergic, bacterial, hemolytic, and circulatory overload.
What is the primary purpose of a tunneled central venous catheter?
Tunneled catheters are intended for long-term use and are implanted under the skin, allowing repeated access for administration of medications or fluids.
List two advantages of using hypotonic solutions in IV therapy.
Hypotonic solutions help hydrate cells and can be beneficial for patients with cellular dehydration.
Describe a hemolytic transfusion reaction.
A hemolytic transfusion reaction occurs when the recipient's immune system attacks and destroys transfused red blood cells, leading to hemolysis, kidney damage, and potentially life-threatening complications.
What are the nursing interventions for managing thrombophlebitis during IV therapy?
Stop the IV infusion, apply a warm compress to the site to promote circulation, and monitor the patient for signs of worsening symptoms or clot propagation.
How often should the access site for peripheral IV therapy be replaced?
Every 72 hours.
Describe the nursing interventions for a suspected hemolytic transfusion reaction.
Stop infusion, replace with saline line, call primary care provider, and initiate hemolytic reaction protocol.
Explain the difference between a non-tunneled and tunneled central venous catheter.
Non-tunneled catheters are temporary and inserted directly into a central vein, while tunneled catheters are intended for long-term use, implanted under the skin, and require a separate tunnel for insertion.
Explain the nursing interventions for managing thrombophlebitis during IV therapy.
Stop the IV infusion, apply a warm compress to the affected area, and assess for any signs of clot formation.
What is the priority nursing action for managing a suspected hemolytic transfusion reaction?
Stop the transfusion immediately, replace with a saline line, call the primary care provider, and initiate the hemolytic reaction protocol.
Explain the term "extravasation" in the context of IV therapy.
Extravasation refers to the accidental leakage of vesicant medications or fluids into the surrounding tissue, leading to tissue damage and potential necrosis.
What is the first step in managing a suspected infection related to peripheral IV therapy?
Stop the infusion and apply a sterile dressing to the site.
What action should the nurse take if a patient experiences an allergic transfusion reaction?
Stop the transfusion, replace with 0.9% normal saline, notify the primary care
What is the role of a jugular central venous catheter?
Jugular catheters are inserted into the jugular vein and can be used for central venous access when subclavian access is not feasible.
Describe the primary nursing interventions for managing infection related to IV therapy.
Stop the IV infusion, apply a sterile dressing to the site, and administer appropriate antibiotics as prescribed.
Explain the nursing interventions for managing circulatory overload during a blood transfusion.
Slow the transfusion rate, monitor vital signs closely, administer diuretics such as furosemide if necessary, and notify the primary care provider.
What is the immediate nursing action if extravasation occurs during IV therapy?
Stop the infusion immediately, aspirate any remaining medication or fluid from the site, and apply a cold compress to minimize tissue damage.
Name two types of central access devices used for IV therapy.
Peripherally inserted central catheter (PICC) and implanted port (Mediport/Portacath).
What is the primary intervention for a suspected bacterial transfusion reaction?
Stop the transfusion, replace with 0.9% normal saline, and notify the primary care provider for possible antibiotic therapy.
List two advantages of using a central venous catheter for IV therapy.
Ability to infuse highly irritating or hyperosmolar solutions and accessibility even in severely volume-depleted patients.
What is the immediate nursing action for managing extravasation during IV therapy?
Stop the infusion immediately, apply a cold compress to the site, and administer the appropriate antidote if available.
What type of reaction is considered life-threatening and a priority for nursing intervention during a blood transfusion?
Hemolytic transfusion reaction.
Describe an infection related to IV therapy.
An infection related to IV therapy occurs when microorganisms invade the bloodstream or surrounding tissue at the insertion site, leading to localized or systemic infection.
What is a Mediport, and what is its primary advantage over other central venous catheters?
A Mediport, also known as a Portacath, is an implanted port device used for long-term IV therapy. Its primary advantage is that when not in use, it remains hidden under the skin, reducing the risk of infection and providing a more aesthetically pleasing option for patients.
How can hemolytic transfusion reactions be prevented?
By carefully checking blood compatibility with another nurse before administration, taking time to verify details, and ensuring correct blood type and Rh factor matching.
What type of nutrition can be administered through central venous catheters?
Total parenteral nutrition (TPN) can be given through central venous catheters, providing essential nutrients directly into the bloodstream.
How can nurses prevent hemolytic transfusion reactions?
By carefully checking blood compatibility with another nurse before administration, ensuring correct blood type and Rh factor matching, and taking time to verify all details to prevent errors.
What are the primary nursing interventions for managing an infection related to IV therapy?
Stop the IV infusion, apply a sterile dressing to the site, obtain cultures as ordered, and administer appropriate antibiotics as prescribed.
What is the purpose of a PICC line in IV therapy?
PICC lines are used for intermediate to long-term IV therapy, such as prolonged antibiotic treatment or total parenteral nutrition (TPN).
What is circulatory overload during a blood transfusion, and what are the nursing interventions to manage it?
Circulatory overload occurs when a patient receives blood transfusion at a rate faster than the body can accommodate, leading to fluid overload and potential cardiac complications. Nursing interventions include slowing the transfusion rate, monitoring vital signs closely, administering diuretics such as furosemide if necessary, and notifying the primary care provider.
Describe a bacterial transfusion reaction, including its potential symptoms and nursing interventions.
A bacterial transfusion reaction occurs when bacteria contaminate the transfused blood, leading to symptoms such as fever, chills, hypotension, and sepsis. Nursing interventions include stopping the transfusion, replacing with 0.9% normal saline, administering antibiotics as prescribed, and closely monitoring the patient's vital signs for signs of systemic infection.