Stop that Drip! 💉
A rapid, severe, life-threatening systemic allergic reaction.
What is anaphylaxis?
A technique that causes local vasodilation, increasing blood flow and vein diameter, which improves vein visualization, palpability, and first-attempt cannulation success.
What is heat application?
Why: Studies have shown that warming the extremity for 5–10 minutes can increase vein diameter by 20–30%, especially in patients with difficult venous access.
This potential complication of Venofer extravasation that may be permanent, even after the IV is removed.
What is brown skin staining (iron staining)?
Why: Even a small amount of iron leaking into surrounding tissue can cause long-lasting discoloration, making careful IV assessment throughout the infusion especially important.
For 23 consecutive years, this profession has ranked #1 in honesty and ethical standards in the annual Gallup poll, earning the title of the most trusted profession in the United States.
What is NURSING!!!
According to Gallup's annual Honesty and Ethics survey, nurses have been voted the most trusted profession in America for 23 consecutive years. This ranking reflects the public's confidence in nurses' integrity, compassion, advocacy, and commitment to patient care. Year after year, nurses rank above physicians, pharmacists, police officers, clergy, teachers, and many other professions, highlighting the unique trust patients place in them during some of life's most vulnerable moments.
True or False: Diphenhydramine is the first-line treatment for anaphylaxis.
What is - FALSE!
Why: Intramuscular epinephrine is the first-line treatment for anaphylaxis. Antihistamines may help relieve itching and hives but do not reverse airway edema, bronchospasm, or hypotension and should never delay epinephrine.
True or False: Using a longer PIV catheter dramatically improves dwell time.
What is - TRUE?
Why: Studies have shown that 1.75–2.5 inch peripheral IV catheters have significantly lower failure rates than standard 1-inch catheters for ultrasound-guided insertions. A 1.75- to 2.5-inch catheter allows much more of the catheter to remain inside the vein, creating: Better catheter stability, less pistoning with movement, and lower infiltration rates.
A intravenous biologic that is most associated with delayed headaches which may not occur until several hours after discharge.
What is IVIG?
Why: IVIG can cause headaches because it temporarily increases blood viscosity and triggers an inflammatory response from cytokine release, which can irritate the meninges (the lining around the brain).
According to nursing folklore, saying this word is the fastest way to guarantee three call lights, a pump alarm, and an infusion reaction within five minutes.
What is "quiet"?
Which symptom is the biggest red flag during an infusion?
A. Flushing
B. Itching
C. Hoarse voice
D. Headache
What is C. Hoarse voice?
Why: Hoarseness may indicate airway involvement and progression toward a severe hypersensitivity reaction.
This ultrasound finding should immediately make you abandon a vein, even if it's large and easy to access.
What is a non-compressible (thrombosed) vein?
Why: A healthy vein should collapse completely when gentle pressure is applied with the ultrasound probe. This is called compressibility and is one of the quickest ways to confirm that the vein is patent. If a vein does not compress, it may contain: A thrombus (blood clot) the most common concern or chronic scarring or fibrosis from previous IVs or PICCs.
A monoclonal antibody medication that has the highest incident of infusion reaction.
What is rituximab?
Why: Rituximab (Rituxan) has one of the highest infusion reaction rates of any IV medication. Up to 77% of patients experience an infusion reaction during their first infusion despite premedication. Most reactions occur within the first 30–120 minutes. The incidence drops dramatically with subsequent infusions.
During a typical 12-hour hospital shift, the average nurse walks roughly this many steps.
What is 8,000–12,000 steps?
That's approximately 4–6 miles of walking- about the same distance as completing a 10K race during a single shift.
A patient receiving their 10th IVIG infusion suddenly develops stridor, hypotension, vomiting, and diffuse erythema. A nurse says, "It can't be an allergy- they've tolerated it nine times before." Why is that statement incorrect?
Previous tolerance does not rule out a future allergic reaction. Patients can become sensitized over time, and true anaphylaxis or severe infusion reactions may occur after multiple uneventful exposures, making prompt recognition and treatment critical.
A patient becomes pale, sweaty, nauseated, and briefly loses consciousness immediately after peripheral IV insertion. Their heart rate is 42 bpm and blood pressure is 82/50 mmHg. What is the most likely cause of these symptoms?
What is a vasovagal response?
A vasovagal response (vasovagal syncope) triggered by the IV insertion. The vagal stimulation causes transient bradycardia and hypotension, leading to decreased cerebral perfusion and syncope. Management includes stopping the procedure, laying the patient flat with legs elevated, monitoring vital signs, and allowing symptoms to resolve before attempting another IV if appropriate.
Unlike many IV iron products, this medication can interfere with MRI interpretation for up to 3 months after administration because of its superparamagnetic iron oxide core.
What is Ferumoxytol (Feraheme)?
Why: Ferumoxytol is not just iron- it's a superparamagnetic iron oxide nanoparticle (SPION) coated with a carbohydrate shell. The iron particles have magnetic properties, which means they interact with the powerful magnetic field used during MRI scans. Because of this, ferumoxytol can alter MRI signal intensity, creating areas that look brighter or darker than expected (mimicking disease, obscuring important findings.)
Which phrase is almost guaranteed to be said before an IV start?
A. "I'm a really hard stick so I need the best nurse here"
B. "They usually always have to use ultrasound or that little red light"
C. "I've been told my veins roll and blow and have lots of valves"
D. All of the above
What is: D!!! "And you only get one chance!"