Chapter 8. Intravenous Therapy Show
8.2 Intravenous Therapy: Guidelines and Potential ComplicationsIntravenous therapy is treatment that infuses intravenous solutions, medications, blood, or blood products directly into a vein (Perry et al., 2018). Intravenous therapy is an effective and quick way to administer fluid or medication treatment in an emergency situation, and for patients who are unable to take medications orally. Approximately 80% of all patients in the hospital setting will receive intravenous therapy. The most common reasons for IV therapy (Waitt, Waitt, & Pirmohamed, 2004) include:
Guidelines Related to Intravenous TherapyThe following are general guidelines for peripheral IV therapy:
Potential Complications of IV TherapySeveral potential complications may arise from intravenous therapy. It is the responsibility of the healthcare provider to monitor for signs and symptoms of complications and intervene appropriately. Complications can be categorized as local or systemic. Most complications are avoidable if simple hand hygiene and safe principles are adhered to for each patient at every point of contact (Fraser Health Authority, 2014; McCallum & Higgins, 2012). Table 8.1 lists the potential local and complications and treatment. It should be noted that local complications are more apparent with PVAD-short catheters but still apply to CVADs.
Some agencies recommend using a phlebitis scale to objectively describe signs and symptoms of this IV site complication. IV sites should be assessed during IV therapy and for days following removal in the event site complications present themselves.
Systemic complications can occur apart from chemical or mechanical complications. To review the systemic complications of IV therapy, see Table 8.3.
Healthcare providers should assess a patient with a central line at the beginning and the end of every shift, and as needed. For example, if the central line has been compromised (pulled or kinked), ensure it is functioning correctly. Each assessment should include: CVCs have specific protocols for accessing, flushing, disconnecting, and assessment. All healthcare providers require specialized training to care for, manage complications related to, and maintain CVCs as per agency policy. Never access or use a central line for IV therapy unless trained as per agency policy. For more information on CVC care and maintenance, see the suggested online reference list at the end of this chapter.
There are potential complications specific to central lines that the nurse should be aware of. Table 8.4 describes complications associated with CVADs specifically, along with signs and symptoms, interventions, and prevention. Assessment for persons with a CVAD also involves observing for the local and systemic complications discussed in Tables 7.9, 8.1 and 8.3.
Critical Thinking Exercises
Which of the following is a complication of intravenous IV therapy?Complications of gaining I.V. may include infiltration, hematoma, an air embolism, phlebitis, extravascular drug administration, and intraarterial injection.
What is the most common complication of IV therapy?The most common include:. Phlebitis. Inflammation of the vein. ... . Extravasation. This happens when the liquid in the IV leaks to the tissue surrounding the vein. ... . Air Embolism. This happens when an air bubble (or air bubbles) enters the vein. ... . Hypervolaemia. This is an abnormal increase in blood volume. ... . Infection.. What should the nurse be looking for when assessing an IV site?Patient and IV site assessments should be done on a regular basis. PIVC assessment includes: Assessment of PIVC insertion site - Catheter position, patency/occlusion, limb symmetry, any signs of phlebitis (erythema, tenderness, swelling, pain etc.), infiltration/extravasation.
What are the most common complications of IV access site?Phlebitis is inflammation of a vein. This complication of peripheral I.V. therapy is usually associated with acidic or alkaline solutions or solutions that have a high osmolarity. Phlebitis can also occur as a result of vein trauma during insertion, use of an inappropriate I.V.
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