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Peripheral IV Therapy

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C
Cathy Lewis

This document provides an overview of principles and best practices for peripheral intravenous therapy. It discusses the roles of healthcare professionals, routine care and maintenance, monitoring for complications, common complications like phlebitis and infiltration and how to assess and manage them, principles of intravenous flow, and troubleshooting issues like catheter occlusion or slow flow rates. The goal is to minimize complications and ensure safe and effective intravenous therapy.

Health & MedicineBusiness
1 of 51
Peripheral Intravenous Therapy Principles and Practice Hospital Name
What You Will Learn Today ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cooperative Roles PATIENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],VAT R.N. Unit R.N. Physician Unit L.P.N. Procedure Area R.N. I.R.
Unit RN Responsibilities for Peripheral IV Lines ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Policies and Procedures for Infusion Nursing
Care & Maintenance Routines ,[object Object],[object Object],[object Object],[object Object],[object Object]
Reasons to Monitor ,[object Object],[object Object],[object Object],MONITORING IS KEY TO COMPLICATION PREVENTION
When Should You Monitor? ,[object Object],[object Object],MONITORING SHOULD BE SYSTEMATIC AND ORGANIZED
Bag to Catheter Tip Assessment ,[object Object],[object Object]
Possible Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],TARGET PHLEBITIS RATE IS LESS THAN 5%
Today’s Focus on Complications ,[object Object],[object Object],[object Object],[object Object]
Phlebitis ,[object Object],[object Object],[object Object],[object Object],[object Object],Phlebitis may not appear until 24h after the cannula has been removed
How to Protect the Intima and Minimize or Delay Onset of Phlebitis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Minimize Friction Against Intima Wall ,[object Object],[object Object],[object Object],[object Object],Venous Free Flow Around Catheter is GOOD! Movement of Catheter is BAD!
Minimize Particulate Matter ,[object Object],[object Object],[object Object],[object Object],[object Object]
Minimize Effects of pH and Osmolality ,[object Object],[object Object],[object Object],[object Object],[object Object]
pH ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Acidic Solutions Predispose V. to Phlebitis Back
How does this size catheter minimize possibility of phlebitis? Baxter Illustration
Common Meds ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],FYI. Heparin increases pH and rarely causes phlebitis
IV Fluid (mOsm/L) (pH range) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Phlebitis Assessment ,[object Object],[object Object],[object Object],[object Object]
Which Grade? Cause is mechanical
Which Grade? Cause is chemical
Which Grade? Photo: C. Lewis
Nursing Intervention: Phlebitis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Infiltration ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Symptoms will be more difficult to recognize early if skin turgor is poor
1, 2, and 3 courtesy of Baxter 1 3 4 2 4 adapted from Baxter
Extravasation ,[object Object],[object Object]
Infiltration Assessment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Nursing Intervention: Infiltration and Extravasation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Grade 1 Photo: C. Lewis Photo: C. Lewis
Grade 2 Photo: C. Lewis
Grade 3 Photo: C. Lewis
Grade 4 Photo: C. Lewis
Which Grade? ,[object Object],Photo: C. Lewis
Which Grade? ,[object Object],[object Object],[object Object],Dobutamine Infusion Photo: C. Lewis
Catheter-Related Infection ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Prevention of Catheter-Related Infection ,[object Object],[object Object],[object Object],[object Object],[object Object]
Principles of Flow ,[object Object],[object Object],[object Object]
Resistance and Pressure = Flow ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],How Do These Factors Influence Resistance and Pressure? ,[object Object],[object Object],[object Object],[object Object],P R
Troubleshooting ,[object Object],[object Object],[object Object],[object Object]
Catheter Occlusion ,[object Object],[object Object],[object Object],[object Object],[object Object]
Signs and Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Thrombotic Mechanical
Nursing Intervention: Occlusion ,[object Object],[object Object],[object Object]
Rate Too Slow ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Rate Too Slow, cont. ,[object Object],[object Object],[object Object],[object Object],[object Object]
Pain, no sign of phlebitis or infiltration ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Venous Spasm ,[object Object],[object Object],[object Object],[object Object],[object Object]
Why Does a Pump Not Alarm When the IV is Infiltrating? ,[object Object],[object Object]
Hot Tip for Pumps ,[object Object]

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Peripheral IV Therapy

Editor's Notes

  1. Super users group
  2. Ask participants to tell you how the factors influence resistance and pressure, i.e., more or less?