Tuesday, July 6, 2010

Intravenous Injection and Complications of IVT

These is the Administering of IV injection and some complications that the patient can possibly have during IV therapy.

* Assemble equipment and check physician’s order.

* Explain the procedure to the patient.

* Perform hand hygiene.

* Ask the patient if he is allergic to latex. (Product use in preparing for IVT).

* Select the most appropriate insertion site and type of cannula for particular patient.

* Most distal site of arm or hand is generally used first so that subsequent IV access can be move progressively upward.

* Excessive hair at the selected site may be removed by clipping to increase the visibility of the veins and prevent infection and to adherence of dressing of IV insertion.

* Because infection can be a major complication of IV Therapy, the device, the fluid, the container and the tubing must be sterile.

* After applying tourniquet, the nurse palpates and inspects the vein. The vein should feel firm, elastic, engorged and round.

* Palpate for arterial pulsation, because arteries lie close to veins in the entecubital fossa.

* The insertion site is scrub with sterile pad soaked with alcohol, working from center of the area to the periphery allowing the area to dry.

* Cannula tips should not rest in a flexion area, as this could inhibit the IV flow.

* IV container should be marked with tape to indicate at a glance whether the correct amount has infused.

* Calculate for the flow rate and monitor at least hourly.



Overloading the circulatory system with excessive IV fluids causes increase blood pressure and central venous pressure.


* Moist crackles on auscultation of lungs.

* Edema

* Increase weight

* Dispend

* Shallow respiration

* Increase respiration


* Rapid infusion of an IV solution.


* Decrease IV infusion

* Monitor vital signs and rate every hour

* Assess breath sounds

* High Fowler position

* Can use infusion pump, if possible.


* Heart Failure

* Pulmonary edema

2. Air Embolism

It is a rare but ever-present and most often associated with cannula of central veins.


* Dyspnea and cyanosis

* Hypotension

* Weakness

* Increase pulse

* Loss of consciousness

* Chest, back and shoulder pain


* Clamping the cannula

* Placing patient on left side, in trendelenburg

* Assessing vital signs and breath sounds

* Administration of oxygen


* Shock

* Death

3. Septicemia / Other infection


* Contamination


* Abrupt elevation of temperature

* shortly after infusion started

* Backache, headache

* Increase pulse rate and respiratory rate

* Nausea and vomiting

* Chills

* General body malaise


* Culturing the cannula, tubing/solution

* Establish new site


* Septic Shock-severe causes

4. Infiltration

-unintentional administration of a non-vesicant solution or medication into surroundings of the tissue.

-can be occurring when the IV cannula dislodges or perforates the wall of the vein.


* Edema around the insertion

* Leakage of IV fluid from insertion site

* Discomfort and coolness in the area on filtration

* A significant decrease of the flow rate


* Stop the infusion

* Start IV infusion, should be started in the

* New site or proximal to the filtration of the same estremities.

* Warm compress

* Elevates the affected site to promote the absorption of the fluid

* If the case is resent cold compress

5. Phlebitis

Inflammation of vein related to chemical or mechanical irritation or both.


* Incidence increase length of time IOV in place

* Composition of fluid/medicine infused.

* Size at site of cannula inserted.

* Ineffective filtration.

* Improper anchoring of the line.

* Introduction of microorganism at the time inserted.


* Redness

* Warm

* Pain or tenderness

* Swelling


* Discontinuing

* Restart the IV infusion

* Warm, moist compress

6. Thrombophlebitis

Presence of clot and inflammation of the vein.


* Pain

* Redness

* Warmth

* Swelling

* Immobility of the extremities because

of discomfort and swelling

* Sluggush flow rate

* Fever

* Malaise and leukocytosis


* Discontinuing

* Cold compress-to decrease flow rate of blood, then,

* Warm compress to increase platelet aggregation

* Evaluating extremities

* Restarting of IV infusion

7. Hematoma

Result when blood leaks into tissue surrounding IV insertion site


Ø Ecchymosis

Ø Immediate swelling at the site

Ø Leakage of blood at the site


Ø Removing needle or cannula

Ø Apply pressure

Ø Apply ice for 24 hours-to avoid extension

of the hematoma and then warm

compress to increase absorption of blood.

Ø Restart

8. Clotting and Obstruction

Blood clots may form in the IV line as a result of kinked IV tubing, a very slow infusion rate, failure to flush the IV line after intermittent medication or solution administration.


Ø Restart

Ø Tubing should not be irrigated/milked

Ø Container should be raised and the clot

should be aspirated from the tubing

Ø Prevent IV bag run dry

Ø Taping the tubing to prevent kinking

and maintain potency

Ø Flushing after intermittent medication

or other solution

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