nurse notes
Thursday, July 8, 2010
Wednesday, July 7, 2010
Tuesday, July 6, 2010
Intravenous Injection and Complications of IVT
Assemble equipment and check physician’s order.
COMPLICATIONS OF INTRAVENOUS THERAPY
1. FLUID OVERLOAD
Overloading the circulatory system with excessive IV fluids causes increase blood pressure and central venous pressure.
Manifestation:
Moist crackles on auscultation of lungs.
Edema
Increase weight
Dispend
Shallow respiration
Increase respiration
Causes:
Rapid infusion of an IV solution.
Management:
Decrease IV infusion
Monitor vital signs and rate every hour
Assess breath sounds
High Fowler position
Can use infusion pump, if possible.
Complication:
Heart Failure
Pulmonary edema
2. Air Embolism
It is a rare but ever-present and most often associated with cannula of central veins.
Manifestation:
Dyspnea and cyanosis
Hypotension
Weakness
Increase pulse
Loss of consciousness
Chest, back and shoulder pain
Management:
Clamping the cannula
Placing patient on left side, in trendelenburg
Assessing vital signs and breath sounds
Administration of oxygen
Complication:
Shock
Death
3. Septicemia / Other infection
Cause:
Contamination
Manifestation:
Abrupt elevation of temperature
shortly after infusion started
Backache, headache
Increase pulse rate and respiratory rate
Nausea and vomiting
Chills
General body malaise
Management:
Culturing the cannula, tubing/solution
Establish new site
Complication:
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.
Manifestation:
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
Management:
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.
Cause:
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.
Manifestation:
Redness
Warm
Pain or tenderness
Swelling
Management:
Discontinuing
Restart the IV infusion
Warm, moist compress
6. Thrombophlebitis
Presence of clot and inflammation of the vein.
Manifestation:
Pain
Redness
Warmth
Swelling
Immobility of the extremities because
of discomfort and swelling
Sluggush flow rate
Fever
Malaise and leukocytosis
Management:
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
Manifestation:
Ø Ecchymosis
Ø Immediate swelling at the site
Ø Leakage of blood at the site
Management:
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.
Management:
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