Interview Questions for Intravenous Therapy Administration

Intravenous catheters come in various sizes and types, each suited for different needs. The choice depends on factors like the patient’s vein size, the duration of therapy, and the type of fluid being infused.

• Over-the-needle catheters (ONC): These are the most common type, used for short-term infusions. A needle is used to insert a flexible catheter into the vein, then the needle is removed. They come in various gauges (14G-26G), with larger gauges suitable for rapid fluid administration or viscous medications, and smaller gauges for less irritating fluids and longer-term use. Think of it like choosing different sized straws for different drinks – a large straw for a thick milkshake, a small straw for juice.
• Peripherally inserted central catheters (PICC): These long catheters are inserted into a peripheral vein (arm or hand) and advanced to a central vein near the heart. They’re ideal for long-term therapies (weeks to months) because they reduce the risk of repeated needle sticks. Imagine a longer, more durable straw reaching the bottom of a larger container.
• Central venous catheters (CVC): These are inserted directly into a large central vein (e.g., subclavian, jugular) and are commonly used for administering fluids, medications, and total parenteral nutrition (TPN) or for drawing blood samples repeatedly. They’re typically used for long-term treatment or when rapid fluid delivery is crucial, like during surgery. They are more invasive and require specialized insertion techniques, akin to using a large, specialized tube directly into a main reservoir.
• Midline catheters: These catheters are inserted into a peripheral vein and advanced into the upper arm, but not into the central venous system. They are longer-lasting than ONC but not as long as PICC lines, suited for therapies lasting a few weeks.

Selecting the appropriate catheter is crucial for patient safety and treatment efficacy. For example, using a small-gauge catheter for rapid fluid resuscitation could lead to prolonged infusion times, while using a large-gauge catheter for a simple IV antibiotic could increase the risk of phlebitis (vein inflammation).

Initiating an intravenous infusion requires meticulous attention to detail and adherence to aseptic technique to minimize the risk of infection. Here’s a step-by-step procedure:

1. Verify the doctor’s order: Ensure you have the correct medication, dose, and infusion rate.
2. Gather supplies: This includes appropriate size IV catheter, antiseptic solution (e.g., chlorhexidine), gloves, gauze pads, tourniquet, tape, and IV fluid bag with administration set.
3. Hand hygiene and don gloves: This is paramount to prevent contamination.
4. Select and prepare the venipuncture site: Apply the tourniquet, palpate the vein, and cleanse the site with antiseptic solution.
5. Insert the catheter: Use appropriate technique (e.g., bevel up for superficial veins) to insert the catheter into the vein. Observe for flashback of blood into the catheter hub to confirm successful insertion.
6. Secure the catheter: Remove the needle, connect the IV tubing, and secure the catheter with tape and a dressing.
7. Regulate the flow rate: Adjust the roller clamp to achieve the prescribed infusion rate.
8. Label the IV site: Indicate the date, time, catheter gauge, and your initials.
9. Document the procedure: Record the site, catheter size, type of fluid, and infusion rate in the patient’s chart.

Throughout the procedure, continuous monitoring of the patient is crucial to identify any signs of complications early on.

Infiltration occurs when the IV fluid leaks into the surrounding tissue instead of remaining within the vein. Extravasation is a similar issue but refers specifically to the leakage of vesicant (irritant) medications into the surrounding tissue. Both can cause pain, swelling, and discoloration at the insertion site. Extravasation can also lead to tissue damage and necrosis, particularly with chemotherapy drugs.

• Signs and symptoms: Swelling, pain, tenderness, coolness around the insertion site, leakage of fluid from the insertion site, blanching of the skin.
• Management: Infiltration is usually managed conservatively by removing the IV catheter, elevating the extremity, applying a warm or cool compress (depending on the fluid infused), and providing analgesics for pain relief. Extravasation requires more urgent intervention depending on the vesicant involved and may involve specific antidotes or other specialized treatments. In both cases, close monitoring for signs of worsening symptoms and proper documentation are crucial.

Prevention involves careful vein selection, proper catheter insertion technique, and regular monitoring of the IV site. For instance, observing for any signs of swelling or change in the infusion rate can help identify problems early.

Calculating IV drip rates involves understanding the relationship between volume, time, and drip factor. The formula is:

Drip Rate (gtts/min) = (Volume (mL) × Drip Factor (gtts/mL)) / Time (min)

Example: A physician orders 1000 mL of normal saline to be infused over 8 hours. The IV tubing has a drip factor of 15 gtts/mL.

First, convert hours to minutes: 8 hours × 60 minutes/hour = 480 minutes

Then, apply the formula: Drip Rate = (1000 mL × 15 gtts/mL) / 480 min = 31.25 gtts/min

You would round the drip rate to the nearest whole number (31 gtts/min) to ensure accuracy and practicality. This calculation needs to be adjusted for electronic infusion pumps which automatically calculate flow rates, removing the need for manual drip rate calculation.

Intravenous therapy, while essential, carries potential complications. Careful technique and vigilant monitoring are key to minimizing risks.

• Infection: Adherence to aseptic technique during insertion and maintenance is crucial. Signs include redness, swelling, pain, and purulent drainage at the insertion site. Management includes removing the catheter, culturing the drainage, and initiating appropriate antibiotic therapy.
• Thrombophlebitis: Inflammation of the vein. Symptoms include pain, redness, swelling, and tenderness along the vein. Management involves removing the catheter and applying warm compresses.
• Infiltration and extravasation: As previously discussed, management involves removing the catheter and appropriate treatment for the extravasated substance.
• Air embolism: Introduction of air into the bloodstream. Prevention involves careful technique during fluid administration and appropriate handling of IV lines. Treatment may involve placing the patient in a left lateral Trendelenburg position (lying on their left side with their legs elevated) and administering oxygen.
• Fluid overload: Excessive fluid administration leading to edema, shortness of breath, and increased blood pressure. Management may involve slowing or stopping the infusion, administering diuretics, and monitoring vital signs.

Prevention strategies include proper patient assessment, meticulous aseptic technique, appropriate site selection, careful monitoring for signs of complications, and education of both the patient and their family members.

I have extensive experience with various IV fluids, each serving different purposes. The choice of fluid depends on the patient’s clinical condition and the specific therapeutic goals.

• Crystalloids (e.g., Normal Saline, Lactated Ringer’s): These are electrolyte solutions that readily distribute throughout the body’s fluid compartments. Normal saline is often used for fluid resuscitation in hypovolemic patients, while Lactated Ringer’s is preferred when replacing electrolytes lost through trauma or surgery. Imagine these like filling up a leaky bucket with water containing electrolytes to restore overall fluid balance.
• Colloids (e.g., Albumin, Dextran): These solutions contain larger molecules that stay within the intravascular space, increasing blood volume more effectively than crystalloids. They are often used in cases of severe hypovolemia or shock, holding onto fluid in the blood vessels more effectively than the crystalloids.
• Blood products (e.g., Packed Red Blood Cells, Fresh Frozen Plasma): Used to replace lost blood volume and components in cases of hemorrhage or anemia, replacing lost blood cells and clotting factors.
• Total Parenteral Nutrition (TPN): A complex mixture of nutrients administered intravenously to provide patients with complete nutritional support when they are unable to eat or absorb nutrients adequately. This is like providing a complete balanced nutritional meal directly into the bloodstream.

For example, a patient with severe dehydration might receive normal saline, while a patient with hypovolemic shock might require albumin or blood products. The selection is always based on the patient’s specific needs and the latest medical guidelines.

Maintaining aseptic technique during IV insertion and maintenance is paramount to preventing infection, a serious complication that can lead to prolonged hospitalization, increased healthcare costs, and even death. It’s about creating a sterile environment around the IV insertion site to minimize the chances of bacteria entering the bloodstream.

This involves:

• Strict hand hygiene: Thorough handwashing or the use of alcohol-based hand rubs before and after any interaction with the IV site or equipment.
• Use of sterile gloves: Gloves protect both the patient and healthcare provider from contamination.
• Proper antiseptic skin preparation: Using an appropriate antiseptic solution (e.g., chlorhexidine) to cleanse the insertion site before catheter insertion.
• Sterile technique during catheter insertion: Minimizing touching of the insertion site and catheter after disinfection.
• Use of sterile dressings and materials: All materials coming into contact with the insertion site must be sterile.
• Regular monitoring of the IV site: Checking for any signs of infection (redness, swelling, purulent drainage).
• Proper disposal of contaminated materials: All used materials must be disposed of according to the institution’s guidelines.

Imagine inserting an IV catheter as a surgeon performing an operation – the same level of care and meticulous technique should be applied to prevent infection. Even a seemingly minor lapse in technique can have significant consequences for the patient’s health.

Assessing IV line patency is crucial to ensure the medication or fluid is infusing correctly and not extravasating (leaking) into the surrounding tissue. We do this through a combination of visual inspection and physical assessment.

• Visual Inspection: Look for signs of infiltration such as swelling, redness, pain, or coolness at the insertion site. The IV fluid should infuse smoothly, without resistance. Observe the tubing for kinks or obstructions. A clear IV bag with no signs of leakage is also important.

• Physical Assessment: Gently palpate (feel) the IV site for any tenderness, hardness, or warmth. Flush the IV line with a small amount of saline solution; if there is resistance or the flush doesn’t flow freely, the line may be blocked. Observe for blood return when aspirating into the IV line (only done with peripheral lines, never central lines). A good blood return indicates patency.

Example: During a recent shift, I noticed slight swelling around an IV site. Upon palpation, the area felt cool and hard, indicating infiltration. I immediately stopped the infusion, removed the IV cannula, and applied a warm compress. I then documented the incident, notified the physician, and started a new IV in a different location.

Discontinuing an intravenous infusion requires careful attention to detail to prevent complications like bleeding or infection. The steps are as follows:

1. Turn off the infusion pump: This prevents further medication or fluid administration.

2. Remove the tape and dressing: Gently remove the tape and dressing securing the IV catheter to the patient’s arm.

3. Apply pressure: Using a sterile gauze pad, apply firm pressure to the insertion site for at least 2-3 minutes (longer if bleeding persists) to prevent hematoma formation.

4. Remove the catheter: Slowly and gently remove the catheter, pulling it straight out in one smooth motion. Never force it.

5. Assess the site: Check for bleeding. If bleeding occurs, continue applying pressure until it stops.

6. Apply a sterile dressing: Once bleeding has stopped, apply a new sterile dressing to the insertion site.

7. Document the procedure: Record the time and date of IV removal, the condition of the insertion site, and any observations.

Important Note: It is essential to follow established infection control protocols. We always adhere to meticulous hand hygiene and use sterile techniques throughout the procedure.

Managing an allergic reaction to intravenous medication is a critical situation requiring immediate action. Symptoms can range from mild (rash, itching) to severe (anaphylaxis, respiratory distress). The priority is to ensure patient safety and provide timely treatment.

• Immediately stop the infusion: This is the first and most important step. Removing the source of the allergen is paramount.

• Assess the patient’s condition: Monitor vital signs (heart rate, blood pressure, respiratory rate, oxygen saturation). Observe for signs of anaphylaxis, such as swelling of the face, lips, or tongue, difficulty breathing, and hypotension.

• Administer emergency medication: Based on the severity of the reaction, administer medications as per hospital protocols and physician orders. This might include administering epinephrine (adrenaline), antihistamines (e.g., diphenhydramine), corticosteroids (e.g., methylprednisolone), and bronchodilators (e.g., albuterol) as needed.

• Maintain airway: If respiratory distress occurs, provide supplemental oxygen and be prepared to assist with airway management (e.g., intubation).

• Monitor vital signs: Closely monitor vital signs throughout the emergency situation. Continuously reassess the patient’s condition.

• Notify physician: Immediately inform the physician of the allergic reaction and the measures taken.

Example: I once responded to a patient experiencing an anaphylactic reaction to an antibiotic. I immediately stopped the infusion, administered epinephrine, and summoned the rapid response team. The patient responded well to treatment and eventually stabilized.

Intravenous medication administration methods vary depending on the medication, patient condition, and facility protocols. Common methods include:

• Bolus injection: A rapid administration of medication directly into the vein. This method is used for medications that need to be delivered quickly, such as emergency medications.

• Intermittent infusion: Medication is administered over a short period, often through a secondary IV line connected to the primary infusion line. This allows flexibility in administering multiple medications.

• Continuous infusion: Medication is administered continuously over an extended period. This method is suitable for medications requiring constant blood levels.

• Piggyback infusion: A small volume of medication is administered through a secondary infusion set connected to the primary IV line. This method is commonly used in hospitals.

Example: A patient receiving chemotherapy might receive a continuous infusion of hydration fluids, with intermittent bolus injections of antiemetic medication.

Electronic infusion devices (EIDs) are essential in modern intravenous therapy, providing precise control and safety features. My experience with EIDs encompasses various models and their functionalities. I am proficient in programming infusion rates, volumes, and medication delivery schedules according to physician orders.

• Safety features: I am well-versed in using the alarm systems on EIDs to alert me to potential problems such as occlusion (blockage), air in the line, or low-battery warnings.

• Programmability: I am experienced in programming EIDs for different types of infusions, including continuous, intermittent, and bolus administrations. I am also proficient in setting up KVO (Keep Vein Open) rates.

• Maintenance: I know how to properly maintain and troubleshoot EIDs. This includes checking battery life, replacing infusion sets, and ensuring the devices are functioning correctly.

• Documentation: I accurately document all EID settings and any interventions.

Example: I recently used an EID to administer a precise dose of a vasoactive medication to a patient requiring careful hemodynamic management. The EID’s accuracy and alarm system ensured safe and effective medication delivery.

Intravenous fluid overload (IVO) occurs when the body receives more fluid than it can process, leading to potentially serious complications. Management involves:

• Slow or stop the IV infusion: The first step is often to reduce or stop the rate of intravenous fluid administration to prevent further fluid accumulation.

• Assess vital signs: Closely monitor vital signs, especially blood pressure, heart rate, and respiratory rate, for signs of heart failure or pulmonary edema.

• Elevate the head of the bed: This helps to improve breathing by reducing pressure on the lungs.

• Administer diuretics: A physician may order diuretic medications to help the body excrete excess fluid. These medications increase urine production, aiding in fluid removal.

• Monitor intake and output: Carefully monitor the patient’s fluid intake and urine output to assess the effectiveness of the treatment.

• Monitor for signs of pulmonary edema: This may include shortness of breath, crackles in the lungs, and increased respiratory rate.

• Supplemental Oxygen: Provide supplemental oxygen as necessary to assist with respiration

Example: I noticed a patient developing signs of IVO, including shortness of breath and increased heart rate. I immediately notified the physician, who ordered a diuretic and adjustments to the IV fluid rate.

Intravenous therapy carries significant legal and ethical considerations. These include:

• Informed consent: Patients must provide informed consent before any IV therapy is initiated. This ensures they understand the procedure, risks, and benefits.

• Right medication, right dose, right patient, right time, right route: Adhering to the “five rights” of medication administration is crucial to avoid medication errors.

• Documentation: Accurate and thorough documentation of all aspects of IV therapy is essential for legal protection and continuity of care.

• Infection control: Following strict infection control procedures is vital to minimize the risk of infection at the IV site. This includes proper hand hygiene, use of sterile equipment, and aseptic technique.

• Confidentiality: Maintaining patient confidentiality is a crucial ethical and legal responsibility.

• Patient safety: Prioritizing patient safety is paramount. This includes monitoring for adverse reactions, promptly addressing complications, and adhering to established protocols.

Example: Failure to obtain informed consent before starting an IV could lead to legal action. Similarly, neglecting to document the details of an IV infusion could compromise patient safety and potentially lead to errors.

Intravenous therapy documentation is crucial for patient safety and legal compliance. It needs to be precise, thorough, and readily accessible. My documentation always follows the facility’s established policies and procedures, and typically includes the following:

• Date and time of each intervention.
• Type of IV therapy administered (e.g., medication, fluids, blood).
• Specific medication or fluid, including dose, route, and rate.
• Site of insertion (e.g., right antecubital fossa).
• Catheter gauge and type (e.g., 20-gauge, over-the-needle catheter).
• Patient’s response to the therapy (e.g., any adverse reactions, pain levels).
• Assessment of the IV site (e.g., patency, signs of infiltration, infection).
• Any complications encountered and the actions taken.
• Initials and signature of the administering healthcare professional.

For example, if administering 1000ml of normal saline at 125ml/hr, I would document: ’10/26/2024 0800: 1000ml NS infusing at 125ml/hr via 20G IV in right antecubital fossa. Site patent, no signs of infiltration or infection.’

I have extensive experience with peripheral venous access, having successfully inserted thousands of IVs throughout my career. My approach emphasizes patient comfort and minimizing complications. This includes a thorough assessment of the patient’s veins, selecting the most appropriate site based on vein size, condition, and patient factors (e.g., age, medical conditions). I meticulously follow aseptic technique to prevent infection.

I’m proficient in various cannulation techniques and use different types of catheters, adapting my approach based on individual patient needs. For example, for elderly patients with fragile veins, I might opt for a smaller gauge catheter and a more superficial insertion site. I regularly assess the IV site for complications such as infiltration, phlebitis, and thrombophlebitis, implementing appropriate interventions as needed.

Inserting a central venous catheter (CVC) is a more complex procedure requiring advanced skills and knowledge. It involves inserting a catheter into a large vein, usually the subclavian, jugular, or femoral vein, and advancing it into the superior vena cava.

The process involves:

• Thorough patient assessment, including identifying contraindications and obtaining informed consent.
• Strict adherence to aseptic technique to minimize the risk of infection.
• Preparation of the insertion site with appropriate antiseptic.
• Local anesthesia to reduce patient discomfort.
• Insertion of the catheter using anatomical landmarks and fluoroscopy (often used for guidance).
• Confirmation of catheter placement via X-ray to ensure it’s in the correct position.
• Securement of the catheter with sutures and a sterile dressing.
• Post-insertion monitoring for complications such as pneumothorax, air embolism, or hematoma.

I’ve performed and assisted with numerous CVC insertions, always prioritizing patient safety and ensuring proper technique to reduce complications. Each insertion is documented meticulously.

Patient safety during intravenous therapy is paramount. My approach is multi-faceted and incorporates several key strategies:

• Strict adherence to aseptic technique during insertion and maintenance of the IV line. This dramatically reduces the risk of infection.
• Regular assessment of the IV site for complications such as infiltration, phlebitis, and thrombosis. Early detection allows for prompt intervention, minimizing harm.
• Patient education about the IV therapy, potential complications, and signs to watch for. Empowered patients are more likely to report problems promptly.
• Proper fluid and medication calculations to ensure accurate dosing and avoid medication errors.
• Use of appropriate infusion pumps to control the rate of infusion and prevent accidental bolus administration.
• Regular monitoring of vital signs and patient response to the therapy. This is critical for early detection of adverse reactions.
• Documentation of all interventions and observations, creating a comprehensive record of the therapy.

Think of it like building a house; a solid foundation (aseptic technique) is crucial, regular inspections (site assessments) prevent collapse, and a detailed blueprint (documentation) ensures everything is in order.

I have significant experience administering blood transfusions, adhering to strict protocols to ensure patient safety and efficacy. This includes:

• Verification of the blood product against the patient’s identification and blood type to prevent transfusion errors.
• Careful monitoring of vital signs before, during, and after the transfusion to detect any adverse reactions.
• Using proper transfusion techniques, including the use of blood warmers and appropriate filters to ensure safe and efficient delivery of the blood.
• Thorough documentation of the transfusion process, including the blood product’s details, the patient’s response, and any complications encountered.

I’ve successfully managed numerous blood transfusions, effectively responding to any challenges encountered, ensuring the patient receives the needed blood products safely.

Recognizing and responding to a blood transfusion reaction is crucial. Symptoms can range from mild (fever, chills, rash) to life-threatening (anaphylaxis, acute hemolytic reaction). My response involves:

• Immediate cessation of the transfusion. This is the first and most important step.
• Assessment of the patient’s condition, including vital signs, physical examination, and assessment of symptoms.
• Notification of the physician immediately and providing a concise report of the situation.
• Implementation of appropriate supportive care based on the type and severity of the reaction (e.g., oxygen administration, fluid resuscitation, medication administration).
• Collection of blood samples for further investigation to determine the cause of the reaction.
• Thorough documentation of the reaction, interventions, and patient’s response.

A calm and efficient response, with rapid communication, is essential in managing transfusion reactions and ensuring patient safety.

Selecting the appropriate vein for IV insertion is a critical skill that requires careful assessment. I consider several factors:

• Vein size and condition: Larger, straighter veins are generally preferred to minimize complications. I avoid veins that are fragile, tortuous, or sclerosed (hardened).
• Patient’s age and medical conditions: Elderly patients and those with underlying conditions may have less accessible veins, requiring a more delicate approach.
• Location of the vein: Antecubital veins in the forearm are generally preferred, followed by veins in the hand and wrist. Veins in the lower extremities are usually avoided due to increased risk of complications.
• Patient comfort and mobility: I always consider the patient’s comfort and mobility when selecting a vein. A more distal site can allow greater patient mobility.

I use palpation and visual inspection to assess the veins. My experience allows me to select the best vein quickly and efficiently, minimizing patient discomfort and risk of complications.

Managing patients with difficult IV access requires a systematic approach combining skill, patience, and appropriate technology. First, I thoroughly assess the patient’s vascular status, noting any previous IV attempts, presence of scarring, edema, or fragile veins. Then, I select the appropriate cannulation site, prioritizing veins in the non-dominant arm and avoiding areas of inflammation or trauma.

If initial attempts are unsuccessful, I may try different vein sizes, using smaller gauge catheters for smaller, fragile veins. I utilize techniques like applying warm compresses to dilate the veins and using a vein finder to improve visualization. If necessary, I’ll use ultrasound guidance for difficult cannulation, particularly in obese patients or those with limited venous access. If all else fails, I’ll consult with a vascular access specialist who can place a central venous catheter or PICC line.

For example, I recently encountered a patient with severe dehydration and extremely fragile veins. After several unsuccessful attempts using conventional methods, we successfully utilized ultrasound guidance to locate and cannulate a suitable vein, ensuring the patient received the necessary fluids.

My experience with Total Parenteral Nutrition (TPN) is extensive, encompassing preparation, administration, and monitoring. TPN is a specialized form of intravenous nutrition, providing complete nutrition for patients unable to consume sufficient calories orally or enterally. I am proficient in calculating daily nutritional requirements based on the patient’s individual needs, including calories, proteins, carbohydrates, lipids, electrolytes, vitamins and trace elements. This often involves close collaboration with a registered dietitian.

Before administration, I meticulously verify the TPN order against the patient’s medical record, checking for compatibility with other medications. I am experienced in the aseptic preparation of TPN solutions and am well-versed in the strict hygiene protocols to prevent contamination. Post-administration, I closely monitor the patient for any signs of complications such as hyperglycemia, hypoglycemia, electrolyte imbalances, or infection.

I remember a case where a patient requiring long-term TPN developed a central line-associated bloodstream infection. Through prompt recognition of symptoms like fever and chills, followed by immediate blood cultures and treatment with appropriate antibiotics, we were able to effectively manage the infection and prevent serious consequences. This highlighted the critical importance of strict adherence to infection control protocols in TPN administration.

Administering chemotherapy via IV requires meticulous attention to detail and adherence to strict safety protocols. My experience includes preparing and administering various chemotherapeutic agents, ensuring accurate dosage calculation and appropriate dilution. I’m familiar with different administration techniques, including bolus injections and continuous infusions, based on the specific chemotherapy regimen.

Before initiating treatment, I always verify the patient’s identity using at least two identifiers. I carefully check the medication order, including the drug, dose, route, and frequency against the patient’s medical record, and again against the prepared medication, a practice known as ‘double-checking’ or ‘two nurse check’. I assess the patient’s vital signs and hydration status before, during, and after the infusion. I closely observe for any adverse reactions such as allergic reactions or extravasation, and am prepared to provide immediate management and supportive care.

For example, I have administered various chemotherapeutic agents such as carboplatin, cisplatin, and paclitaxel, carefully adhering to established protocols and closely observing for any immediate or delayed adverse effects.

Handling chemotherapy drugs via IV necessitates stringent precautions to protect both the patient and healthcare personnel from exposure. This involves working under a biological safety cabinet (BSC) whenever preparing or handling these agents. Appropriate personal protective equipment (PPE) is critical, including gowns, gloves, masks, and eye protection. All procedures are carried out according to strict aseptic techniques to avoid contamination.

Spill kits are readily available and personnel are trained on proper spill management procedures in case of accidental spills. Chemotherapy waste is handled and disposed of according to guidelines to minimize environmental contamination. The importance of proper hand hygiene before and after every procedure cannot be overstated. Regular training and competency assessments ensure staff is up-to-date with current safety protocols.

A critical aspect is understanding the specific hazards of each chemotherapy agent and its potential side effects. This informs the precautions taken during handling and administration. For example, some chemotherapy drugs are vesicants, meaning they can cause severe tissue damage if extravasated. This necessitates careful cannulation and close monitoring during infusion to prevent extravasation.

Unexpected complications during IV therapy require prompt assessment and decisive action. Common complications include extravasation (leakage of fluid from the vein), phlebitis (inflammation of the vein), thrombophlebitis (blood clot formation in the vein), infiltration (leakage of fluid into surrounding tissue), air embolism, and infection. The first step is to immediately stop the infusion and assess the patient’s condition.

In case of extravasation, I would immediately discontinue the IV, elevate the affected limb, and apply a cold or warm compress depending on the medication infused (cold for vesicants, warm for others). For phlebitis, I would remove the IV catheter, apply warm compresses, and monitor the site for signs of infection. For infiltration, I would discontinue the infusion and potentially apply warm compresses and elevation. If an air embolism is suspected, I would immediately place the patient in the left lateral Trendelenburg position to trap air in the right atrium and notify the physician.

Documentation of the complication, the actions taken, and the patient’s response is crucial. The physician would be notified immediately, and further management, such as administering medication or calling for additional help, would be undertaken as necessary. Patient education on early signs and symptoms of complications is an essential part of proactive management.

Educating a patient about their IV therapy is crucial for their comfort, cooperation, and safety. The education should be tailored to the patient’s level of understanding and health literacy. I start by explaining the purpose of the IV therapy in simple terms, emphasizing the benefits and addressing any concerns.

I explain the procedure, including the sensation they might experience during insertion and the ongoing care required. I show them the IV line and explain its purpose and function. I provide clear instructions on reporting any pain, swelling, redness, or other symptoms at the IV site or any changes in their overall condition. I provide detailed information about the medication being administered, including its purpose, potential side effects, and any necessary precautions.

I emphasize the importance of proper hand hygiene and any restrictions or precautions they need to follow during IV therapy. I encourage them to ask questions and discuss any concerns they have. After the education, I provide them with written instructions, and make sure they understand and repeat back the instructions to ensure comprehension. For example, when explaining chemotherapy, I would emphasize the importance of managing side effects and explain the importance of keeping their doctor informed.

Maintaining infection control in intravenous therapy is paramount to patient safety. This involves adherence to strict aseptic techniques throughout the entire process, from hand hygiene to catheter insertion and dressing changes. Before initiating any IV therapy, I perform thorough hand hygiene using an alcohol-based hand rub or soap and water. I use sterile gloves, drapes, and equipment. The insertion site is cleaned with an antiseptic solution according to established guidelines.

Following insertion, the catheter is secured with a sterile dressing, changed according to institutional protocols, and carefully monitored for any signs of infection, such as redness, swelling, or purulent drainage. IV fluid bags are used only once and are discarded after use. The IV tubing is changed every 72 hours to reduce the risk of contamination. Regular assessment of the insertion site is critical in preventing infection.

In addition to these standard precautions, compliance with all other infection control procedures such as proper disposal of sharps, adherence to isolation protocols (if applicable), and regular surveillance for healthcare-associated infections are critical for maintaining a safe environment. Regular training and competency assessments ensure healthcare professionals maintain up-to-date knowledge and skills to minimise the risk of intravenous-associated infections.