Regodos IV Theraphy Quiz

REGODOS, JULIUD IAN CYRUS G.
IV THERAPHY QUIZ
CASE SCENARIO: Mr. OS is a 79 year old male who has been admitted to the General Medical Unit
(GMU) with the diagnosis of a GI bleed. He has had a single lumen PICC placed in his upper left arm
basilic vein and he is currently receiving the first of 2 units of packed red blood cells (PRBC).
1. Compare and contrast a central line and a peripheral IV. (10)
CENTRAL LINE PERIPHERAL LINE
1. A central venous catheter, also known as a 1. A peripheral IV line (PIV, or just “IV”) is a short
central line, central venous line, or central venous catheter that's typically placed in the forearm. It
access catheter, is a catheter placed into a large starts and ends in the arm itself. A PICC line is a
vein. It is a form of venous access. longer catheter that's also placed in the upper
arm.
2. Indicated for Fluid resustication, Drug Infusion
and central venous pressure monitoring. 2. Used for therapeutic purposes such as
administration of medications, fluids and/or blood
3. Usually days to week of use products as well as blood sampling.
3. Usually lasts for several weeks
2. What does PICC stand for? Is a PICC considered a central line or a peripheral line? (5)
PICC - Peripherally Inserted Central Cathether. PICC is considered a Central Line.
3. List at least 5 basis to consider with site selection of PICC. (5)
3.1. Use a vein in the non-dominant arm if possible
3.2. Use most distal sites so you can move proximally as needed
3.3. Assess the patient’s condition, vein condition, vein size and location, patient age, and the type and
duration of therapy to insure ideal and safe IV.
3.4. Avoid antecubital fossa
3.5. Avoid previously used puncture sites.

4. List recommendations of sites to avoid when starting a peripheral IV line (5)
4.1. Skin Grafts
4.2. Fistulas
4.3 Edematous sites
4.4. Sites with Hematoma
4.5 Scarred Tissues
5. What supplies/materials will you need to take with you to insert Mr. OS’ new peripheral IV? (10)
Antiseptic solution
Gloves
Tourniquet
Peripheral short catheter
Sterile 2x2 gauze pads or a sterile, transparent, semi-permeable dressing
1" non-allergenic tape (if applying a gauze dressing)
Sterile tape or sterile surgical strips or a manufactured securing device
Flush solution (.9% sodium chloride, 20 milliliter vial, preservative-free
Flush syringes (3-5 milliliter size)
Sharps container
IV solution with attached, primed tubing (if ordered) or an already primed saline or heparin lock
IV pole (for administration of fluids or IV medications if needed)
6. List three Gerontologic Considerations when starting an IV on an elderly patient. (3)
A. Fragile veins may cause infiltration immediately upon catheter insertion.
B. Immobilize the catheter well to prevent movement, which may cause skin tears.
C. The Nurse should use the back of the hand for the IV line.
7. How long do you need to let the site dry after you have cleaned it? (3)
Less than 30 seconds
8. Enumerate nursing interventions on how will you treat the following IV therapy complications:
(3 points per letter)
a. Phlebitis - is an inflammation of a vein. Treatment of phlebitis consists of discontinuing the IV line and
restarting in another site, and applying warm compress to the affected site.
b. Infiltration - if infiltration occurs the infusion should be stopped, the IV cathether discontinued and a
sterile dressing is applied to the site after careful inspection to determine the extent of infiltration.
c. Air embolism - treatment is immidiately clamping the cannula and replacing a leaking infusion system,
placing the patient on the left side in Trendelenberg position. Assess VS, breathe sounds and
administering oxygen.
d. Extravasation - removal of the cannula and stop the infusion. Apply warm compress for alkaloids, cold
compress for alkylating and antibiotic vesicants.
9. During a venipuncture procedure a sudden swelling occurs around the puncture site, what will be
your actions? (3)
If this occurs, discontinue the procedure and select another suitable site for venipuncture, apply warm,
moist compress to the affected site.
10. List at least 4 guidelines for proper and safe ‘Flushing’ in maintaining patent IV line. (4)
10.1. Use aseptic non touch techniques including cleaning the access port (scrub the hub) with a dual
disinfectant agent (e.g. chlorhexidine and alcohol) vigorously for at least 15 seconds and allowing to dry
prior to accessing the system.
10.2.Flush in a pulsatile (push-pause) motion.
10.3. Use normal saline when flushing.
10.4 Flush catheters:

A. Immediately after placement
B. Prior to and after fluid infusion (as an empty fluid container lacks infusion pressure and will allow
blood reflux into the catheter lumen from normal venous pressure) or injection.
C. Prior to and after blood drawing.

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REGODOS, JULIUD IAN CYRUS G.

1. Compare and contrast a central line and a peripheral IV. (10)

CENTRAL LINE PERIPHERAL LINE

3. Usually lasts for several weeks

PICC - Peripherally Inserted Central Cathether. PICC is considered a Central Line.

3. List at least 5 basis to consider with site selection of PICC. (5)

3.1. Use a vein in the non-dominant arm if possible

3.4. Avoid antecubital fossa

3.5. Avoid previously used puncture sites.

4.1. Skin Grafts

4.3 Edematous sites

4.4. Sites with Hematoma

4.5 Scarred Tissues

Peripheral short catheter

Sterile 2x2 gauze pads or a sterile, transparent, semi-permeable dressing

1" non-allergenic tape (if applying a gauze dressing)

Sterile tape or sterile surgical strips or a manufactured securing device

Flush solution (.9% sodium chloride, 20 milliliter vial, preservative-free

Flush syringes (3-5 milliliter size)

IV pole (for administration of fluids or IV medications if needed)

6. List three Gerontologic Considerations when starting an IV on an elderly patient. (3)

A. Fragile veins may cause infiltration immediately upon catheter insertion.

Less than 30 seconds

(3 points per letter)

10.2.Flush in a pulsatile (push-pause) motion.

10.3. Use normal saline when flushing.

10.4 Flush catheters:

C. Prior to and after blood drawing.

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