2. Objectives Enumerate the kinds of intravenous therapy complications. Identify the types of each kind of intravenous therapy complications and describe them according to the following: Definition Causes Signs & Symptoms Nursing Interventions
12. Nursing Interventions Remove the device Apply warm soaks to aid absorption Elevate the limb Notify the doctor if severe Assess circulation Restart the infusion Document the patient's condition and your interventions
13. Prevention Check the I.V site frequently Don't obscure area above site with tape Teach the patient to report discomfort, pain, swelling
44. Cause Injury to endothelial cells of vein wall, allowing platelets to adhere and thrombus form
45. Nursing Interventions Remove the device; restart the infusion in the opposite limb if possible Apply warm soaks Watch for I.V therapy – related infection
48. Infusions allowed to continue after thrombophlebitis develops will slow and eventually stop, indicating progression to an obstructive thrombophlebitis.
72. Pulmonary Embolism It associated with venous access devices is usually the result of a thrombus that has become detached from the wall of the vein. It is carried by the venous circulation to the right side of the heart and then into the pulmonary artery. Circulatory and cardiac abnormalities are caused by full or partial obstruction of the pulmonary artery, with possible progression to pulmonary hypertension and right-sided heart failure.
73. Air Embolism Occurs most frequently with the use of central venous access devices. Occur with the insertion of an IV catheter, during manipulation of the catheter or catheter site when the device is removed, or when IV lines associated with the catheter are disconnected.
74. Catheter Embolism This can occur during the insertion of a catheter if appropriate placement techniques are not strictly adhered to. The tip of the needle used during the placement of the catheter can shear off the tip of the catheter. The catheter tip then becomes a free-floating embolus. This can occur with both over-the-needle and through-the-needle catheters. If this happens, cardiac catheterization may be required to remove the embolus.
75. Signs & Symptoms Sudden vascular collapse with the hallmark symptoms of cyanosis, hypotension, increased venous pressures, and rapid loss of consciousness. Respiratory distress Unequal breath sounds Weak pulse
76. Causes Empty solution container Solution container empties; next container pushes air down line Tubing disconnected from venous access device or I.V bag
77. Nursing Interventions Discontinue the infusion Place the patient in Trendelenburg position on his left side to allow air to enter the right atrium and disperse through the pulmonary artery. Administer oxygen Notify the doctor Document the patient's condition and your interventions.
89. Causes Failure to maintain aseptic technique during insertion or site care Severe phlebitis, which can set up ideal conditions for organisms growth Poor taping Prolonged indwelling time of device Immunocompromised patient
90. Nursing Interventions Notify the doctor. Administer medications as prescribed Culture the site and the device Monitor the patient's vital signs
91. Prevention Use scrupulous aseptic technique Secure all connections Change I.V solutions, tubing and venous access device at recommended times Use I.V filters
113. Nursing Interventions Raise the head of the bed Slow the infusion rate Administer oxygen as needed Notify the doctor Administer medications as ordered
