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Advanced Clinical Examination: Cardiovascular, Pulmonary, Renal, Gastrointestinal, Neurological, Urological, Endocrine, Hematologic, Immunologic, Infectious, Oncologic, Pharmacologic, Diagnostic Imaging, Surgical Interventions, Patient Assessment, Pathoph

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Advanced Clinical Examination: Cardiovascular, Pulmonary, Renal, Gastrointestinal, Neurological, Urological, Endocrine, Hematologic, Immunologic, Infectious, Oncologic, Pharmacologic, Diagnostic Imaging, Surgical Interventions, Patient Assessment, Pathophysiology, Risk Factors, Lab Interpretation, Medication Management, IV Therapy, Electrolyte Balance, Pain Management, Preoperative/Postoperative Care, Chronic Disease Management, Preventive Health, Rehabilitation, Neuromuscular Disorders, Autoimmune Conditions, Genetic Disorders, Hormonal Dysregulation, Cardiopulmonary Resuscitation, Fluid Volume Management, Patient Safety, Health Promotion Exam Questions Verified and Provided with Complete A+ Graded Rationales Latest Updated 2026 What size catheter is the best for this pt and this situation? 20 and 22 gauge - bigger the gauge the smaller the lumen If you use the largest gauge it can cause phlebitis because the lumen is bumping on the side of the veins and causing irritation if they need emergency surgery then they need a 20 gauge so the large red blood cells can move smoother and faster through the lumen How long is it going to stay in? 4 days How long are they going to need the IV? Would it be more efficient to put a central line in? Instead of re-sticking them every 4 days. Assessment Age- the older the pt is the smaller the veins are Type and duration of therapy- what is going in and how long and what its used for Corticosteroid use- soldumetrol - Weakens the walls of the veins and a purple bloom or splotch will be on the arm. - use a smaller lumen Hydration status- dehydrated- vein shrinks and flattens - make pt eating drink a lot during breakfast to help the veins Condition of veins- some veins get hard Right or left handed- try to get the arm they don't use as much so that the IV doesn't get dislodged. Are you allergic to iodine?-if using iodine ask if allergy to iodine or shellfish Sites Antecubital space - try to avoid because the pt will bend the arm a lot and can kinked easier Forearm- The straightest, most distal vein is best!- bc There are not joints that get in the way- ALWAYS be able to feel it with eyes closed. IF YOU CANT FEEL IT DONT STICK IT!!!!! And as the pt needs more IV's go more proximal by each one. —1 inch long of the same vein Hands- veins closest to the surface- these hurt more bc there are more nerve endings Other possibilities (only with an MD order) Scalp (babies) Feet and Legs (only if absolutely necessary, can cause blood clots)- farthest away from the heart- Sites to Avoid Bony prominences Antecubital space Bend of wrist Valve locations- where is the valve? It feels like a bump. Gather Equipment Tourniquet (can use a BP cuff) Alcohol and Betadine (this is a clean/sterile procedure) OR, chlorhexadine (now in most IV start kits.) IV catheters (bring in 2) Tubing or saline lock adapter (also called a prn adapter) Tape and sterile dressing (clear, occlusive dressing)- tegaderm so u can see the site day after day. Saline for priming saline lock and for flushing Catheter (Cannula) Size The smaller the catheter, the better. They cause less irritation.

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Advanced Clinical Examination: Cardiovascular, Pulmonary, Renal,
Gastrointestinal, Neurological, Urological, Endocrine, Hematologic,
Immunologic, Infectious, Oncologic, Pharmacologic, Diagnostic
Imaging, Surgical Interventions, Patient Assessment, Pathophysiology,
Risk Factors, Lab Interpretation, Medication Management, IV Therapy,
Electrolyte Balance, Pain Management, Preoperative/Postoperative
Care, Chronic Disease Management, Preventive Health,
Rehabilitation, Neuromuscular Disorders, Autoimmune Conditions,
Genetic Disorders, Hormonal Dysregulation, Cardiopulmonary
Resuscitation, Fluid Volume Management, Patient Safety, Health
Promotion Exam Questions Verified and Provided with Complete A+
Graded Rationales Latest Updated 2026

What size catheter is the best for this pt and this situation?

20 and 22 gauge - bigger the gauge the smaller the lumen



If you use the largest gauge it can cause phlebitis because the lumen is bumping on the side of the veins
and causing irritation



if they need emergency surgery then they need a 20 gauge so the large red blood cells can move
smoother and faster through the lumen




How long is it going to stay in?

4 days



How long are they going to need the IV? Would it be more efficient to put a central line in? Instead of re-
sticking them every 4 days.

, Assessment

Age- the older the pt is the smaller the veins are



Type and duration of therapy- what is going in and how long and what its used for



Corticosteroid use- soldumetrol - Weakens the walls of the veins and a purple bloom or splotch will be
on the arm. - use a smaller lumen



Hydration status- dehydrated- vein shrinks and flattens - make pt eating drink a lot during breakfast to
help the veins



Condition of veins- some veins get hard



Right or left handed- try to get the arm they don't use as much so that the IV doesn't get dislodged.



Are you allergic to iodine?-if using iodine ask if allergy to iodine or shellfish




Sites

Antecubital space - try to avoid because the pt will bend the arm a lot and can kinked easier



Forearm- The straightest, most distal vein is best!- bc There are not joints that get in the way- ALWAYS
be able to feel it with eyes closed. IF YOU CANT FEEL IT DONT STICK IT!!!!!



And as the pt needs more IV's go more proximal by each one.



—1 inch long of the same vein




Hands- veins closest to the surface- these hurt more bc there are more nerve endings

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