ATI COMPREHENSIVE MEDS FOR
CARDIAC
1. COMPLICATIONS ASSOCIATED WITH IV INFUSION
A. Infiltration
i. Prevention
1. Use smallest catheter for prescribed therapy, stabilize port-access, assess blood
return
ii. Treatment
1. Stop infusion, remove peripheral catheters, apply cold compress, elevate
extremity, insert new catheter in opposite extremity
B. Extravasation
i. Prevention
1. Know vesicant potential before giving medication ii.
Treatment
1. Stop infusion, discontinue administration set, aspirate drug if possible, apply
cold compress, document condition of site (may photograph)
C. Phlebitis/thrombophlebitis
i. Prevention
1. Rotate sites every 72 to 96 hours, secure catheter, use
aseptic technique; for PICCs, avoid excessive activity
with the extremity
ii. Treatment
1. Stop infusion, remove peripheral IV catheters, apply heat compress, insert new
catheter in opposite extremity
D. Hematoma
i. Prevention
1. Avoid veins not easily seen or palpated; obtain hemostasis after
insertion ii. Treatment
1. Remove IV device and apply light pressure if bleeding; monitor for signs of
phlebitis and treat
E. Catheter embolus
i. Prevention
1. Do not reinsert stylet needle into catheter
ii. Treatment
, 1. Immediately apply tourniquet high on extremity to limit venous flow
2. Prepare for removal under x-ray
2. COMPLICATIONS ASSOCIATED WITH CENTRAL VENOUS CATHETERS
A. Pneumothorax (during insertion)
i. Prevention
1. Use ultrasound to locate veins, avoid subclavian insertion when possible
ii. Treatment
1. Administer oxygen, assist provider with chest tube insertion
B. Air embolism
i. Prevention
1. Have client lie flat when changing administration set or needleless
connectors, ask client to perform Valsalva maneuver if possible
ii. Treatment
1. Place client in left lateral Trendelenburg, administer oxygen
C. Lumen occlusion
i. Prevention
1. Flush promptly with
NS between, before, and after
each medication ii. Treatment
1. Use 10 mL syringe with a pulsing motion
D. Bloodstream infection
i. Prevention
1. Maintain sterile
technique ii. Treatment
1. Change entire infusion system, notify provider, obtain cultures, and administer
antibiotics
3. COMPLICATIONS ASSOCIATED WITH PICC LINE
A. Catheter occlusions
i. Prevent kinks, reposition arm, confirm blood return, flush catheter between
medications, administer approved antithrombolytic
B. Catheter dislodges
i. Assess blood return, discomfort in jaw, chest, or ear, contact provider
C. Phlebitis
2
CARDIAC
1. COMPLICATIONS ASSOCIATED WITH IV INFUSION
A. Infiltration
i. Prevention
1. Use smallest catheter for prescribed therapy, stabilize port-access, assess blood
return
ii. Treatment
1. Stop infusion, remove peripheral catheters, apply cold compress, elevate
extremity, insert new catheter in opposite extremity
B. Extravasation
i. Prevention
1. Know vesicant potential before giving medication ii.
Treatment
1. Stop infusion, discontinue administration set, aspirate drug if possible, apply
cold compress, document condition of site (may photograph)
C. Phlebitis/thrombophlebitis
i. Prevention
1. Rotate sites every 72 to 96 hours, secure catheter, use
aseptic technique; for PICCs, avoid excessive activity
with the extremity
ii. Treatment
1. Stop infusion, remove peripheral IV catheters, apply heat compress, insert new
catheter in opposite extremity
D. Hematoma
i. Prevention
1. Avoid veins not easily seen or palpated; obtain hemostasis after
insertion ii. Treatment
1. Remove IV device and apply light pressure if bleeding; monitor for signs of
phlebitis and treat
E. Catheter embolus
i. Prevention
1. Do not reinsert stylet needle into catheter
ii. Treatment
, 1. Immediately apply tourniquet high on extremity to limit venous flow
2. Prepare for removal under x-ray
2. COMPLICATIONS ASSOCIATED WITH CENTRAL VENOUS CATHETERS
A. Pneumothorax (during insertion)
i. Prevention
1. Use ultrasound to locate veins, avoid subclavian insertion when possible
ii. Treatment
1. Administer oxygen, assist provider with chest tube insertion
B. Air embolism
i. Prevention
1. Have client lie flat when changing administration set or needleless
connectors, ask client to perform Valsalva maneuver if possible
ii. Treatment
1. Place client in left lateral Trendelenburg, administer oxygen
C. Lumen occlusion
i. Prevention
1. Flush promptly with
NS between, before, and after
each medication ii. Treatment
1. Use 10 mL syringe with a pulsing motion
D. Bloodstream infection
i. Prevention
1. Maintain sterile
technique ii. Treatment
1. Change entire infusion system, notify provider, obtain cultures, and administer
antibiotics
3. COMPLICATIONS ASSOCIATED WITH PICC LINE
A. Catheter occlusions
i. Prevent kinks, reposition arm, confirm blood return, flush catheter between
medications, administer approved antithrombolytic
B. Catheter dislodges
i. Assess blood return, discomfort in jaw, chest, or ear, contact provider
C. Phlebitis
2
