NURSING 1025 EXAM 2 STUDY GUIDE
Introduction to Intravenous Therapy
Ch. 41
1. Nursing knowledge base
a. Fluid and electrolyte imbalances can severely affect infants, as well as the severely
ill, disoriented, or immobile.
b. Prolonged or severe compromises may lead to irreversible chronic health problems.
2. Physical Assessment
a. Daily weights
b. Intake and output
c. Laboratory studies
3. Nursing Diagnosis
a. Critical thinking must be used when suspected fluid, electrolyte, and acid-base
imbalances occur.
i. Skin integrity issues, fluid overload or deficit
b. Use NANDA-I–approved list of nursing diagnoses.
4. Implementation
a. Enteral replacement of fluids
b. Restriction of fluids
c. Parenteral replacement of fluids
d. Total parenteral nutrition
e. Evaluation
5. IV Therapy
a. Crystalloids
b. Vascular access devices
c. Types of solutions
6. Initiation of IV Therapy
a. Equipment
b. Venipuncture
c. Regulating fluid
d. Maintaining the system
e. Complications
7. Types of IV Fluids
a. Three main types of IVF:
i. Isotonic fluids
ii. Hypotonic fluids
iii. Hypertonic Fluids
8. Role of the Nurse
a. Initiating intravenous therapy
i. Preparing the client
ii. Selecting the site most distal
iii. Preparing the site
iv. Performing the venipuncture
v. Securing the venipuncture device
9. Role of the Nurse
a. Maintaining intravenous infusions
i. Monitoring and documentation
ii. Changing dressings and tubing (per CDC recommendations of 72-96
hours)
iii. Changing intravenous solutions (solutions every 24 hours)
iv. Intermittent flushing of an intravenous lock
v. KVO rate “Keep veins open”
10. Phlebitis (inflammation of vein)
, 11. Role of the Nurse Never Delegate IV
a. Discontinue an intravenous infusion: When all ordered fluids have infused or when
complications develop
b. Inspect the integrity of the catheter after removal
c. Document!!
12. Peripheral Lines
a. Short or intermittent use
b. Arm, hand
c. Start low so you can move up!
d. Non-dominant hand preferable
e. Choose the site that:
i. Meets the patient’s needs for meds and fluids
ii. Keeps patient comfortable and functioning
f. Size: 14G -24G
g. Midline catheters (Not a central line)
13. Assessing Peripheral Veins:
a. Back of the hand: Dorsal basilic or cephalic vein permits movement of arm,
ambulation
b. Forearm: Basilic or cephalic veins are stable, allow for limb movement, mobility
c. Antecubital fossa : Median basilic & median cephalic veins are large, usu.
visible,palpable, & accessible. Site may be uncomfortable for the patient-May be
difficult to bend arm
i. ***Avoid Antecubital area, and put in the non dominant hand.
14. Veins of the Upper Extremities
a. Cephalic
i. BEWARE of radial artery/nerve
b. Medial Cephalic
i. Joins the Cephalic below the elbow bend
ii. Larger gauge catheters, but may be a difficult angle to hit and maintain
Introduction to Intravenous Therapy
Ch. 41
1. Nursing knowledge base
a. Fluid and electrolyte imbalances can severely affect infants, as well as the severely
ill, disoriented, or immobile.
b. Prolonged or severe compromises may lead to irreversible chronic health problems.
2. Physical Assessment
a. Daily weights
b. Intake and output
c. Laboratory studies
3. Nursing Diagnosis
a. Critical thinking must be used when suspected fluid, electrolyte, and acid-base
imbalances occur.
i. Skin integrity issues, fluid overload or deficit
b. Use NANDA-I–approved list of nursing diagnoses.
4. Implementation
a. Enteral replacement of fluids
b. Restriction of fluids
c. Parenteral replacement of fluids
d. Total parenteral nutrition
e. Evaluation
5. IV Therapy
a. Crystalloids
b. Vascular access devices
c. Types of solutions
6. Initiation of IV Therapy
a. Equipment
b. Venipuncture
c. Regulating fluid
d. Maintaining the system
e. Complications
7. Types of IV Fluids
a. Three main types of IVF:
i. Isotonic fluids
ii. Hypotonic fluids
iii. Hypertonic Fluids
8. Role of the Nurse
a. Initiating intravenous therapy
i. Preparing the client
ii. Selecting the site most distal
iii. Preparing the site
iv. Performing the venipuncture
v. Securing the venipuncture device
9. Role of the Nurse
a. Maintaining intravenous infusions
i. Monitoring and documentation
ii. Changing dressings and tubing (per CDC recommendations of 72-96
hours)
iii. Changing intravenous solutions (solutions every 24 hours)
iv. Intermittent flushing of an intravenous lock
v. KVO rate “Keep veins open”
10. Phlebitis (inflammation of vein)
, 11. Role of the Nurse Never Delegate IV
a. Discontinue an intravenous infusion: When all ordered fluids have infused or when
complications develop
b. Inspect the integrity of the catheter after removal
c. Document!!
12. Peripheral Lines
a. Short or intermittent use
b. Arm, hand
c. Start low so you can move up!
d. Non-dominant hand preferable
e. Choose the site that:
i. Meets the patient’s needs for meds and fluids
ii. Keeps patient comfortable and functioning
f. Size: 14G -24G
g. Midline catheters (Not a central line)
13. Assessing Peripheral Veins:
a. Back of the hand: Dorsal basilic or cephalic vein permits movement of arm,
ambulation
b. Forearm: Basilic or cephalic veins are stable, allow for limb movement, mobility
c. Antecubital fossa : Median basilic & median cephalic veins are large, usu.
visible,palpable, & accessible. Site may be uncomfortable for the patient-May be
difficult to bend arm
i. ***Avoid Antecubital area, and put in the non dominant hand.
14. Veins of the Upper Extremities
a. Cephalic
i. BEWARE of radial artery/nerve
b. Medial Cephalic
i. Joins the Cephalic below the elbow bend
ii. Larger gauge catheters, but may be a difficult angle to hit and maintain
