ADVANCED IV THERAPY UPDATED
ACTUAL Exam Questions and
CORRECT Answers
IV THERAPY COMPLICATIONS REVIEW - CORRECT ANSWER - 1. Hematoma
2. Thrombosis
3. Phlebitis
4. Infiltration
5. Extravasation
6. Sepsis
7. Speed Shock
1. HEMATOMA - CORRECT ANSWER - Occurs during IV start or needle stick for blood
draw
Needle goes through vein, slices top
Action:
-Remove needle/catheter
-Remove tourniquet
-Apply direct pressure
-Don't reapply tourniquet
2. THROMBOSIS - CORRECT ANSWER - Leading cause of catheter occlusion
Fibrin threads occlude catheter
-Partial occlusion: May flush easily, but not able to aspirate blood return
-May totally occlude
*Risks* =
,-Small catheter lumen
-Catheter in area of flexion
-Flow controlled by gravity
*Prevention* =
-Avoid putting IV in area of flexion
-Frequent site assessment
-Flush saline locks regular per protocol
-Administer infusions timely
-Use of infusion pumps
-For gravity flow control, use microdrip tubing to maintain potency flow
*Treatment* =
-DO NOT flush totally occluded lines - can result in clot embolization
-Peripheral line: Infusing well, yet no blood return, may not be thrombosed - may use, but watch
for increased occlusion. D/C if occluded, red, painful
-Central line: Agency protocols for "clot busting"
3. PHLEBITIS - CORRECT ANSWER - Detection = redness, tenderness, induration
(starts @ catheter tip).
Proceeds upward along course of vein
-Mechanical causes: Catheter rubs endothelium
-Catheter too large for vein
-Hub not well-secured
-IV in area of flexion
*Chemical Phlebitis* =
-Hypertonic solutions
-Irritating medications: KCl, some ABX, chemo
, -Inadequate dilution of meds
*Prevention* =
-Avoid flexion areas for starts
-Anchor hub securely
-Use central line for irritating infusions
-Proper dilution of IV meds - request from pharmacy PRN
-Slow rate if complains of pain - plan to rotate IV sites ASAP
*Treatment* =
-D/C IV catheter
-Initially apply cold therapy to decrease intradermal skin toxicity for 45 min
-Apply cold or warm therapy per patient comfort/toleration
-Notify MD if serious and monitor for infection
4. INFILTRATION - CORRECT ANSWER - Solution goes into tissue instead of vein
*Causes* =
-Catheter becomes dislodged
-Vein integrity impaired:
Insertion point enlarges, allowing leakage
Catheter rubs
Too rapid infusion creates too high pressure
*Detection* =
-Gravity infusion slows or stops
-Pump gives occlusion alarm
-No blood return or pinkish return
ACTUAL Exam Questions and
CORRECT Answers
IV THERAPY COMPLICATIONS REVIEW - CORRECT ANSWER - 1. Hematoma
2. Thrombosis
3. Phlebitis
4. Infiltration
5. Extravasation
6. Sepsis
7. Speed Shock
1. HEMATOMA - CORRECT ANSWER - Occurs during IV start or needle stick for blood
draw
Needle goes through vein, slices top
Action:
-Remove needle/catheter
-Remove tourniquet
-Apply direct pressure
-Don't reapply tourniquet
2. THROMBOSIS - CORRECT ANSWER - Leading cause of catheter occlusion
Fibrin threads occlude catheter
-Partial occlusion: May flush easily, but not able to aspirate blood return
-May totally occlude
*Risks* =
,-Small catheter lumen
-Catheter in area of flexion
-Flow controlled by gravity
*Prevention* =
-Avoid putting IV in area of flexion
-Frequent site assessment
-Flush saline locks regular per protocol
-Administer infusions timely
-Use of infusion pumps
-For gravity flow control, use microdrip tubing to maintain potency flow
*Treatment* =
-DO NOT flush totally occluded lines - can result in clot embolization
-Peripheral line: Infusing well, yet no blood return, may not be thrombosed - may use, but watch
for increased occlusion. D/C if occluded, red, painful
-Central line: Agency protocols for "clot busting"
3. PHLEBITIS - CORRECT ANSWER - Detection = redness, tenderness, induration
(starts @ catheter tip).
Proceeds upward along course of vein
-Mechanical causes: Catheter rubs endothelium
-Catheter too large for vein
-Hub not well-secured
-IV in area of flexion
*Chemical Phlebitis* =
-Hypertonic solutions
-Irritating medications: KCl, some ABX, chemo
, -Inadequate dilution of meds
*Prevention* =
-Avoid flexion areas for starts
-Anchor hub securely
-Use central line for irritating infusions
-Proper dilution of IV meds - request from pharmacy PRN
-Slow rate if complains of pain - plan to rotate IV sites ASAP
*Treatment* =
-D/C IV catheter
-Initially apply cold therapy to decrease intradermal skin toxicity for 45 min
-Apply cold or warm therapy per patient comfort/toleration
-Notify MD if serious and monitor for infection
4. INFILTRATION - CORRECT ANSWER - Solution goes into tissue instead of vein
*Causes* =
-Catheter becomes dislodged
-Vein integrity impaired:
Insertion point enlarges, allowing leakage
Catheter rubs
Too rapid infusion creates too high pressure
*Detection* =
-Gravity infusion slows or stops
-Pump gives occlusion alarm
-No blood return or pinkish return
