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IV Therapy (week 4): Complications


started with a quiz

ecchymosis/hematoma = localized mass of blood outside vessel wall--discoloration at site, swelling, discomfort
may occur during insertion, we use 24 gage needles, happens more with larger needles
speed of insertion matters
aspirin irreversibly inhib plt activation, plt life 7 days, acetomenophen reversible
steroids are catabolic, causes incr metab of protein, need aa's for gluconeogenesis, chews up skin
wasting dz
folding arm after needle removal doesn't help, may disrupt plt plug
speed of removal during butterly also influences

infiltration = seepage of non-vesicant IV fluid/meds into surrounding tissue, coolness of skin around site, taut skin, edema, pain, backflow absent, infusion rate slow but continues
mbdt puncture of posterior wall of vein, happens, saw flash but nothing goes in
use back of hand to assess skin temp

vesicant = relates to blister/vesicle, substance that is capable of causing tissue damage, colchicine is the only one she has mentioned

nonvesicant = won't cause tissue damage, blister, necrosis, etc, physiologic saline, most IV vits and minerals are in this category

catheter embolism = plastic tip shears off inside vein, occurs with over-the-needle catheter systems when part of the catheter becomes nicked and hsears off, resulting in sudden sharp pain at the IV site, cyanosis, weak rapid pulse
she's never seen one
catheters are radiopaque so they can be located by plain film
tx: tourniquette and transport, she says she'd do two tourniquettes, also uses for very shy veins to start iv
at hospital may do cut down, vasc surgeon removes catheter tip

extravasation = infiltration of a med into tissue-->edema, blisters, sloughing, necrosis, pain, burning, infusion stop/slowed, skin blanched or cool
colchicine = vesicant solution, def dmgs tissue, we're no longer allowed to use it
never get last bit, some in needle bore on removal
irritant solution under skin become evident immediately
ray gel is product used to obviate adverse effects on skin
aloe vera leaf juice works, process a bit messy, works for radiation burns too
tx: possibly apply cold, depends on how serious it is, may need ER for tissue irrigation

air embolism = air introducted into vasc sys goes to R vent and lodges vsthe pulm valve, blocks flow of blood from ventirclas into pulm aa->palpitations, light-headedness, weakness, pulm changes, CV changes, neuro impairment

precautionary principle = ? test chem before using to know what it will do, rather than just distributing anything you can make

thrombosis = trauma to ECs of vein-->plt adhesion, clot, pain, warm, slugg/no infusion, or site may appear ok
more with dehydration
nattokinase = naturopathic clot buster
avoid cannulation of lower extremities, they're more likely to clot

phlebitis = inflam of the intima of the vein dt mech, chem or bact infx-->redness, swelling, palpable vein cord, warmth, slugging infusion rate, incr temp
more with hyperosmolar solution ie high dose vit C, osmolarity 1050 on some IVs
285 is normal blood osmolarity
more with acidic solutions, an immune formula burned her-->blowtorch sensation in vein
pH was 4.5, they added sodium bicarb to bag
inflam-->thrombus-->embolus risk

allergic rxn = hypersensitivity to IV solution or material used for infusing solutions-->itching, rash, tachypnea/SOB, tachycardia

venous spasm = pain during insertion of IV and during or after infusion, difficulty locating vein after insertionn of over-the-needle catheter, pain at site
she has encountered a few times, just pause, take a breath

circ overload = infusion of excessive amounts of iso or hypertonic solution-->tachypnea, sob, edema puffy eyelids, htn, wt gain, wide variance of intake and output of fluid, distended neck veins, rise in venous pressure

speed shock = when foreign substance usu meds rapidly introduced to circ-->dizzy, ha, tight chest, hypotension, irreg pulse or bradycardia

septicemia = systemic infx

rushed through last few

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