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Complications of PIV

QuestionAnswer
Define infiltration. Leakage of non‑vesicant IV fluid/med into surrounding tissue.
3 classic signs of infiltration. Swelling/tightness cool or blanching skin/redness decreased flow rate or occlusion alarms.
First action at first sign of infiltration. Stop infusion remove device elevate limb warm/cool compress per solution restart IV at a new site with new tubing.
Two prevention tips for infiltration. Avoid areas of flexion secure catheter and verify patency before infusing.
Define extravasation. Leakage of a vesicant into tissue → risk of ulceration/necrosis and loss of function.
Early signs of extravasation. Discomfort/burning/tightness leakage cool/blanching skin → may progress to blistering/sloughing.
First actions for suspected extravasation (sequence). Stop infusion → leave catheter in place → aspirate through catheter → give antidote if ordered → elevate limb → appropriate compresses → document restart at new site with new tubing.
Name four vesicants (non‑chemo included). Vancomycin, amiodarone, promethazine, dopamine (others: hydroxyzine, digoxin, many antineoplastics).
When should a central line be used for vesicants? Per facility policy many institutions require CVAD for vesicant administration.
Define PIV‑related infection and first response. Infection at/near PIV or systemic; stop infusion, remove device, notify provider; culture tip only if CRBSI suspected.
Two prevention steps for PIV infection during access. Hand hygiene/ANTT scrub injection ports with alcohol 15 seconds before every use.
Define phlebitis and list three causes. Vein inflammation; chemical (pH/osmolarity/rate), mechanical (trauma/large device), bacterial (poor asepsis).
Signs of phlebitis.. Pain/tenderness warmth/erythema swelling/induration palpable cord possible purulence
Management of phlebitis. Stop infusion warm moist compress elevate limb new PIV in opposite arm/larger vein/smaller device with new tubing document.
Phlebitis prevention— device selection. Use smallest appropriate gauge allowing hemodilution verify dilution/rate per drug reference frequent site checks.
Define hypersensitivity reaction to IV meds. Immediate, potentially life‑threatening reaction: rash/urticaria, wheeze/bronchospasm, hypotension, facial/airway swelling, sudden fever.
First steps for suspected IV hypersensitivity. Stop infusion notify provider give epinephrine/antihistamines/fluids as ordered monitor vitals and support emotionally.
Prevent/detect early hypersensitivity with a new drug. Confirm allergies stay with patient first 5–10 min of new infusion monitor at policy intervals.
Critical difference in catheter handling: infiltration vs extravasation. Infiltration: remove catheter. Extravasation: leave in to aspirate/administer antidote, then remove.
What must be changed before restarting after a complication? Site (different/proximal or contralateral) and IV tubing per facility protocol.
Patient teaching to reduce PIV complications. Report pain, swelling, burning, tightness, or leakage promptly; avoid bending limb if site near flexion.
Two documentation essentials after a complication. Describe site/symptoms and amount extravasated (if applicable) record all interventions and patient response.
Created by: Anmag002
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