Michael Jones G.

Balansag

BSN IVA

October 17, 2013

Intravenous Complications and its nursing interventions. 1. Infiltration is the diffusion or accumulation (in a tissue or cells) of substances not normal to it or in amounts in excess of the normal. The material collected in those tissues or cells is called infiltrate. a. Remove the device b. The use of warm compresses to treat infiltration. c. Elevate arm to enhance circulation. d. Assess circulation. e. restart infusion. 2. Hematoma occurs when there is leakage of blood from the vessel into the surrounding soft tissue. This can occur when an IV angiocatheter passes through more than one wall of a vessel or if pressure is not applied to the IV site when the catheter is removed. A hematoma can be controlled with direct pressure and will resolve over the course of 2 weeks. a. Stop the infusion. b. Remove the device. c. Elevate the affected part. d. Apply cold compress to decrease edema and pain. e. Apply moist heat to facilitate the absorption of fluid at grossly infiltrated site. 3. Air embolism occurs as a result of a large volume of air entering the patient's vein via the I.V. administration set. The I.V. tubing holds about 13 CCs of air, and a patient can generally tolerate up to 1 CC per kilogram of weight of air; small children are at greater risk. Air embolisms are easily prevented by making sure that all the air bubbles are out of the I.V. tubing; fortunately, it is an extremely rare complication. a. Discontinue the infusion. b. Place the patient in trendelenburg position on his left side to allow air to enter the right atrium and disperse through the pulmonary artery. c. Administer oxygen. d. Notify the physician. e. Document the patients condition and monitor. 4. Phlebitis is inflammation of the vein which occurs due to the pH of the agent being administered during the administration of the I.V, while thrombophlebitis refers to inflammation associated with a thrombus. a. Assess Phlebitis b. Remove the needle c. Avoid multiple insertion d. Apply warm compress e. Continuously monitor the patients vital signs

5. Extravasation is the leakage of a fluid out of its container. In the case of inflammation, it refers to the movement of white blood cells from the capillaries to the tissues surrounding them (diapedesis). a. Stop the I.V. flow, aspirate the remaining drug in the catheter, and remove the I.V. line, unless you need the needle to infiltrate the antidote. b. Estimate the amount of extravasated solution and notify the physician. c. Instill the appropriate antidote according to your facility's protocol. d. Elevate the extremity. e. Record the extravasation site, patient's symptoms, estimated amount of infiltrated solution, and treatment. Include the time you notified the physician and the physician's name. Continue documenting the appearance of the site and associated symptoms.