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occlusion - the blockage or closing of a blood vessel

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occlusion - the blockage or closing of a blood vessel

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pain, tenderness, redness, and a bulging vein.

Causes:
sitting to long on  long drives, train or plane rides, varicose veins, some cancers, and after surgery.

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escape of vesicant solutions into interstitial tissue causes coolness at site, taut skin, tissue necrosis

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escape of vesicant solutions into interstitial tissue causes coolness at site, taut skin, tissue necrosis

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-IV line must be discontinued and a new line inserted in another vein. -Apply warm, moist heat on the site of phlebitis can offer some relief to the patient.
-Bleeding might occur from the venipuncture site, nurse needs to apply a pressure dressing to site to control bleeding. Bleeding from vein is usually slow, continuous seepage and is not serious

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"Infiltration: occurs when drugs or fluid infiltrates into the tissue surrounding the venipuncture site. This happens when the tip of catheter slips out of the vein, catheter passes through the wall of the vein, or as blood vessel wall stretches which allows fluid to infuse into the surrounding tissue". 

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"Infiltration: occurs when drugs or fluid infiltrates into the tissue surrounding the venipuncture site. This happens when the tip of catheter slips out of the vein, catheter passes through the wall of the vein, or as blood vessel wall stretches which allows fluid to infuse into the surrounding tissue". 

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(https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Peripheral_Intravenous_IV_Device_Management/)

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Extravasation may occur due to either the cannula piercing the vessel wall or from increased venous pressure that causes leakage around the original venepuncture site.

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ouch! Phlebitis is inflammation of the vein. This can be caused by fluid additives or chemical irritation. we can treat phlebitis by discontinuing the IV (with dr order) applying warm compress and then a cool one.

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Sluggish infusion

Ability to infuse but not aspirate

Inability to infuse or aspirate

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May include:

Redness around the site.

Swelling, puffy skin around the site or at the site of infiltration.

Blanching around the IV site

tenderness or pain around the site.

IV not working. (cannot flush or push fluids through)

Skin maybe cool to the touch at the site.

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IV fluids given too quickly  or to high of a volume can lead to fluid overload. Signs and symptoms are : headache, hypertension, anxiety and SOB. Clients should report any of these S/S immediately and IV flow rate must be adjusted or discontinued

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IV fluids given too quickly  or to high of a volume can lead to fluid overload. Signs and symptoms are : headache, hypertension, anxiety and SOB. Clients should report any of these S/S immediately and IV flow rate must be adjusted or discontinued

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6) What would you chart in the nurses notes?

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6) What would you chart in the nurses notes?

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Charting for extravasion would include:
- patient name and PHN
- date and time of the extravasation
- name of the drug extravasated and the diluent used
- patient's signs and symptoms, (5) description of the IV access
- extravasation area (including approximate amount of the drug extravasated)
- management steps with time and date.

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an inflammation of the vein. noted after using IV  line, cause trauma to the vein. can  feel the hardening of the vein. patient complain of pain or irritation. 

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an inflammation of the vein. noted after using IV  line, cause trauma to the vein. can  feel the hardening of the vein. patient complain of pain or irritation. 

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Report it to the RN. check facility policy. Apply moist warm compress over area. monitor affected site, and document pain rate stated by patient, size , which site is it and how site looks like (DRIPS) .

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Assess for phlebitis inspect for localized redness, tenderness, swelling over vein sites. IV sites must be rotated every 72-96 hours to reduce the risk, discontinue IV, and apply warm compresses then consult RN.

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3)S & S : Tachypnea, apnea, wheezing, coughing, chest pain, hypotension, cyanosis.

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3)S & S : Tachypnea, apnea, wheezing, coughing, chest pain, hypotension, cyanosis.

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Cause : It might cause by due heart failure or kidney failure , as kidneys unable to maintain sodium and fluid balance.
S&S - Rapid weight gain,↑ BP, noticeable swelling,  cramping, headache.

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Cause of Air Embolism: This happens when air bubble (or air bubbles) enters the vein. It could be fatal if not caught early, since the air can travel to the person's brain, heart or lungs.

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Cause of Air Embolism: This happens when air bubble (or air bubbles) enters the vein. It could be fatal if not caught early, since the air can travel to the person's brain, heart or lungs.

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1) The abnormal presence of air in the cardiovascular system. Resulting in obstruction of blood flow. Air embolisms can occur if a large quantity of air (Bolus of air) is inadvertently introduced by injection into veins or by trauma (puncture/trauma to chest may allow air from the lungs to enter the vascular space). ( Mosby's Pocket Dictionary 8th edition)

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1) The abnormal presence of air in the cardiovascular system. Resulting in obstruction of blood flow. Air embolisms can occur if a large quantity of air (Bolus of air) is inadvertently introduced by injection into veins or by trauma (puncture/trauma to chest may allow air from the lungs to enter the vascular space). ( Mosby's Pocket Dictionary 8th edition)

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A embolism can cause a ischemia or infraction in tissues distal to the obstruction , producing organ dysfunction and pain.
( understanding pathophysiology 1st Edition )

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Pain, swelling, redness and presence of vesicles on the skin

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What would you chart in the nurses notes?

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What would you chart in the nurses notes?

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Nurse should assess and chart Phelebitis grading scale 0 - 5.

Source : http://www.pedagogy-inc.com/Home/Resources/IV/Phlebitis-Grading-Scale.aspx

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Doctor can diagnose by doing physical exam looking for any swelling in the body, and checking sodium level via blood work. Treatment: If the patient is on IV therapy we will slow the drip rate, and monitor the  fluid in take , check vital signs.

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Doctor can diagnose by doing physical exam looking for any swelling in the body, and checking sodium level via blood work. Treatment: If the patient is on IV therapy we will slow the drip rate, and monitor the  fluid in take , check vital signs.

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1. Clear the central line of air prior to insertion.

2. Use iv pumps with in-line air detectors.

3. Use the head-down position and the Valsalva maneuver during both insertion and removal.

4. Use screw-on connections, and secure them with tape.

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1. Clear the central line of air prior to insertion.

2. Use iv pumps with in-line air detectors.

3. Use the head-down position and the Valsalva maneuver during both insertion and removal.

4. Use screw-on connections, and secure them with tape.

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- follow the policies and procedures of the facility
-avoid the veins in the hand, wrist and antecubital fossa. Use the veins of the forearm instead.
- keep monitoring the site for any dislodgement.

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4)Nursing actions? Interventions.                                     -	Use tubing with twist-lock connections                                 •	Check all junctions and make sure they are secure        •	Do not use anything sharp near an IV line                             •	Eliminate air from syringes and IV tubing               •	Keep the client supine and perform the valsalva maneuver as the catheter is removed to increase pressure and reduce the risk of air entering circulation                                    •	Encourage ambulation to prevent venous stasis                •	Manage pain by repositioning frequently            •	Assess for hypoxemia and monitor SPO2 levels                  •	Relieve anxiety                

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4)Nursing actions? Interventions.                                     -	Use tubing with twist-lock connections                                 •	Check all junctions and make sure they are secure        •	Do not use anything sharp near an IV line                             •	Eliminate air from syringes and IV tubing               •	Keep the client supine and perform the valsalva maneuver as the catheter is removed to increase pressure and reduce the risk of air entering circulation                                    •	Encourage ambulation to prevent venous stasis                •	Manage pain by repositioning frequently            •	Assess for hypoxemia and monitor SPO2 levels                  •	Relieve anxiety                

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Jay

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Nursing Interventions: Apply either ice packs or warm compresses to the affected area, depending on the type of vesicant. For most extravasations, you'll apply ice for 20 minutes four to six times a day for 24 to 48 hours. Stop the infusion and disconnect tubing 

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Nursing Interventions: Apply either ice packs or warm compresses to the affected area, depending on the type of vesicant. For most extravasations, you'll apply ice for 20 minutes four to six times a day for 24 to 48 hours. Stop the infusion and disconnect tubing 

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Risk Factors for Phlebitis are Catheter material, chemical irritation of additives, drugs given intravenously, rate of the medication administration, the skill of the individual inserting the catheter, anatomical position of the catheter ,dehydration, poor hand hygiene, not disinfecting the site properly before inserting the canula.

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6) What would you chart in the nurses note?

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6) What would you chart in the nurses note?

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- we have to chart the site of the IV Infiltration, the date of incident, the general assessment in the IV site. the  clinical symptoms if the infiltration,  how swollen it is, the extent of the tissue injury.

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nursing intervention may include monitoring I/O. SBAR the physician and get an order to stop the IV infusion and for fluid restriction. also may administer diuretics ( by the doctor order) Monitor closely I/O, and promote client comfort.

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Flush or saline lock properly and regularly of the I/V line before and after use                                        Ensure catheter tip/ locks/clams are on place
Administer prescribed anticoagulant / saline flush regularly (8-12Hrs)

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if infiltration occur stop the infusion and discontinue the IV. Restart a new IV line in different extremity (by RNs)
Elevate the affected extremity
Notify the physician
apply a warm, moist compress to the reduce the area of inflammation
Record the procedure

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- Client would state itchiness or burning at the site, and you as the nurse would see edema and feel coolness at the site.

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Phlebitis is the inflammation of a vein, Symptoms of phlebitis affect the arm or leg where the inflamed vein is located , some of the symptoms include : redness, swelling, warmth, visible red “streaking” on your arm or leg tenderness rope- or cord-like structure that you can feel through the skin

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Phlebitis is the inflammation of a vein, Symptoms of phlebitis affect the arm or leg where the inflamed vein is located , some of the symptoms include : redness, swelling, warmth, visible red “streaking” on your arm or leg tenderness rope- or cord-like structure that you can feel through the skin

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6) what would you chart in the nurses notes?

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6) what would you chart in the nurses notes?

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Nurses note charting would include: client assessment, nursing interventions, physician notified, and treatment.

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- Pain, increase temperature
-inflammation in the vein
- discontinue IV line, apply moist and warm compress, monitor site qh, for redness and tenderness
-0-4- erythema, pain, edema, red steak on the vein, palpable venous cord, purulent drainage