TYPES OF IV ACCESS

Peripheral vein via a catheter

Jugular or subclavian vein via a central venous access device through venipuncture (such as a peripherally inserted central catheter, or PICC), or by surgical intervention with implantation of access ports for long‑term use

PREPROCEDURE EQUIPMENT

● Correct size catheter ◯ 16‑gauge for clients who have trauma, rapid fluid volume

◯ 18- to 20-gauge for clients who are having surgery, rapid blood administration

◯ 22- to 24-gauge for other clients (adults) ● Tubing ● Infusion pump ● Clean gloves ● Scissors or electric shaver for hair removal

NURSING ACTIONS ● Check the prescription (solution, rate). ● Assess for allergies to latex, tape, or iodine. ● Follow the rights of medication administration

(including compatibilities of all IV solutions). ● Perform hand hygiene. ● Examine the IV solution for clarity, leaks, and

expiration date. ● Prime the tubing. ● Don clean gloves before insertion. ● Assess extremities and veins. ● Clip hair at and around the insertion site with scissors

or shave it with an electric shaver.

CLIENT EDUCATION ● Identify the client and explain the procedure. ● Place the client in a comfortable position.

INTRAPROCEDURE NURSING ACTIONS

● Select the vein by choosing ◯ Distal veins first on the nondominant hand ◯ A site that is not painful or bruised and will not interfere with activity

◯ A vein that is resilient and has a soft, bouncy feeling ● Document in client’s medical record

◯ Date and time of insertion ◯ Insertion site and appearance ◯ Catheter size ◯ Type of dressing ◯ IV fluid and rate ◯ Number, locations, and conditions of previously attempted catheterizations

◯ The client’s response

Sample documentation: 1/16/2016, 1423, Inserted 22‑gauge IV catheter into right wrist cephalic vein (one attempt); applied sterile occlusive dressing. IV lactated Ringer’s infusing at 100 mL/hr per infusion pump without redness or edema at the site. Tolerated without complications. L. Turner, RN

● Be sure to document thoroughly and accurately throughout the client’s course of IV therapy.