IVT Complications Preventions Signs and Treatment Nursing Responsibilities Nursing Diagnosis

symptoms
PHLEBITIS  Careful  Redness  Removal of IV  Sterile technique of
- Inflammation of a placement of  Swelling catheter catheter insertion
vein and it can be catheter  Warmth  Warm compress  Good nursing
caused by any insult  Early  Visible red  Antibiotics hygiene
to the blood vessel mobilization streaking on  Elevation of  Monitor patient’s
wall, impaired venous after surgery (if arms and legs involved condition
flow, or coagulation permitted)  Tenderness extremity  Promote optimal
abnormality.  Wear  Itchy comfort
- also caused by compression  Low grade
administration of stockings fever
irritating medications  Stretching your
SUPERFICIAL PHELEBITIS arms and legs
- Affects nerves on skin  Oral anti-
surface inflammatory
- Usually caused by (Ibuprofen:
local trauma to a Advil,
vein. Diclofenac:
- Superficial phlebitis is Voltaren)
most often caused by
an intravenous
catheter (IV) placed
in a vein, and the
vein
becomes irritated
THROMBOPHLEBITIS
- One or more blood
clots in the vein that
causes inflammation
- Mostly occurs in leg
veins

COMPLICATION: DVT
RISK FACTORS: Hormone
therapy, pregnancy,
birth control pills, obesity,
cigarette smoking
INFILTRATION  Select an  Inflammation  Stop  Advise the patient to
- Infiltration occurs appropriate IV at insertion site administration report any swelling
when I.V. fluid or site avoiding  Swelling and remove or tenderness at the
medications leak into areas of flexion  Taut skin w catheter IV site
the surrounding tissue.  Use proper pain  Elevate the limb 
- Caused by improper venipuncture  Blanching and  Warm compress
placement or technique coolness of  Check the
dislodgment of the  Observe the IV skin around IV patients pulse
catheter. site site and capillary
- Patient movement  Slowed or refill time
can cause the stopped  Perform
catheter to slip out or infusion venipuncture in
through the blood  No backflow different
vessel lumen. location

EXTRAVASATION
- Leaking of vesicant  Avoid veins that
drugs into surrounding are small and or
tissue. fragile
- Extravasation can  Veins with pre-
cause severe local existing edema
tissue damage,  Be aware of
possibly leading to vesicant
delayed healing, medications
infection, tissue (Doxurubicin,
necrosis, Vinblastine, and
disfigurement, loss of Vincristine,
function, and even Digoxin,
amputation. Dopamine)
NERVE INJURY  Numbness  Surgical  Assist in surgical
- Caused by too much  Weakness intervention procedure
pressure , stretching,  Pain  Physical therapy  Careful
or cut  Use of electrical venipuncture
stimulators technique

HEMATOMA  Discoloration  Remove  Sterile technique of

- Leakage of blood  Select an of the skin catheter catheter insertion
from the vessels into appropriate IV  Site swelling  Elevate  Good nursing
the surrounding site avoiding and extremity hygiene
tissues areas of flexion discomfort  Apply direct  Monitor patient’s
- Caused by trauma to  Use proper  Inability to pressure condition
the vein (Usage of venipuncture advance  Promote optimal
large cannula) technique catheter all comfort
- This can occur when  Advice patient the way into  DIRECT PRESSURE
an IV angiocatheter to report any the vein
passes through more swelling and during
than one wall of a discoloration insertion
vessel or if pressure is  Resistance to
not applied to the IV flushing
site when the
catheter is removed.

VENOUS SPASM  Slow and  Sharp pain at  Slow and  Apply warm soaks
- Spasm usually occurs regulated IV site that regulated over and
because of severe infusion travels up to infusion surrounding area
VEIN IRRITATION from  Use blood the arm  Use blood  Slow flow rate
the I.V. DRUG or fluid warmer for  Sluggish flow warmer for
or from COLD FLUIDS blood or PRBC rate blood or PRBC
OR BLOOD when  Blanched skin when
PRODUCTS. appropriate over vein appropriate
- It can also be due to
a very rapid flow rate
- Sudden involuntary
contraction of a vein
resulting in temporary
cessation of blood
flow
LOCAL INFECTION  Practice of  Fever, chills,  Primary  Monitor Vital signs
- Caused by: aseptic malaise treatment is  Administer
prolonged indwelling technique upon  Contaminate removal of medications as
time of IV catheter insertion d IV site catheter prescribed
- Failure to maintain  Use scrupulous usually with  Secure IV lines
aseptic technique aseptic NO SIGNS  Change IV
- Severe phlebitis technique when AND solutions, tubings,
- Immunocompromise handling SYMPTOMS and access device
d patients are at risk solutions and at recommended
tubings, times
inserting
venipuncture
device, and
discontinuing
infusion
 Monitor
patency of IV
catheter
PNEUMOTHORAX - Recognizing risk - chest pain - observation - maintaining chest tube
- the presence of air or factors for difficult - shortness of - outpatient drainage system
gas in the cavity catheterization breath insertion of a - monitoring lung sounds
between the lungs and - Use of - skin that is bluish Heimlich valve - monitor vital signs
the chest wall, causing standardized in color - inpatient tube
collapse of the lung. method of CVC - fatigue thoracostomy
insertion - rapid breathing
- Assistance from - rapid heartbeat
experienced - cough
clinician
HEMOTHORAX - Select the - dyspnea - A chest tube is - Check out respiratory
- is a collection of blood optimal insertion - tachypnea inserted through function, noting rapid or
in the space between site - chest pain the chest wall shallow respirations,
the chest wall and the - Guide CVC - cyanosis between the ribs to dyspnea, reports of “air
lung (the pleural cavity). placement with - decreased or drain the blood hunger,” development
ultrasound absent breath and air of cyanosis, changes in
- Remove sounds on the - It is left in place vital signs.
unnecessary affected site and attached to - tell patient to report
suction for several any pain
central lines
days to re-expand -
immediately
the lung
CHYLOTHORAX - can be - bilateral chest -
-is a type of pleural asymptomatic tube drainage
effusion. It results from - dyspnea - omission of oral
lymph formed in the - chest discomfort feeds
digestive system called - cough
chyle accumulating in - pleuritic chest
the pleural cavity due to pain
either disruption or
obstruction of the
thoracic duct.
CATHETER MALPOSITION - insufficient
- malposition of a CVC blood return at
means a catheter lies entry ports owing
outside of SVC, whose tip to the collapse of
does not lie in the ‘ideal’ weaker vein walls
position. on the distal port
when blood
drawing creates
negative
pressure.
- chest pain
PINCH OFF SYNDROME
- Occurs when the
catheter is
compressed between
the first rib and the
clavicle, causing an
intermittent
mechanical
occlusion for both
infusion and
withdrawal.

SUPERIOR VENA CAVA

SYNDROME

THROMBOTIC  maintain  Swelling on  Rule out  Assist physician in

OCCLUSION catheter affective area mechanical guide wire insertion
- the formation of patency,  Pain upon dysfunction and/or fibrin sheath
 a blood clot inside monitor redness, palpation  “linogram” stripping if
a blood vessel, inflammation,  Presence of (contrast study thrombolytic therapy
obstructing the flow blood recoil palpable of the catheter) is ineffective.
of blood through  reduce other cord to detect an
the circulatory system possible  Discoloration, intraluminal clot
- when catheters complications including a or fibrin sheath.
become occluded  record the bluish suffused Ultrasound and
secondary to a insertion date to color venogam may
thrombotic process. monitor the how also be done.
Drugs or parenteral long catheter  Administer
nutrition preparations has been thrombolytics as
can also obstruct flow inserted ordered into the
through the catheter.  flush before and catheter lumen
- after with a dwell
medication time of 30
administration minutes and
 low dose repeated dose
heparin/warfari as needed.
n as prophylaxis  If catheter
but may be patency is not
contraindicated restored, infuse
to other patients low dose
. alteplase over 6
 Positioning of to 8 hours as
the Central ordered.
Venous  Once patency
Catheters is restored,
 Maintain clean initiate
technique, anticoagulant
keep area dry prophylaxis and
to prevent flush catheter
infection with normal
saline to
prevent
occlusion
recurrence.