IV CANNULATION .pptx

IV CANNULATION

1. IV CANNULATION By Nursing S uperintendent Kailash hospital

2. OBJECTIVES Enumerate the kinds of intravenous therapy and their complications. Identify the types of each kind of intravenous therapy complications and describe them.

3. WHAT IS CANNULA? A cannula is a flexible tube that can be inserted into the body. For medical use, there are 11 different types of cannula. The most commonly used are the intravenous and the nasal cannula .

4. TYPES OF CANNULA Iv cannula pen-like model. Iv cannula with wings model. Iv cannula with injection part model. Iv cannula y-type model

5. Pen-like model

6. With wings model

7. With injection part model

8. Y-type model

9. LENGTH OF CANNULA

10. INDICATION OF CANNULATION Repeated blood sampling Intravenous fluid administration Intravenous medications administration Intravenous chemotherapy administration Intravenous nutritional support Intravenous blood or blood products administration Intravenous administration of radiological contrast agents for computed tomography, magnetic resonance imaging, or nuclear imaging

11. Intravenous Therapy Complications LOCAL COMPLICATIONS Infiltration Extravasation Thrombosis Thrombophlebitis Phlebitis SYSTEMIC COMPLICATIONS Embolism Hematoma Systemic infection Speedshock Circulatory overload Allergic reaction

12. Local complications 1- Infiltration: Results when the infusion cannula becomes dislodged from the vein and fluids are infused into the surrounding tissues.

13. Signs & Symptoms Increasing edema at the site of the infusion Discomfort, burning, pain at site Feeling of tightness at site Decreased skin temperature around site Blanching at site Absent backflow of blood Slower flow rate

14. Nursing Interventions Remove the device/ stop the infusion Apply warm soaks to aid absorption Elevate the limb Notify the doctor if severe Assess circulation Restart the infusion

15. 2-Extravasation It occurs when fluids seep out from the lumen of a vessel into the surrounding tissue. CAUSES: Damage to the posterior wall of the vein. Occlusion of the vein proximal to the injection site

16. Signs & Symptoms Swelling Discomfort Burning Tightness Coolness in the adjacent skin Slow flow rate

17. Nursing Interventions Immediately stop the infusion and remove the device Elevate the affected limb Apply cold compress to decrease edema and pain Apply moist heat to facilitate the absorption of fluid at grossly infiltrated sites

18. 3-Thrombosis Occurs when blood flow through a vein is obstructed by a local thrombus. Catheter-related thrombosis arises as a result of injury to the endothelial cells of the venous wall. Signs & Symptoms Painful, reddened, & swollen vein Sluggish or stopped I.V flow Cause: Injury to endothelial cells of vein wall, allowing platelets to adhere and thrombus form.

19. Nursing Interventions Remove the device Restart the infusion in the opposite limb if possible Apply warm soaks Watch for I.V therapy – related infection

20. 4-Thrombophlebitis Occurs when thrombosis is accompanied by inflammation. Infusions allowed to continue after thrombophlebitis develops will slow and eventually stop, indicating progression to an obstructive thrombophlebitis.

21. Signs & Symptoms Local tenderness Swelling Induration A red line detectable above the IV site

22. 5-Phlebitis Injury during Venipuncture Prolonged use of the same IV site Irritating./incompatible IV additives Use of vein that is too small for the flow rate Use of needle size too large for the vein size

23. Signs & Symptoms Pain Vein that is sore, hard, cord like and warm to touch Red line above the site of IV fj Signs of infection

24. Nursing Interventions Upon assessment of phlebitis, removal the needle Avoid multiple insertion Application of warm compress Continuously monitor the patient- vital signs

25. SYSTEMIC COMPLICATIONS 1- Catheter Embolism This can occur during the insertion of a catheter if appropriate placement techniques are not strictly adhered to. The tip of the needle used during the placement of the catheter can shear off the tip of the catheter. The catheter tip then becomes a free-floating embolus. This can occur with both over-the-needle and through-the-needle catheters. If this happens, cardiac catheterization may be required to remove the embolus.

26. Signs & Symptoms S udden vascular collapse with the hallmark symptoms of cyanosis, hypotension, increased venous pressures, and rapid loss of consciousness. Respiratory distress Unequal breath sounds Weak pulse

27. Nursing Interventions Discontinue the infusion Place the patient in Trendelenburg position on his left side to allow air to enter the right atrium and disperse through the pulmonary artery. Administer oxygen

28. 2-Hematoma The seepage of blood into the extravascular tissue Causes : Coagulation defects Inappropriate use of tourniquet Unsuccessful insertion attempts Little pressure upon removal of cannula Discoloration of the tissue at the IV site

29. Nursing Interventions Frequent assessment of the site Upon insertion, slowly advance the needle to prevent puncturing both vein walls Discontinue therapy if with edema Apply pressure for at least 5 minutes upon removal

30. 4- Systemic Infection Is the successful transmission or encounter of host with potentially pathogenic organism. Major hazard - can be local or systemic (septicemia)‏ Caused by: Staphylococcuaureus, Klebsiella, Serratia, Pseudomonas Aeruginosa

31. S igns & symptoms Fever, chills, & malaise for no apparent reason Contaminated I.V site, usually with no visible signs of infection at site Causes : Failure to maintain aseptic technique during insertion or site care Severe phlebitis, which can set up ideal conditions for organisms growth Poor taping Prolonged indwelling time of device Immunocompromised patient

32. Nursing Interventions Notify the doctor Administer medications as prescribed< Culture the site and the device Use scrupulous aseptic technique Secure all connections Change I.V solutions, tubing and venous access device at recommended times Use I.V filters

33. 5-Speedshock R apid introduction of a foreign substance, usually a medication, into the circulation. Signs & Symptoms Flushed face Headache Tight feeling in the chest Irregular pulse Loss of consciousness

34. Nursing Interventions STOP the infusion Careful monitoring of IV flow rate and patient response. Maintain prescribed rate. Know the actions and side effects of the drug being administered Use of IV pumps when indicated Begin infusion of 5% dextrose at a KVO rate in emergency cases Evaluate circulatory and neurologic status Notify the physician

35. 6-Circulatory Overload An excess of fluid disrupting homeostasis caused by infusion at a rate greater than the patient’s system is able to accommodate.

36. Signs & Symptoms S hortness of breath Elevated blood pressure Bounding pulse Jugular vein distention Increased Respiratory rate Edema Crackles or rhonchi upon auscultation

37. Causes Roller clamp loosened to allow run – on infusion Flow rate too rapid Miscalculation of fluid requirements

38. Nursing Interventions Raise the head of the bed Slow the infusion rate Administer oxygen as needed Notify the doctor Administer medications as ordered

39. 7- Allergic Reaction Maybe a Local or generalized response to tape, cleansing agent, medication, solution or intravenous device. Signs & Symptoms Runn y nose Tearing Bronchospasm . Wheezing Generalized rash Wheal Redness Itching at the site

40. Nursing Interventions If reaction occurs, stop the infusion immediately and infuse normal saline solution. Maintain a patent airway. Notify the doctor. Administer antihistaminic steroid, anti – inflammatory, & antipyretic drugs, as ordered. Give 0.2 to 0.5ml of aqueous epinephrine subcutaneously. Repeat at 3-minute intervals and as needed