During an initial assessment, the skin surrounding an IV cannula should be examined for any redness, swelling, warmth or induration (hardening). These issues can be indication of infection, phlebitis or infiltration (Wolters Kluwer, 2015).
Appropriate site prep utilizing a Chloraprep scrub. Proper cleaning and aseptic technique is crucial to avoid infection.
Insertion of a BD Nexiva 20 gauge IV catheter.
Flushed and ready for future use after additional securement.
Complications
Infection
PIVs that display signs of infection should be removed promptly. Proper cleaning, aseptic technique and appropriate maintenance can prevent localized or systemic infection related to IV use. Signs and symptoms of infection will include pain, redness, warmth and swelling.
Representation of obvious infection at an IV site.
Phlebitis
Phlebitis is the term to describe irritation and inflammation of a vein. There are many causes of phlebitis including mechanical irritation, trauma to the vein with insertion, infusion of caustic or high osmolarity medications and infection to name a few. A palpable, hardened vein may be felt proximal to the insertion site. Pain is a common symptom of phlebitis.
Representation of phlebitis related to infusion of caustic or high osmolarity medication through a peripheral IV.
This site would be painful to touch or attempts to flush and should be discontinued.
Source: http://www.vipscore.net/wp-content/uploads/2012/04/002-IV3000-A4-score-and-vein-card.pdf
Click image for larger size.
Treatments for phlebitis may vary depending on facility policy. Infusions contributing to the development of venous phlebitis should always be stopped. A central venous access device may be warranted if an irritating solution must be infused.
Infiltration
Actual infiltration of an IV in the patient's right hand. Source:
https://nursingug.wordpress.com/2015/12/13/iv-insertionadministration-complications/
Infiltration involves the failure of a catheterized vein, and the leaking of infused solution into surrounding tissues. Treatment for simple infiltration of non-vesicant solutions is conservative. Elevate the limb and consider applying warmth to assist the body in absorption of infiltrated fluids. This is different than extravasation which must involve a vesicant solution that has infiltrated. Extravasation is serious as the vesicant solution will harm surrounding tissues. Follow facility policy for either occurrence.