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Assess, assess, assess. Got blood return? Fushes well? Edema? Think about the catheter, blood flow, IV fluid flow. If the catheter is in a postion where the tip is against the vein wall or possible valve, you may get retro flow. Thrombus, phlebotic vessel, cellulitis, third spacing fluid or the vein is just tired of being messed with. You could check the pH of the fluid and spend the whole day figuring out what is running out of the insertion site or spend two mins changing your access.
What is best for the patient? You will never second guess yourself when you put them first.
well there was no edema, reddness or tenderness to the site it was just leaky. I think the reason i tried to avoid changing the site is because im a new nurse and still have difficulty with IVs...i probably only get 60% that i try and then what? i have to bother another nurse to do it for me. I know practice makes perfect.....im just not confident
An IV site should NOT leak....the first question you should ask is...How old is the site and is it near an area of flexion...old sites often start leaking then next often will infiltrate or extravasate. Sites at areas of flexion often start leaking within 24 hours. just b/c you are not "good" at venipunture is not a sound clinical reason to leave in a site that has a complication or problem. One concept that many nurses need to grasp is vein preservation...veins need to be used wisely and once a site goes bad...you need to immediatly re-site it, and then discontinue the old one. I have seen many nurses push a borderline site b/c there shift is almost over..they are not good at IV starts..they need lunch...none are good reasons and if you push a site it only makes it worse. If you make it a gola of yours to learn how to properly start an IV you will be doing yourself a really big favor. My ability to start IVs has been invaluable...but I started with a tiny step and built upon it every day. So ask to go with an IV nurse and let them teach you the basics and then build upon it....although it is expected of RNs to do this job..very few actaully have any good training...and it is a very difficult task indeed...you never know what you are going to get....great big mississippi pipes or nothing at all...its an art form really..just one I am blessed to have...just do not let me read your EKG..LOL...I hate looking at EKGs