IVRUS BSN, RN

Vascular Access

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All Content by IVRUS

  1. IVRUS

    no blood return port a cath

    IVRUS replied to carabear1028's topic in Infusion, Intravenous

    The main reason why a line has a persistent withdraw occlusion (PWO), is not because the catheter is up against the vessel wall, but rather fibrin build-up at the catheter's tip. Now, there are times...
  2. IVRUS

    Respiratory Therapists Inserting PICC Lines

    IVRUS replied to Asystole RN's topic in Infusion, Intravenous

    First of all, A patient who is deliberately pulling out a PICC or even a Midline, is NOT a candidate for repeated lines such as these. I will place a short term, less than 3 inch IV catheter, but...
  3. IVRUS

    PICC lines and k-pads

    IVRUS replied to onetiredmomma's topic in General Nursing

    Back in the 1990's, we as Infusion Nurses used kpads s/p Midline or PICC placement because we were worried about sterile mechanical phlebitis secondary to its placement. This wasn't a true phlebitis,...
  4. IVRUS

    Central Line associated BSI's

    IVRUS replied to aprilfresh's topic in PICU, Pediatric

    Our dressings are changed q 7 days and prn, or q 48 hrs if a transparent sterile membrane wasn't used. For instance, if gauze is needed because of allergies, or excessive diaphoresis, then the...
  5. IVRUS

    Got an email saying that we are encouraged to have our MSN by 2017

    IVRUS replied to pheonixRN's topic in Nursing Professionalism

    I thought that a Nurse Practitioner was two additional years after the MSN??? Tell me if I am wrong.
  6. IVRUS

    IV Amiodarone extravasation

    IVRUS replied to WAheartnurse's topic in Cardiac

    Amiodarone has a pH of 4.1. So when the vessel breaks down and allows the solution to permeate the SQ tissue, or the catheter erodes through the vessel, tissue necrosis can result, and unfortunately,...
  7. IVRUS

    Why do you choose to start IVs in certain veins

    IVRUS replied to DorothyR's topic in Nursing Student Assistance

    I agree with Esme, Start looking distally and then work your way up the forearm. If you start in the Forearm and "blow-it" you can't go back to the hand. However, hand veins in the elderly may not...
  8. IVRUS

    Dosage Calculation Question

    IVRUS replied to PedsHopeful's topic in Nursing Student Assistance

    Once you get kg amount (77.27)...The rest is easy.. Want ------ x Volume. Have What you want is 1623 units a hour (77.27 x 21) rounded What you have is 28,000 divide 1623 by 28000 then...
  9. IVRUS

    HH patient with homicidal ideation...

    IVRUS replied to rprn2009's topic in Home Health

    Wow, I wonder if anyone was as conscientous as you are when they dealt with the Navy Yard killer, or Fort Hood massacre. I'd say no, they just let it drop. I applaud you for attempting to find him...
  10. IVRUS

    Stuck with IV Spike

    IVRUS replied to caffinatednurse's topic in General Nursing

    Ideally, When one gets ready to discard the IV tubing, it should be done at the time of bag changing, so that the old IV tubing and bag are thrown out as a unit... I will drain the bag into a proper...
  11. IVRUS

    Question about 10cc syringes and picc/ports

    IVRUS replied to mappers's topic in General Nursing

    Muno is right in that it is the force applied meeting pressure from a narrowing, or occlusion in the catheter that becomes the issue. No occlusion = no resistance, and that is why you can ascertain...
  12. IVRUS

    Question about 10cc syringes and picc/ports

    IVRUS replied to mappers's topic in General Nursing

    Jade, The Internal diameter (ID)of most PICC's is usually less than 1.5 cc, and many are around .9 to 1 cc to prime. INS standards say to use (at least) twice the ID volume to flush. So, P&P...
  13. IVRUS

    Question about 10cc syringes and picc/ports

    IVRUS replied to mappers's topic in General Nursing

    SocalVARN, It is the syringe barrel that determines the PSI's that will be exerted on the IV catheter. A 10cc syrninge barrel will generate less PSI's on the IV catheter than a smaller 5 or 3 cc...
  14. IVRUS

    TPN order I'm confused on if this is too much or too little for this patient

    IVRUS replied to ren09's topic in Patient Education

    While it may seem daunting to you that an LPN can administer TPN to a patient, I think that with the appropriate education an LPN can indeed hang TPN as long as the state, and facility P&P are in...
  15. IVRUS

    Changing dressing on Groshong

    IVRUS replied to cm8816's topic in Infusion, Intravenous

    A Solo Groshong??? Never heard of it. Now, A Solo Power PICC, yes, that has the Valve at its proximal end. However, because the distal end is open, these catheters are infamous for occlusions. Again,...
  16. IVRUS

    Standing up to my charge nurse prevented a mistake

    IVRUS replied to 002rn05's topic in Patient Safety Issues

    Think of it this way, When you pull on a large syringe, it has much more "power to suck" thus much greater negative pressure occurs in the syringe, which usually results in a collapsed catheter and a...
  17. IVRUS

    Standing up to my charge nurse prevented a mistake

    IVRUS replied to 002rn05's topic in Patient Safety Issues

    When flushing a catheter over three inches in length, one definitely wants a 10cc syringe barrel or larger syringe, but with withdrawing, the opposite is true. the larger barrel syringes exert too...
  18. IVRUS

    Standing up to my charge nurse prevented a mistake

    IVRUS replied to 002rn05's topic in Patient Safety Issues

    "Unfortunately this pt only had access through a Midline in the subclavian, and due to the patients stage V renal failure, was pitting 4 edema without a vein in site. Per policy we are not allowed to...
  19. IVRUS

    Abdominal IV

    IVRUS replied to dmurph615's topic in General Nursing

    PMFB-RN, "Most people who need IV therapy don't need vesicants"... Really? So your patient who needs a K-ridder, or Vancomycin, or IV Phenegran - which are all common IV meds.. Don't have to worry,...
  20. IVRUS

    Abdominal IV

    IVRUS replied to dmurph615's topic in General Nursing

    True nrsang97... Just because one hasn't seen it before, doesn't mean that it can't be done, as we ALL are in a perpetual learning state, however, I said, this nurse's hesitency has merit and wasn't...
  21. IVRUS

    Abdominal IV

    IVRUS replied to dmurph615's topic in General Nursing

    There is a reason why this is not done.... Your supervisor's hesitency is NOT SILLY, but actually has merit. As a clinician, one must take into account the possibility of what an infiltrate, or in...
  22. IVRUS

    Changing dressing on Groshong

    IVRUS replied to cm8816's topic in Infusion, Intravenous

    A Groshong IV catheter is VALVED, so as long as negative pressure with withdraw or positive pressure like infusing, isn't performed, the valve stays shut. Therefore, there is no worry about blood...
  23. IVRUS

    Do I need a BSN to be an IV nurse?

    IVRUS replied to morningland's topic in Infusion, Intravenous

    IMO, it is always good to advance your education, however, Infusion Nursing is a speciality that only requires one to have their RN, and then ideally, obtain your Certified Registered Nurse Infusion...
  24. IVRUS

    Size matters? (IV question)

    IVRUS replied to theantichick's topic in General Nursing

    The flow rate for a 22g is over 2000 cc/hour. And because you work geriatrics, that elderly patient usually will not receive that blood product in any less of a time frame that 3-4 hours secondary to...
  25. IVRUS

    D50 for blood glucose protocol vs juice/snacks, your thoughts

    IVRUS replied to Billy_Ruben's topic in General Nursing

    First of all, It truly puzzles me why nurses in a hospital setting aren't proactive and getting orders for Cathflo when ANY central line doesn't yeild a blood return. A central line that doesn't...