הפסקת נוזלים תוך ורידי וקו תוך ורידי היקפי
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Q1: When should a peripheral intravenous catheter be discontinued?
A peripheral IV catheter should be discontinued when the patient's fluid volume has returned to baseline, the patient is being discharged, or the IV needs replacement. Additionally, discontinue if the site shows signs of infection, infiltration, extravasation, or phlebitis. The CDC recommends replacing peripheral IV catheters every 72-96 hours in adults to prevent infection risk.
Q2: What assessments should be performed before removing an IV catheter?
Before removal, assess the IV site for redness, swelling, or bruising indicating irritation, inflammation, infection, or thrombus formation. Palpate the area for tenderness and compare skin temperature, texture, and swelling to the opposite limb. Review the patient's history for bleeding risk factors including bleeding disorders, anticoagulant therapy, and low platelet counts.
Q3: What is the correct procedure for removing a peripheral IV catheter?
Occlude the IV tubing by sliding the clamp toward the narrow end, then disconnect the tubing from the patient. Gently peel back the transparent dressing, grasp the catheter near its hub, and pull it out along the vein line. Apply firm pressure with gauze for 1-3 minutes until bleeding stops, then secure clean gauze with tape or non-adhesive dressing.
Q4: How should you verify patient identity before discontinuing IV fluids?
Verify the patient's identity using two independent identifiers, such as the patient's name and medical record number. Never use the patient's room or bed number as identifiers. This verification step ensures the correct patient receives the procedure and prevents medication or treatment errors.
Q5: What supplies are needed to remove a peripheral IV catheter?
Gather two sterile 2 x 2 gauze packages, tape or non-adhesive self-adhering wrap based on patient preference, and clean gloves. Ensure supplies are placed on the bedside table on the same side as the patient's IV. Proper preparation prevents delays and maintains aseptic technique during the removal procedure.
Q6: What signs indicate complications after IV catheter removal?
Monitor the IV site for continued bleeding after removal. Redness can indicate irritation, inflammation, infection, or thrombus formation. Bruising at the insertion site may signal a hematoma, which could damage surrounding tissues. Instruct the patient to apply pressure if bleeding resumes and report any concerning symptoms.
Q7: What documentation is required after discontinuing an IV catheter?
Document the discontinuation of IV fluids and catheter removal in the patient's electronic health record. Include the patient's response to the procedure and any abnormal findings such as bleeding, swelling, or infection signs. Before discontinuing, review the MAR to determine if there is continued need for IV access and administering intermittent intravenous medications.