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NURS366 IV Insertion Exam Study Guide: Comprehensive Q&A for Nursing Students, Exams of Nursing

This study guide provides a comprehensive overview of iv insertion techniques, encompassing patient preparation, site selection, catheter insertion methods, and post-insertion care. it includes detailed explanations of potential complications, such as infiltration and phlebitis, and offers practical advice for successful iv starts. The guide is designed to help nursing students prepare for exams and master the essential skills of intravenous therapy.

Typology: Exams

2024/2025

Available from 04/18/2025

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NURS366 IV Insertion Exam Study Set
With Accurate Answers
Before starting an IV... What is essential information that a nurse needs to know? -
ANSWER - Appropriate IV therapy order: Solution, Route, Rate, Time Frame
- What is the patient's plan of care?
- Why does the patient need an IV?
- What is the duration of treatment?
- Patient History: IV experience, Allergies, Comorbidities, Medications
- Patient Assessment: Physical findings, Lab Values, Age, Mobility, Skin, Mucous
membranes, Dominant hand
- What supplies are needed to start an IV?
Patient Preparation Prior to IV Start - ANSWER Education
- What patient teaching principles would you use?
- What would you say?
- What words would you choose?
Patient Comfort
- Positioning
- Nonpharmacologic measures
- Anesthetic use
Supplies for IV Start - ANSWER - Prepared patient
- Towel or chux
- Sharps disposal
- Gloves (well fitted)
- Tourniquet
- IV site prep (betadine, alcohol or chlorohexidine prep)
- IV catheter (at least 2 of appropriate size)
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NURS366 IV Insertion Exam Study Set

With Accurate Answers

Before starting an IV... What is essential information that a nurse needs to know? - ANSWER - Appropriate IV therapy order: Solution, Route, Rate, Time Frame

  • What is the patient's plan of care?
  • Why does the patient need an IV?
  • What is the duration of treatment?
  • Patient History: IV experience, Allergies, Comorbidities, Medications
  • Patient Assessment: Physical findings, Lab Values, Age, Mobility, Skin, Mucous membranes, Dominant hand
  • What supplies are needed to start an IV? Patient Preparation Prior to IV Start - ANSWER Education
  • What patient teaching principles would you use?
  • What would you say?
  • What words would you choose? Patient Comfort
  • Positioning
  • Nonpharmacologic measures
  • Anesthetic use Supplies for IV Start - ANSWER - Prepared patient
  • Towel or chux
  • Sharps disposal
  • Gloves (well fitted)
  • Tourniquet
  • IV site prep (betadine, alcohol or chlorohexidine prep)
  • IV catheter (at least 2 of appropriate size)
  • Gauze
  • T-connector and flush or IV tubing with solution
  • Tape
  • IV dressing Size of Catheter - ANSWER 24g: pediatric; frail elder 22g: IVFs &Abxs; low flow fluids 20g: blood products; hypertonic solutions 18g: OR, L&D, blood products, high flow fluids 16g: OR, trauma Characteristics of Good Vein - ANSWER - Superficial
  • Smooth (lumpy veins = multiple valves)
  • Bouncy (hard veins = sclerosis)
  • No pulsation (pulsation = artery)
  • Avoid vein bifurcation
  • Not close to a joint
  • Skin is normal Palpating the Vein - ANSWER Vein Dilation Techniques
  • Tourniquet (single & multiple)
  • Tapping
  • Rubbing
  • Moist heat
  • Gravity
  • Fist clenching What if there are no good options for a peripheral IV? - ANSWER Possibly a PICC line Preparing the IV site - ANSWER - Select area for cleansing
  • Remove hair PRN
  • Apply tourniquet ~ 6 in above site
  • remove stylet & attach IV tubing Advancing the Cannula: Pushing cannula off stylet - ANSWER - Recommended for catheters with push-off tab
  • Advance catheter halfway into vein
  • Pressing foreginger or thumb against push-off tab, advance catheter forward --> move it off the stylet

Finale (after advancing the catheter) - ANSWER - Release tourniquet

  • Hold IV catheter steady
  • Remove stylet (initiate safety device)
  • Attach T-connector or tubing
  • Anchor IV with tape
  • Cover IV with transparent dressing
  • Label IV dressing (date, time, initials, size of catheter)
  • Flush IV tubing and catheter

Documentation - ANSWER - Time & date of insertion

  • Location of site
  • Gauge of catheter
  • Length of catheter
  • Number of attempts and complications
  • Type of dressing
  • Status IV site
  • Client response to procedure

Techniques used by nurses to facilitate IV insertion - ANSWER 1. Use positive self talk/self relaxation

  • assertive, confident approach
  1. Adapt needle (don't do)
  • bend catheter insertion needle
  1. Use 2-step puncture (don't do)
  • puncture skin, then vein
  1. Avoid inflicting pain
  • no probing
  1. Do not use gloves (don't do)
  2. Have assistance

IV insertion unsuccessful - ANSWER - Loss of blood return --> may have pierced through vein

  • Severe pain --> may be in surrounding tissue, may have pierced a nerve
  • During flushing --> vein puffs up (infiltrates)
  • No blood return --> may have missed the vein

Explain to patient, discontinue IV, apply pressure and plan for the next stick (proximal, opposite arm)

Rule: Two strikes and you are out! Know IV start backup resources.

Common reasons for unsuccessful IV starts - ANSWER - Improper tourniquet placement

  • failure to release tourniquet
  • using a tentative "stop and start" technique
  • Failure to recognize that IV catheter has pierced through the vein
  • stopping too soon after insertion
  • inserting cannula too deep
  • failure to penetrate vein wall (angle too shallow or too steep)

A. Infiltration B. Phlebitis C. IV infection D. Hypervolemia - ANSWER

Discontinuing an IV - ANSWER - Gather supplies

  • Check MD orders (RN decision if IV complication; then must be restarted)
  • Identify patient with 2 identifiers
  • Wash hands & apply gloves
  • Stop infusion
  • Stabilize IV catheter & loosen dressing and tape
  • Remove catheter carefully & smoothly
  • Apply direct pressure with sterile 2x2 after catheter out
  • Elevate arm (do not bend elbow)
  • Observe for redness, swelling, hematoma
  • Document (per institutional protocol)