Vads vascular access devices catheters cannulas or

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hypotension and shock. VAD’s (vascular access devices): catheters, cannulas, or infusion ports designed for repeated access to the vascular system. Venipuncture : technique in which a vein is punctured through the skin by a sharp rigid stylet (e.g. butterfly needle or metal needle), a stylet partially covered with a plastic cannula (over the needle cannula [ONC]), or a needle attached to a syringe Review IV Equipment and Supplies: typically using a 20 gauge needle, start distal and work proximal if necessary, if it’s for surgery or blood--> 18 gauge needle Demonstrate steps to initiate/discontinue IV therapy: 1. Review order for type and amount of IV fluid, rate of fluid administered, purpose of infusion. Follow 6 rights for administration of medications 2. Assess for clinical factors/conditions that will respond to or be affected by IV fluid administration 3. Assess client’s previous or perceived experience with IV therapy and arm placement preference 4. obtain info from drug reference book or pharmacist about composition of IV fluids, purposes of administration, potential incompatibilities, and side effects for monitoring guidelines 5. determine if client is to undergo any planned surgeries or is to receive blood infusion later 6. assess for the following risk factors: child or older adults, presence of heart or renal failure, skin lesions, infection, low platelet count, receiving anticoagulants 7. assess laboratory data and client’s history of allergies to iodine, adhesive, or latex 8. explain to client and family the procedures, its purpose, and what is expected of client. Explain what sensations client is to expect 9. Assist client to comfortable sitting or supine position. Be positioned at a level position with client. Provide adequate lighting 10. check client’s identification using 2 identifiers 11. perform hand hygiene. organize equipment.
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Skills Test 3 12. change client’s gown to the more easily removed gown with snaps at shoulder is available 13. open sterile packages using sterile aseptic technique 14. prepare IV tubing and solution (check solution, open set, place roler clamp 2 to 5 cm below drip chamber, set roller to off position, remove sheath over IV port on plastic IV solution bag, insert infusion set into fluid bag or bottle [spike bag], prime line, squeeze drip chamber, remove protective cap open roller allow to flow then switch to off, make sure tubing free of air and bubbles, replace cap 16. apply clean gloves 17. identify accessible vein, apply tourniquet 4 to 6 inches above proposed insertion site 18. select vein for IV insertion (use most distal site in the nondominant hand) 19. release tourniquet temporarily and carefully (optional to apply local anesthetic to site) 20. place connection of infusion set nearby 21. clean site with cholrhexidine 22. reapply tourniquet 10 to 12 cm above site 23. perform venipuncture. Anchor vein by placing thumb over vein and gently tighten the skin distal to the site 1 ½ to 2 inches. Warn client of sharp, quick stick (bevel up!) 24. observe for blood return through flashback cannula, advance catheter into arm
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