The nurse is preparing to insert a peripheral vascular access device.
Place the following actions in the order in which they need to be performed, starting from first to last.
The nurse is preparing to insert a peripheral vascular access device.
Place the following actions in the order in which they need to be performed, starting from first to last.
Correct
Place the tourniquet 10 to 15 cm (4–6 inches) above the proposed site.
Palpate vein at intended insertion site by pressing downward.
Release tourniquet temporarily.
Clean the selected area using an alcohol-based 2% chlorhexidine solution using friction for 30 seconds.
Reapply the tourniquet 10 to 15 cm (4–6 inches) above the anticipated insertion site.
Insert the intravenous catheter at a 15 to 30 degree angle.
Advance the catheter until a flash of blood is seen, then advance the catheter into the vein while removing the needle.
Release the tourniquet and connect the Luer-Lok end of short extension tubing to the needleless connector to the catheter hub.
Apply sterile dressing over the intravenous site.
Correct Answer is:
Place the tourniquet 10 to 15 cm (4–6 inches) above the proposed site.
Palpate vein at intended insertion site by pressing downward.
Release tourniquet temporarily.
Clean the selected area using an alcohol-based 2% chlorhexidine solution using friction for 30 seconds.
Reapply the tourniquet 10 to 15 cm (4–6 inches) above the anticipated insertion site.
Insert the intravenous catheter at a 15 to 30 degree angle.
Advance the catheter until a flash of blood is seen, then advance the catheter into the vein while removing the needle.
Release the tourniquet and connect the Luer-Lok end of short extension tubing to the needleless connector to the catheter hub.
Apply sterile dressing over the intravenous site.
Statistics
Difficulty level - Hard
34%of peers got it right
Time taken - 196 s
Subject/Lesson
Subject
Pharmacology
Lesson
Medication Administration
Client Need
Test Plan
Pharmacological and Parenteral Therapies
Related Topic
Parenteral/IV Therapies
Item Type
Item Type
Application
Explanation
The correct sequence of steps to start a peripheral intravenous line are as follows:
- Apply a tourniquet around the upper arm about 10 to 15 cm (4–6 inches) above the proposed insertion site
- With your fingertip, palpate the vein at the intended insertion site by pressing downward. Note resilient, soft, bouncy feeling while releasing pressure
- Release tourniquet temporarily
- Perform skin antisepsis with alcohol-based 2% chlorhexidine solution using friction in a back-and-forth motion
- Reapply the tourniquet 10 to 15 cm (4–6 inches) above the anticipated insertion site
- Perform venipuncture. Anchor vein below anticipated insertion site by placing thumb over vein 4 to 5 cm (1½–2 inches) distal to site and gently stretching skin against direction of insertion
- Observe for blood return in catheter or flashback chamber of catheter, indicating that bevel of needle has entered vein. Advance VAD approximately ¼ inch (0.6 cm) into vein and loosen stylet (needle) of the catheter. Continue to hold skin taut while stabilizing VAD and, with index finger on push-off tab of VAD, advance catheter off needle into vein until hub rests at venipuncture site
- Release tourniquet or BP cuff with other. Apply gentle but firm pressure with middle finger of nondominant hand 3 cm (1¼ inches) above insertion site.
- Quickly connect Luer-Lok end of short extension tubing with needleless connector to end of catheter hub
- Take the previously attached 10-mL prefilled syringe that contains 0.9% sodium chloride (normal saline [NS]) and is connected to short extension set. Aspirate by pulling back on syringe to remove air and assess blood return. Then, slowly inject NS from syringe into VAD
- Apply a sterile dressing to the area and document the procedure
Additional Info
✓ When establishing a vascular access device, the nurse should consider the intention of the therapy and the duration
✓ It is highly preferred that a site be selected on the client's non-dominant arm
✓ To prevent skin injury, the nurse should consider using a blood pressure cuff instead of a tourniquet
✓ Good skin cleansing of at least thirty seconds is necessary to maintain an aseptic technique
Last Updated - 12 Oct 2024
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