ExamFinch.com My Study

Study guide

7.7 IV Therapy and Complications

Practice this exam

NCLEX-RN Registered Nurse

Track your progress as you read

Finished sections get a check mark.

1 Introduction

About the NCLEX-RN Exam Next Generation NCLEX (NGN) Clinical Judgment Measurement Model (NCJMM) How to Use This Course

2 Chapter 2: Management of Care

2.1 Legal Rights and Responsibilities 2.2 Advance Directives and Self-Determination 2.3 Informed Consent Protocols 2.4 Client Advocacy and Rights (HIPAA) 2.5 Assignment, Delegation, and Supervision 2.6 Five Rights of Delegation 2.7 Scope of Practice (RN vs LPN vs UAP) 2.8 Ethical Practice Principles

3 Chapter 3: Safety and Infection Prevention and Control

3.1 Standard Precautions and Hand Hygiene 3.2 Transmission-Based Precautions (Contact, Droplet, Airborne) 3.3 PPE Donning and Doffing Sequences 3.4 Fall Prevention and Restraints 3.5 Fire Safety (RACE/PASS) 3.6 Disaster Triage and Emergency Response

4 Chapter 4: Health Promotion and Maintenance

4.1 Growth and Development (Erikson/Piaget) 4.2 Developmental Stages: Infancy through Older Adult 4.3 Maternal and Newborn Care (Antepartum) 4.4 Intrapartum Care and Fetal Monitoring 4.5 Postpartum Care (BUBBLE-HE) 4.6 Health Screening Guidelines 4.7 Immunization Schedules

5 Chapter 5: Psychosocial Integrity

5.1 Therapeutic Communication Techniques 5.2 Non-Therapeutic Communication (What to Avoid) 5.3 Anxiety Disorders and Mental Health Concepts 5.4 Schizophrenia: Hallucinations and Delusions 5.5 Depression and Suicide Assessment 5.6 Substance Misuse and Withdrawal 5.7 Grief and End-of-Life Care

6 Chapter 6: Basic Care and Comfort

6.1 Mobility and Hazards of Immobility 6.2 Assistive Devices (Crutches, Canes, Walkers) 6.3 Nutrition and Diet Therapy 6.4 Enteral Nutrition (Tube Feeding) 6.5 Bowel Elimination and Ostomy Care 6.6 Urinary Elimination and Catheter Care

7 Chapter 7: Pharmacological and Parenteral Therapies

7.1 Medication Administration Rights 7.2 Medication Calculations 7.3 High-Alert Medications: Insulins 7.4 High-Alert Medications: Anticoagulants 7.5 High-Alert Medications: Opioids 7.6 High-Alert Medications: Digoxin and Electrolytes 7.7 IV Therapy and Complications 7.8 Blood Product Administration 7.9 Total Parenteral Nutrition (TPN)

8 Chapter 8: Reduction of Risk Potential

8.1 Laboratory Values: Hematology (CBC) 8.2 Laboratory Values: Metabolic Panel (BMP) 8.3 Laboratory Values: Coagulation Studies 8.4 Vital Signs and Trend Recognition 8.5 Perioperative Care (Pre-Op and Post-Op) 8.6 Nasogastric Tubes and Therapeutic Procedures

9 Chapter 9: Physiological Adaptation

9.1 Fluid Imbalances (Hypovolemia and Hypervolemia) 9.2 Arterial Blood Gases (ABGs) and Acid-Base Balance 9.3 Medical Emergencies: Stroke (CVA) 9.4 Medical Emergencies: Myocardial Infarction (MONA) 9.5 Diabetic Emergencies (Hypoglycemia and DKA) 9.6 Respiratory Conditions (COPD, Pneumonia) 9.7 Cardiac Conditions (Heart Failure) 9.8 Neurological Conditions (Seizures)

7.7 IV Therapy and Complications

Key Takeaways Explain This Topic AI

Infiltration presents as coolness, pallor, and swelling at the IV site - stop infusion, remove catheter, elevate extremity

Phlebitis presents as redness, warmth, and a palpable cord along the vein - discontinue IV, apply warm compress

Extravasation involves vesicant medication leaking into tissue causing necrosis - stop immediately, aspirate if possible, follow antidote protocol

Air embolism is prevented by priming tubing completely and using Luer-lock connections; position patient in Trendelenburg on left side if suspected

Central line infections present with fever and redness at insertion site; use strict aseptic technique and change dressings per protocol

Last updated: October 2026

Intravenous (IV) therapy is one of the most common invasive procedures in healthcare. Understanding proper technique, recognizing complications, and knowing appropriate interventions is essential for safe practice.

Types of IV Access

  • Type Description Duration Uses
  • Peripheral IV (PIV) Catheter in peripheral vein 72-96 hours Short-term fluids, meds
  • Midline Catheter Longer catheter in arm vein 1-4 weeks Extended therapy
  • PICC Line Catheter threaded to SVC Weeks to months Long-term therapy, TPN
  • Central Venous Catheter Direct access to central vein Variable Vasopressors, TPN, frequent access
  • Implanted Port Surgically placed under skin Years Chemotherapy, intermittent access
  • Peripheral IV Complications
  • Infiltration
  • Definition: Non-vesicant fluid leaks into surrounding tissue
  • Assessment Finding Description
  • Swelling/edema Around insertion site
  • Coolness Tissue feels cooler than surrounding area
  • Pallor Skin appears pale
  • Pain Discomfort at site
  • Decreased flow rate Infusion slows or stops

Interventions:

  • Stop the infusion immediately
  • Remove the IV catheter
  • Elevate the extremity
  • Apply warm or cool compress per facility policy
  • Document the event
  • Restart IV in different location (preferably opposite arm)
  • Phlebitis
  • Definition: Inflammation of the vein

Types:

  • Chemical (irritating medications)
  • Mechanical (catheter movement)
  • Bacterial (infection)
  • Assessment Finding Description
  • Redness Along the vein path
  • Warmth At and around site
  • Tenderness Pain with palpation
  • Palpable cord Hardened vein
  • Streak Red streak following vein

Interventions:

  • Discontinue the IV
  • Apply warm, moist compress
  • Document using phlebitis scale
  • Restart in opposite extremity
  • Notify provider if severe or infectious
  • Extravasation
  • Definition: Vesicant medication leaks into tissue, causing tissue damage or necrosis

Vesicant Medications:

  • Chemotherapy agents (many)
  • Dopamine, norepinephrine
  • Calcium chloride
  • Potassium chloride (concentrated)
  • Vancomycin
  • Diazepam
  • Assessment Finding Description
  • Pain/burning Often severe
  • Swelling At injection site
  • Redness progressing to blanching Tissue damage occurring
  • Blistering Indicates tissue necrosis

Interventions:

  • STOP the infusion immediately
  • Leave catheter in place initially
  • Aspirate residual drug if possible
  • Apply cold or warm compress (drug-specific)
  • Administer antidote if available (drug-specific)
  • Notify provider immediately
  • Document thoroughly with photos if possible
  • May require surgical intervention
  • Systemic IV Complications
  • Air Embolism
  • Definition: Air enters the bloodstream through IV system

Risk Factors:

  • Disconnected IV tubing
  • Empty IV bag
  • Central line removal
  • Poor IV technique

Signs and Symptoms:

  • Sudden chest pain
  • Dyspnea, tachypnea
  • Hypotension
  • Confusion, altered LOC
  • Churning "mill-wheel" heart murmur

Interventions:

  • Clamp the IV line immediately
  • Position patient on left side in Trendelenburg (traps air in right atrium)
  • Administer 100% oxygen

Notify provider immediately - emergency!

Prepare for possible aspiration of air

Prevention:

  • Prime tubing completely before use
  • Use Luer-lock connections
  • Ensure all connections are tight
  • Use IV pumps with air detection
  • Proper technique for central line care
  • Speed Shock
  • Definition: Systemic reaction to rapid IV medication infusion

Signs and Symptoms:

  • Flushing of face and neck
  • Headache
  • Chest tightness
  • Hypotension
  • Cardiac arrest

Prevention:

  • Use infusion pumps
  • Verify correct rate before administration
  • Know safe infusion rates for medications
  • Fluid Overload (Circulatory Overload)

Risk Factors:

  • Elderly patients
  • Heart failure
  • Renal impairment
  • Rapid infusion

Signs and Symptoms:

  • Dyspnea, crackles in lungs
  • Jugular vein distension (JVD)
  • Peripheral edema
  • Hypertension
  • Bounding pulse

Interventions:

  • Slow or stop the infusion
  • Raise head of bed
  • Administer diuretics as ordered
  • Monitor I&O strictly
  • Apply oxygen as needed
  • Central Line Complications
  • Catheter-Related Bloodstream Infection (CRBSI)

Signs and Symptoms:

  • Fever, chills
  • Redness, warmth, drainage at site
  • Elevated WBC
  • Positive blood cultures

Prevention (Central Line Bundle):

  • Hand hygiene
  • Full barrier precautions during insertion
  • Chlorhexidine skin prep
  • Optimal catheter site selection
  • Daily assessment for line necessity
  • Proper dressing changes

Interventions:

  • Obtain blood cultures (from line AND peripheral)
  • Notify provider
  • Administer antibiotics as ordered
  • Line may need to be removed
  • Pneumothorax
  • Associated with: Subclavian and internal jugular central line placement

Signs and Symptoms:

  • Sudden dyspnea
  • Chest pain
  • Absent breath sounds on affected side
  • Hypoxia
  • Tracheal deviation (tension pneumothorax)
  • Post-Procedure: Obtain chest X-ray to confirm placement and rule out pneumothorax
  • IV Solution Types
  • Solution Type Use
  • 0.9% NaCl (Normal Saline) Isotonic Volume replacement, blood administration
  • Lactated Ringer's Isotonic Fluid resuscitation, surgery
  • D5W Isotonic in bag, hypotonic in body Provides free water
  • 0.45% NaCl (Half Normal Saline) Hypotonic Cellular dehydration
  • D5NS Hypertonic Maintenance fluids
  • 3% NaCl Hypertonic Severe hyponatremia (ICU only)
  • On the Exam
  • Recognize infiltration vs. phlebitis vs. extravasation
  • Know position for air embolism (left side, Trendelenburg)
  • Understand prevention strategies
  • IV solution characteristics