Peripheral Intravenous Catheter Insertion, Part I

1. When palpating a vein to be used for IV catheter insertion, it should feel:

Tortuous, full, and ropy.

Hard, full, and bumpy.

Flexible, full, and bouncy.

Rigid, flat, and stringy.

A flexible, full, and bouncy vein is an appropriate vein in which to attempt peripheral IV catheterization. A tortuous vein may not be straight enough to accept the entire length of the catheter, and feeling ropy is not an ideal characteristic. A hard, bumpy vein may be sclerotic and should be avoided. Tendons generally feel rigid and stringy.

Explanation

A flexible, full, and bouncy vein is an appropriate vein in which to attempt peripheral IV catheterization. A tortuous vein may not be straight enough to accept the entire length of the catheter, and feeling ropy is not an ideal characteristic. A hard, bumpy vein may be sclerotic and should be avoided. Tendons generally feel rigid and stringy.

2. All of the following are common veins used for peripheral IV catheterization, EXCEPT:

Cephalic vein.

Median antecubital vein.

Brachial vein.

Internal jugular vein.

Basilic vein.

The internal jugular (IJ) vein is not a peripheral vein, although it is used for intravenous access. An IJ catheter is a central catheter, which would have to be placed under sterile technique by someone trained in ultrasound-guided cannulation of of the IJ.

Explanation

The internal jugular (IJ) vein is not a peripheral vein, although it is used for intravenous access. An IJ catheter is a central catheter, which would have to be placed under sterile technique by someone trained in ultrasound-guided cannulation of of the IJ.

3. In order to successfully find a vein for peripheral IV catheterization, one only need to inspect the area visually.

True

False

In order to find a vein for peripheral IV catheterization, one must feel for the vein. The vein may be visualized as well, but not always. The most important technique is palpation and knowing how an appropriate vein should feel.

Explanation

In order to find a vein for peripheral IV catheterization, one must feel for the vein. The vein may be visualized as well, but not always. The most important technique is palpation and knowing how an appropriate vein should feel.

4. When selecting a site for IV catheterization, one should AVOID (select all that apply):

Previously used or sclerotic veins.

Veins of the hand.

Sites with infection, infiltration, thrombosis.

Veins at the antecubital fossa.

Veins in the arm of an arteriovenous fistula.

Veins in the arm of an axillary dissection (commonly seen with a mastectomy).

Veins of the hand are not ruled out for IV catheterization unless they also have the characteristics of the other statements included in this question.

Explanation

Veins of the hand are not ruled out for IV catheterization unless they also have the characteristics of the other statements included in this question.

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5. Describe the rationale for intravenous (IV) therapy (select all that apply).

All hospitalized patients need IV therapy for quick venous access.

IV access provides the quickest route for medication administration.

IV access is necessary for vital signs to be taken.

IV access is necessary for transfusion of blood or blood components

IV access is used to transfuse IV fluids.

IV access may be used for nutritional support (TPN).

IV access may be used for assessment of blood gases.

Direct IV access by catheterization has nothing to do with being able to take vital signs. Blood gases are assessed via arteries, not veins. All of the other statements are true.

Explanation

Direct IV access by catheterization has nothing to do with being able to take vital signs. Blood gases are assessed via arteries, not veins. All of the other statements are true.

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