Lab #2: Venipuncture, PIV insertion, Saline lock/flush, IV Med Bolus

Which sites are most frequently used for venipuncture? (ranked)

1. Antecubital (optimal and 1st choice) 2. Forearm 3. Back of hand (rare)

What are 3 factors that determine therapeutic drug levels?

1. Patient age & size 2. Extent and rate of drug absorption or excretion 3. Metabolic rate

What are the 3 reasons for venipuncture?

1. Screening for disease, monitoring changes in acute or chronic diseases, and evaluate responses to therapies. 2. Therapeutic Drug Monitoring (TDM) to monitor effects of medication 3. Obtain blood for donor transfusion (or certain conditions)

Where should a tourniquet be applied during venipuncture?

10 cm above venipuncture site (approx. length of a closed hand

Which PIV catheter sizes would you insert into the AC for trauma situations and emergent fluid therapy?

16-14G

Which PIV catheter sizes would you use for forearms, surgery, and/or medication delivery?

20-18G

Which PIV catheter sizes would you use for hands, elderly, and children?

24-22G

How many mL should you use to flush a saline lock?

3 to 5 mL

Why do we use a tourniquet during venipuncture?

A tourniquet blocks venous return to heart from extremity, causing veins to dilate for easier visibility.

What is the range of catheter sizes for PIV?

Catheter sizes range from 14G to 26G.

What is Therapeutic Drug Monitoring?

Entails monitoring blood drug levels to determine effective drug dosages and to prevent toxicity. Helpful in patients that have disease that can effect levels or when medications have a narrow therapeutic margin.

What is Vasovagal Syncope?

Fainting caused by body overreacting to certain triggers -> body increase heart rate and drops blood pressure, leads to reduced blood flow to the brain, causing loss of consciousness. Can be a complication of venipuncture

True or False: the first choice for PIVs is the antecubital site.

False: save AC's for blood draws when possible

How long can a tourniquet be left on?

Less than 1 minute. Wait 2 minutes before putting back on.

If veins are not visible for venipuncture, what are 3 things we can do?

Makes veins dilate: 1. Ask patient to open and close their hands multiple times 2. Lower arm under the level of the heart 3. Warm towel over puncture site

Which vein is preferred for venipuncture?

Median cubital vein

What characteristics do you want to look for when trying to find a patent vein for venipuncture?

Vein should be palpated -> patient, healthy vein is elastic and rebounds Should not be rigid or cordlike and shouldn't roll