Complications and side effects can occur during the process of intravenous (IV) therapy. Below are potential complications/side effects and guidelines for management.
-
Shock during IV therapy and how to manage it
Causes:
- May be due to the IV solution, contamination in the tubing, or excessively rapid infusion.
Symptoms:
- Difficulty breathing
- Chills
- Sweating
- Pale complexion
- Rapid pulse, low blood pressure
Management of shock during IV therapy:
- Stop the infusion immediately.
- Warm the patient.
- Follow the anti-shock protocol.
- Identify the cause (e.g., impure solution, contaminated tubing, rapid infusion, etc.).
-
Acute pulmonary edema during IV therapy
Causes:
- Due to rapid infusion or excessive fluid volume in a patient with hypertension or heart failure.
Symptoms:
- Chest pain
- Severe shortness of breath, coughing up pink froth
- Cyanotic (bluish) skin tone
Management:
- Stop the infusion immediately and inform the doctor.
- Rotate tourniquets on three limbs every 5 minutes.
- Administer diuretics.
- Provide oxygen therapy.
- Address other symptoms depending on the extent of the damage.
-
Pulmonary embolism during IV therapy
Causes:
- Air entering through the IV tubing into the bloodstream.
Symptoms:
- Sudden chest pain
- Difficulty breathing: Can lead to rapid death.
Management:
- Stop the infusion immediately.
- Inform the doctor and begin CPR (if the patient has stopped breathing or the heart has stopped).
- Provide oxygen therapy.
-
Infection at the infusion site
Causes:
- Due to improper sterility during the procedure or prolonged use of the IV needle (longer than 72 hours)
Symptoms:
- The patient experiences pain and swelling at the infusion site
Management:
- Inform the doctor, apply a thin sterile dressing to the swollen area.
- Switch the infusion site to another location.
- Change the dressing on the swollen area daily if prescribed.
-
Clogged needle, no flow during IV therapy
Causes and management:
- Dislodged needle: Adjust the needle and reposition the hub.
- Collapsed vein: Gently massage the vein to encourage blood flow.
- Clogged needle: Temporarily clamp the IV tubing for 1-2 seconds, then release to force the fluid through. If this does not work, replace the needle and restart the infusion.
-
Swelling at the infusion site
Causes:
- Fluid leaking outside the vein due to:
- Needle piercing through the vein wall.
- Needle not fully inside the vein (half in, half out).
- Vein rupture
Management:
- Move the infusion to a different site.
- If hypertonic solution has leaked out, stop the infusion, administer a Novocain block to reduce swelling, and monitor the infusion site for signs of necrosis.
-
Infection at the injection site due to lack of sterility
Causes:
- Contaminated equipment or improper sterile technique by the practitioner.
Prevention:
- Ensure all equipment is completely sterile, and the practitioner follows proper procedural protocols.
Note: Blood-borne diseases like Hepatitis B, Syphilis, and HIV should be considered by nurses when performing IV therapy, especially in patients with coexisting conditions.
Source of reference: Bach Mai Medical College (Hanoi)
=>> READ MORE: IV THERAPY SAFETY STANDARDS
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