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The Potential Side Effects of Intravenous Therapy

Complications and side effects can occur during the process of intravenous (IV) therapy. Below are potential complications/side effects and guidelines for management.

  1. 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.).
  1. 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.
  1. 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.
  1. 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.
  1. 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.
  1. 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.
  1. 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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