NCLEX-PN

Selecting Appropriate Veins for Intravenous Therapies Nurses play a critical role in identifying and selecting appropriate veins for various intravenous therapies. Several key factors are considered when choosing the optimal vein for intravenous access: ●​ Distal Veins on the Nondominant Hand : Whenever possible, nurses prefer to use distal veins on the non-dominant hand. This approach allows clients to retain the full use of their dominant hand for everyday activities. The veins in this location are often accessible and suitable for intravenous therapies. ●​ Upper Extremities Over Lower Extremities : The upper extremities, such as the arms, are typically preferred over the lower extremities (legs) for intravenous access. This choice helps prevent lower extremity phlebitis and the risk of emboli. ●​ Avoiding Specific Areas : Certain areas should be avoided for intravenous access. These include: ○​ The side of a client's mastectomy : This area is sensitive, and intravenous access can be uncomfortable. ○​ Paralyzed limbs : Intravenous access in paralyzed limbs may be challenging and less reliable. ○​ Dialysis access sites : These areas are reserved for specialized access and should not be used for routine intravenous therapies. ○​ Areas distal to previous phlebitis or infiltration sites : To minimize complications, veins distal to sites with a history of inflammation or infiltration should be avoided. ●​ Consideration of Therapy Type : The choice of vein should align with the type of therapy the client requires. Larger intravenous catheters are needed for specific therapies, such as blood transfusions. For example: ○​ An 18-gauge catheter is typically used for blood transfusions. ○​ Major trauma cases in the emergency department may require a larger 16-gauge catheter to address various needs. ○​ Smaller 22 or 24-gauge catheters are suitable for clients receiving intravenous fluids and medications through peripheral venous access. Inserting a Peripheral Intravenous Catheter The procedure for inserting a peripheral intravenous catheter is as follows: 1.​ Explain the procedure to the client, and maintain sterile supplies and techniques for starting an intravenous line.

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