According to the accredited Dynamic Nursing Education CE course, there are five reasons for intravenous therapy: access to administer blood and medications; providing vitamin and nutritional supplementation; replacing previous fluid lost; replacing concurrent fluid losses; and providing an access for electrolyte replacement. This is accomplished by inserting a needle or angiocatheter into a vein, commonly in the upper extremities. Complications can occur at the insertion site or the vein, which can lead to serious problems.
Infiltration
The Columbia Center for New Media Teaching and Learning at Columbia University describes infiltration as the infusion of fluid or medication into the surrounding soft tissue. The causes of this can be poor or improper placement of the needle or angiocatheter or the movement of the patient, causing the needle to be pulled out or to puncture the vein. The surrounding skin will appear slightly swollen and pale and be firm and cool to the touch, according to the center.
Hematoma
A hematoma, or bruise, may appear at the puncture site from the seeping of blood into the local tissues. Caused by the improper withdrawl of a needle or angiocatheter, or the lack of pressure upon the withdrawl site, a hematoma usually disappears in a couple of weeks.
Inflammation of Vein
Phlebitis, or inflammation of the vein, is caused by the difference in pH balance of the medication, agent or fluid being administered or introduced into the vein. A metal needle is less irritating to tissues, but an angiocatheter, which is more likely to cause phlebitis, according to Columbus University, is normally used for extended periods of time. Application of warm compresses and elevating the hand or arm usually alleviate the symptoms.
Air Embolism
Air can enter the vein through the IV tubing, although this is a rare occurrence. Most adults can tolerate one cc of air per kg of weight, therefore air embolisms are greater risks for children, explains the Columbia Center for New Media Teaching and Learning. It is important for the provider to ensure all air is out of the tubing prior to the administration of fluids.
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