TroubleshootingSpotting and correcting equipment problems

Spotting and correcting equipment problems

I.V. equipment

Infusion interruptions

When an infusion stops, assess the I.V. system systematically—from the patient to the fluid container—for potential trouble areas.

Check the I.V. site

Check for infiltration or phlebitis, which may slow or stop the flow rate.

Check for patency

Evaluate the I.V. device for patency and catheter-related complications, keeping in mind that several factors can affect it.

♦ Increased blood pressure may stop the I.V. flow if the patient’s limb is flexed or is lying directly on the I.V. site. Reposition the limb as necessary.

♦ If the patient’s arm is wrapped with tape, a tourniquet effect may reduce the I.V. flow rate. Taping the I.V. site too tightly can cause the same problem. Release or remove the tape and reapply it.

♦ Local edema or poor tissue perfusion as a result of disease can block the venous flow. Move the I.V. line to an unaffected site.

♦ Infusion of incompatible fluid or medication may cause a precipitate to form. This can block the I.V. tubing and venipuncture device and may even expose the patient to a life-threatening embolism. Always check the compatibility of all medications and the I.V. solution before administering them. Replace the venipuncture device if it’s occluded.

Check the filter

Use filters with total parenteral nutrition (TPN) and medications that require filtering. Make sure that the inline filter is the right size and type. TPN fluids are run through a 0.22- or 0.45-micron filter to eliminate air and microorganisms from the system.

If you use the wrong size or type of filter, the solution may not pass through it. For example, such drugs as amphotericin B and lymphocyte immune globulin (Atgam) consist of molecules that are too large to pass through a 0.22-micron filter; they rapidly block the filter and stop the I.V. flow. If necessary, replace the filter.

The interval between filter changes is usually every 72 hours, depending on the manufacturer’s instructions. Change the filter, if necessary.

Check the clamps

Make sure that the flow clamps are open. Check all clamps, including the roller clamp and any clamps on secondary sets such as a slide clamp on a filter. A roller clamp may become jammed if the roller is pushed up too far.

Check the tubing

Determine if the tubing is kinked or if the patient is lying on it. Also check whether the tubing remains crimped where a clamp was tightened around it. If so, gently squeeze the area between your fingers to round out the tubing to its original shape or change the tubing altogether.

Check the air vents

If you’re using an evacuated glass container, you’ll need an air vent to make the I.V. solution flow. Insert one, as needed. On a volume-control set, the air vent is usually located at the top of the calibrated chamber. If the solution flow stops, check the patency of the vent and the position of the vent clamp. Follow the manufacturer’s instructions to check the vent’s patency.

Check the fluid level

Observe the fluid level in the I.V. container. If the container is empty, replace it, as ordered. If the solution is cold, it may be causing venous spasm, thus decreasing the flow rate. Applying warm compresses can relieve venous spasm and increase the flow rate. Make sure that other solutions are given at room temperature. Finally, check to see if the spike at the end of the administration set has been pushed far enough into the container to allow the solution to flow.

If you can’t identify the problem with this series of checks, remove the I.V. line and restart it at a different site. Document the episode in the patient’s chart.

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Aug 18, 2016 | Posted by in NURSING | Comments Off on TroubleshootingSpotting and correcting equipment problems

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