Case Study Worksheet for IV Lab Day
To prepare for your IV skills day and to complete this worksheet:
- Complete the ATI IV Therapy Skills module. After you have completed this module, please
print your post-test results and bring this to class. If you are having difficulty please email Dr. Thompson
(kthompson55@liberty.edu).
-Read Perry & Potter Clinical Nursing Skills & Techniques (8th ed.) pages 694 – 708, and 724 –
725; Lewis et al.: Medical Surgical Nursing pg. 309 – 312; BD Autogard Tips for Success; BD Vessels of
Upper Extremities; you will need a drug book as well to complete the worksheet below.
( Bring this completed worksheet with you on Friday)
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MC is a 79 year old male who has been admitted to the General Medical Unit
(GMU) with the diagnosis of a GI bleed. He has had a single lumen PICC placed in his
upper left arm basilic vein and he is currently receiving the first of 2 units of packed red
blood cells (PRBC).
1. Compare and contrast a central line and a peripheral IV.
In a central line, the tubing ends within the superior vena cava. In a peripheral IV, the
tubing ends in the extremity where the IV is inserted.
2. What does PICC stand for? Is a PICC considered a central line or a peripheral line?
Peripherally Inserted Central Catheter. It’s considered a central line.
MC’s physician has just written an order for him to receive 8 mg of Zofran IV X1
now to help with all of the nausea he has been experiencing. Your instructor states that he
will need a peripheral IV placed since PRBC’s are infusing through his single lumen PICC.
3. The BD Vessels of Upper Extremities handout lists 8 key points to consider with site selection.
Summarize these 8 points.
1. The location and condition that the vein is in should be considered. Soft and straight
veins are usually preferred
2. The purpose that you’re giving the infusion and the type of infusion should be
considered.
3. The duration that the patient will undergo IV therapy.
4. The material that the catheter is made of.
5. The size of the catheter to be inserted.
Case Study Worksheet for IV Lab Day
6. The age of the patient, their medical history, former IV insertion sites, and the
patients procedure.
7. The patients activity level.
8. Ask if the patient has a preference for the insertion site.
4. According to BD Vessels of Upper Extremities, list the suggestions of sites to avoid when
starting a peripheral IV.
1. Joint regions.
2. Sclerotic veins.
3. IV access near a site experiencing complication such as phlebitis, infection or
infiltration.
4. sites located under or near restraints.
5. Locations with impaired circulation such as varicosities.
6. Legs and feet except for babies.
7. Veins on the inside of the wrist.
8. Veins located in the same arm as a mastectomy.
9. A Vein in an arm with an arteriovenous shunt or fistula.
5. According to Perry and Potter, what supplies will you need to take with you to insert MCs
new peripheral IV?
1. proper vascular access device. 20-guage for an adult, 22-guage catheter for eldery
patients and children
2. Sterile drape.
3. Tourquinet.
4. Antiseptic swaps.
5. Transparent dressing.
Case Study Worksheet for IV Lab Day
6. non allergic tabe and sterile tape.
7. Local anesthetic.
8. Short extension tubing with fused or separate needless connector.
9. syringe containing 1 to 3mL of normal saline.
10. A catheter stabilization device.
11. clean gloves.
12. 8 mg of Zofran
6. If your patient has hairy arms, what is the best way to prepare the site according to Perry &
Potter?
Clip the of insertion using scissors because the hair may interfere with the puncture
and impair the adherence of the dressing.
7. List three Gerontologic Considerations (from Perry & Potter) when starting an IV on an
elderly patient.
1. Don’t tap the the IV insertion site or a hematoma could occur.
2. Veins tend to roll away from the needle due to loss of subcutaneous tissue. Apply
slight traction on the skin below the insertion site
3. Avoid vigorous friction while cleaning the access site to prevent tearing of skin.
8. According to INS Standard (Perry & Potter, pg. 696), how long do you need to let the site dry
after you have cleaned it?
Until the site is dry because it reduces the risk of microbial infection and phlebitis.
9. According to the BD Angiocath Autogard Handout Tips for Success, what are the three points
regarding ‘Threading with Ease’?
1. After the flash, lower the angle and advance slightly, before threading catheter off
the needle.
2. Avoid the push-pull technique when advancing the catheter
Case Study Worksheet for IV Lab Day
3. Maintain traction on the skin.
10. Once you have successfully placed MCs new peripheral IV, how will you prepare and
administer the above Zofran medication order? (use your drug handbook to look up the
information on how this medication needs to be prepared and administered)
1. The maximum dosage of Zofran is 16 mg.
2. The medication should be diluted in 50 mL of Dextrose 5% of 0.9% normal saline.
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