Chapter 8: IV Therapy
8.7 Priming IV Tubing / Changing IV Bags / Changing IV Tubing
Critical Thinking Exercises: Questions, Answers, and Sources / References
- What is the purpose of removing air from IV tubing?
Answer: to prevent possible air emboli for the patient. It is unknown how much air will cause death, but deaths have been reported with as little as 10 ml of air. The best way to avoid air bubbles in IV tubing is to prevent them in the first place (Perry et al., 2014).
2. You come on shift and notice the patient’s IV tubing is not labeled. Describe your next actions.
Answer: IV tubing should be changed according to agency protocols. Generally IV tubing that has an infusion is changed every 96 hours. IV tubing used for intermittent IV infusion (ie. antibiotics) is changed every 24 hours. PN tubing is changed every 24 hours. Blood tubing is changed every 4 hours or after 2 units, which ever comes first.
The first step is to investigate when the tubing was changed. Sometimes the nurse can figure it out ie. if the patient was just admitted then they can presume the tubing is new. If in doubt the nurse should change the tubing and ensure it is labelled clearly for all to see.
Sources:
Fulcher, E. M., & Fraser, M. S. (2007). Introduction to intravenous therapy for health professionals. St Louis, MO: Elsevier.
Perry, A.G., Potter, P.A., & Ostendorf, W. (2017). Clinical skills and nursing techniques (9th ed). St. Louis, MO: Elsevier-Mosby.
- When changing an IV bag, the nurse accidentally touches the spike. What should the nurse do?
| a. | Stop. Drop the equipment and get help. | Incorrect. Yes the nurse must stop. Dropping the equipment may cause more harm. The nurse should stop the infusion if they haven’t already and quickly get another IV set up, prime the line and hang it. |
| b. | Stop. Protect the IV tubing / patient from further risk of CRBSI (catheter related blood stream infection). Get new IV tubing. | Correct. Contaminating the spike increases risk to the patient for infection. The nurse should quickly get another IV set up, prime the tubing and reestablish the infusion. |
| c. | Nothing. Proceed as if nothing has happened. The nurse is assured because they had just completed good hand hygiene prior. | Incorrect. A contaminated spike puts the patient at risk for CRBSI. The nurse should get new tubing, prime it and re-establish the infusion. |