SKILLS ENHANCEMENT N103 CHECKLIST NAME:__________________________________ Sec.:______________________ Yr.

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PROCEDURE: Assisting in Intravenous Therapy (IV) Purpose : Perform 1. To maintain/replace body stores of water ed and electrolytes 2. To restore acid-base balance 3. Provide avenue for administration of medications I.Assisting in Preparation of IV line Ye No 4. Assess the following: s a. Take baseline V/S b. Skin turgor c. Allergy to adhesive tape / iodine d. Bleeding tendencies e. Status of veins appropriate for venipuncture f. Disease or injury to extremity 5. Identify/ enumerate the different IV access sites (at least 7) 6. Hand hygiene 7. Assemble equipments 8. Explain the procedure 9. Assist in opening and preparing of the infusion set a. remove the tubing from the container and straighten it out. b. slide the tubing clamp along the tubing until it is low the drip chamber c. close clamp d. leave the end of the tubing covered with plastic caps until the infusion is started 10.Assist in spiking the solution a. remove the protective cover from the entry site of the bottle b. remove cap from the spike c. insert the spike into the insertion site of the bag/ bottle. 11.Help in applying a timing label on the solution container 12.Hang solution container on the IV pole 3feet above clients Head. 13.Assist in filling the drip chamber ( half
SKILLS ENHANCEMENT N103 CHECKLIST

COMMENTS

Assisting in Intravenous Therapy (IV) 1

full ) 14.Assist in priming the tubing II. Assisting during the insertion : 15.Accurately give the necessary equipments needed by the nurse IV therapist/ physician a. antimicrobial swabs b. tourniquet c. appropriate gauge of IV catheter d. splint or armboard e. transparent dressing / adhesive tap 16.Help in taping the catheter in place ( as per policy of the institution) a. tape the catheter by U method or as per facility policy b. Prepare adhesive tape (3) each about 7.5 cm long. c. Place the first adhesive tape sticky side under the Catheters hub. d. Place the second adhesive tape sticky side over Catheters hub e. Place third adhesive tape sticky side down over the Tubing. 17.Ensure appropriate infusion flow with primary nurse a. Do own calculation of desired flow and verify with primary nurse b. Assist in adjusting desired flow 18.Label IV tubing with the date and time and your initial or per facility protocol as verified by primary nurse 19.Label the IV bottle (name of the solution, flow rate, time infused time IV will be consumed) as verified by primary nurse 20.Document relevant data as verified by primary nurse. a. time of infusion b. flow rate c. amount and type of solution d. type and gauge of needle e. venipuncture site f. clients response III. Nursing Care of a Client in IV Therapy 21.Check the IV at least every hour or as often as needed.
SKILLS ENHANCEMENT N103 CHECKLIST Assisting in Intravenous Therapy (IV) 2

22.Maintain the correct rate of flow. If the IV stops dripping, check the ffg: a. Kinks in the tubing b. Patient lying on the tubing c. Infiltration d. Amount of fluid left in the bottle e. Position 23.Do not speed IV rate to catch up 24.Check the position of the extremity 25.Check the appearance of the solution 26.Support the arm while patient is turning on bed 27.Observe the venipuncture site for complications 28.Report to primary nurse or physician any significant findings 29.Assist in the management of complications, if there are any 30.Document relevant information and management given. IV. Assisting in Changing IV Solution 31.Review clients medical record for an order 32.Prepare the new solution for changing with primary nurse 33.Move roller clamp to off position as instructed by primary nurse 34.Remove old solution from the IV stand 35.Quickly remove spike from old IV solution without touching the tip and insert spike to new intravenous solution 36.Hang new IV solution in the IV pole 37.Assist in regulating the flow rate to prescribed rate 38.Dispose old IV solution appropriately 39.Record amount and type of fluid infused with the date and time as verified by the primary nurse V. Disconnecting an IV catheter 40.Review clients medical record for an order 41.Assemble equipments 42.Wash hands 43.Identify client 44.Explain the procedure 45.Turn off IV fluids by closing the roller clamp on the infusion tubing as instructed by primary nurse
SKILLS ENHANCEMENT N103 CHECKLIST Assisting in Intravenous Therapy (IV) 3

46.Don clean gloves 47.Maintain aseptic technique 48.Loosen transparent dressing and tape, start at the outer edges and pull towards the IV puncture site 49.Place a 2x2 gauze pad over puncture site and withdraw the IV catheter by pulling straight back away from the puncture site. 50.Apply pressure to the puncture site with the gauze pad for 1-2 mins. Or until bleeding stops. 51.Use alcohol or soap and water or per facility policy to remove dried blood from around the site. 52.Cover with new 2x2 gauze pad and tape 53.Examine catheter for intactness 54.Remove all IV equipment from room 55.Record IV site location, time removed, IV catheter intactness, appearance of puncture site and surrounding skin and amount of fluid infused (or as per facility policy).

Total score: 55

Prepared by: N103 Team

Noted by: PROF. GEMELIN B. CELIZ Over-all Clinical Coordinator

SKILLS ENHANCEMENT N103 CHECKLIST

Assisting in Intravenous Therapy (IV) 4