Lesson 1, Topic 1
In Progress

Monitoring IV Therapy

April 11, 2024

Monitoring IV Therapy

Learning Objective: Demonstrate how to monitor IVs and reduce the risk of complications.

Once the IV is initiated, the medical assistant must monitor the IV infusion and the patient. The rest of the chapter addresses monitoring and maintaining IVs, identifying complications, and discontinuing IV therapy.

Monitoring the Infusion and the Patient

Learning Objective: Describe how a medical assistant should monitor the IV infusion and the patient for complications.

The patient should be checked at least every 30 to 60 minutes, depending on the situation and the facility’s policy. The medical assistant should check on the patient and the site for complications. The medical assistant should obtain the vital signs, listen for changes in the patient’s breathing, and ask how the patient is feeling. Concerns such as pain at or above the insertion site or difficulty breathing need to be reported to the provider. If a gravity infusion is used, the flow rate must be checked.
Even though a medical assistant sets the flow rate, frequent checking of the flow rate is critical to the safety of the IV infusion. If the IV catheter is inserted near an area of flexion, the flow rate can change if the patient bends the area. Sometimes patients change their positions, which can speed up or slow down the infusion rate. The hand and arm should be below the heart level. If raised above the heart, the flow rate can change. If the tubing becomes kinked, the infusion rate slows down. In some situations, the patient or family member may “adjust” the roller clamp, changing the flow rate. The patient should be instructed not to touch the roller clamp. Frequent checks can help prevent infusion issues.

Reducing the Risk of Complications

Learning Objective: Describe strategies to reduce the risk of complications.ve: Describe how a medical assistant should monitor the IV infusion and the patient for complications.

Many times, a patient receives a one-time treatment of IV solution. The catheter is inserted, the IV therapy is performed, and the catheter is removed. In some cases, the patient may need to return to the ambulatory care facility for additional infusions. In those cases, the medical assistant must know the guidelines for flushing the IV catheter and when to change the IV site, tubing, and IV solution bags. The following strategies are used to reduce the risk of complications.Even though a medical assistant sets the flow rate, frequent checking of the flow rate is critical to the safety of the IV infusion. If the IV catheter is inserted near an area of flexion, the flow rate can change if the patient bends the area. Sometimes patients change their positions, which can speed up or slow down the infusion rate. The hand and arm should be below the heart level. If raised above the heart, the flow rate can change. If the tubing becomes kinked, the infusion rate slows down. In some situations, the patient or family member may “adjust” the roller clamp, changing the flow rate. The patient should be instructed not to touch the roller clamp. Frequent checks can help prevent infusion issues.

• Use sterile technique when changing IV solution bags or priming IV tubing.
• IV tubing and the site are changed every 72 to 96 hours or per the healthcare facility’s policies.
• The IV catheter is removed if the insertion site has any tenderness, redness, swelling, or drainage.
• If the IV catheter remains in for an extended period of time, the transparent semipermeable membrane dressing should be changed every 5 to 7 days. Gauze dressings should be changed every 2 days.
• IV solution bags are changed every 24 hours (Procedure 36.3).
• IV catheter and extension tubing not in use need to be flushed every 12 hours with 3 to 5 mL of sterile normal saline. This maintains the patency of the catheter. (Flushing IV catheters may be outside the medical assistant’s scope of practice in some states.)Even though a medical assistant sets the flow rate, frequent checking of the flow rate is critical to the safety of the IV infusion. If the IV catheter is inserted near an area of flexion, the flow rate can change if the patient bends the area. Sometimes patients change their positions, which can speed up or slow down the infusion rate. The hand and arm should be below the heart level. If raised above the heart, the flow rate can change. If the tubing becomes kinked, the infusion rate slows down. In some situations, the patient or family member may “adjust” the roller clamp, changing the flow rate. The patient should be instructed not to touch the roller clamp. Frequent checks can help prevent infusion issues.