Intravenous therapy involves the direct administration of fluids, medications, and blood products into a vein. This route offers the fastest systemic absorption, bypassing the digestive tract and first-pass metabolism in the liver. Nurses utilize IV access in various clinical scenarios, including severe dehydration, emergency resuscitation, administration of vesicant drugs, and total parenteral nutrition. Contraindications include localized infections, severe burns at the insertion site, or damaged peripheral vasculature in the chosen extremity.
Successful cannulation relies on choosing an appropriate superficial vein on the upper extremities. Common sites include the metacarpal veins on the back of the hand, the cephalic and basilic veins along the forearm, and the median cubital vein in the antecubital fossa. Nurses should always begin with the most distal veins of the upper limb, preserving proximal sites for future access if complications arise. Sclerosed, bruised, or surgically compromised limbs must be avoided.
Continuous assessment of the infusion site prevents severe local tissue damage. Nurses inspect the insertion site during every shift change or medication administration, checking for pain, redness, swelling, or coolness. Infusion tubing and intermittent locks must be changed according to institutional infection control guidelines. Patency is verified by flushing with normal saline before and after medication administration.
Discontinuation occurs when therapy is complete, complications arise, or the site is no longer required. The nurse closes the roller clamp, gently removes the tape and transparent dressing, and withdraws the cannula parallel to the skin. Pressure is applied immediately using sterile gauze until bleeding stops. The nurse inspects the removed catheter to ensure the tip is intact, preventing retained catheter fragments in circulation.
Accurate charting protects both the patient and the healthcare provider. Nurses must record the date and time of insertion, catheter gauge, anatomical site, type of fluid or medication, number of attempts, and the patient's tolerance. Any complications and subsequent nursing interventions require detailed logging in the patient record. Failure to document accurately can lead to legal liability for negligence.