A nurse is caring for a homeless client who is moderately malnourished and suffering from pneumonia. The client needs a peripheral IV line for fluid administration. Which IV site should the nurse select to reduce the risk for infection?

Question

A nurse is caring for a homeless client who is moderately malnourished and suffering from pneumonia.  The client needs a peripheral IV line for fluid administration.  Which IV site should the nurse select to reduce the risk for infection?

Quizplus · Accepted Answer

11ecbb05_cb63_5cfb_b433_d5c046ea23ea_MD0009_00 Clients most at risk for catheter-related bloodstream infections are those with compromised immune systems; therefore, this client is at high risk. The IV site chosen for catheter insertion can influence the infection risk. The risk is higher using the lower extremities compared to the upper extremities and using the wrist or upper arm compared to the hand. Unless the client is very old or very young, the hand is a good site as it is most distal, allowing future sites to be selected higher on the arm if needed. (Option A) The antecubital fossa is commonly selected in emergency situations due to its size and ease of cannulation but is problem prone for longer-term needs as it is in the bend of the elbow. Bending of the arm can move the catheter, causing irritation at the insertion site and increasing infection risk. (Option C) The foot is not typically accessed in adults without a specific health care provider prescription. It is occasionally used in emergency situations; however, veins in the legs and feet may have decreased venous return, and complications can lead to thrombophlebitis or deep vein thrombosis. (Option D) The radial vein is present on the lateral side of the wrist but is in close proximity to several nerves, which could cause severe pain or nerve damage. Educational objective: Peripheral IV sites should be selected in the hand or forearm to reduce the risk of catheter-related bloodstream infections. Sites on the upper extremities located at flexion sites (eg, wrist, bend of arm) and the lower extremities should be avoided.

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