I.V. Infiltration: Causes, Symptoms & Treatment

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  • 0:04 I.V. Infiltration
  • 1:03 I.V. Infiltration Causes
  • 1:38 I.V. Infiltration Treatment
  • 2:12 I.V. Infiltration Prevention
  • 2:34 Lesson Summary
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Lesson Transcript
Instructor: Nadine Kantala
In this lesson, you will learn about I.V. infiltration. Upon the completion of this lesson, you should be able to define and list the causes, symptoms, and treatment of I.V. infiltration.

I.V. Infiltration

Imagine this: you're the nurse on duty and one of your patients is due to receive I.V. furosemide (Lasix). As you begin to administer the medication, your patient complains that the I.V. site hurts. She says that it has never hurt like this before. You take a closer look and find that there is significant swelling at the site, especially when compared to the opposite limb. What has happened here?

I.V. infiltration occurs when nonvesicant drugs escape the vein and leak out into the surrounding tissue. Nonvesicant drugs are drugs that do not cause blisters or tissue necrosis. A related complication is I.V. extravasation, which occurs when vesicant drugs escape the vein and leak out into the surrounding tissue. Generally speaking, this is a more serious condition, since vesicant solutions have the potential to cause blisters, tissue injury, or necrosis. Common vesicant drugs include antineoplastic drugs such as doxorubicin or vinblastine. Other vesicant drugs include digoxin and dopamine.

I.V. Infiltration Causes

Sometimes the vein wall can accidentally be punctured during the insertion process. Sometimes the patient's movements can dislodge the I.V. catheter. Another cause is inflammation, which can enlarge the gap between the cells in the wall of the vein, thus letting fluid leak out.

Common signs and symptoms of I.V. infiltration include the following:

  • Edema
  • Blanching
  • Coolness at the insertion site
  • Patient's report of pain
  • A ''tight'' feeling

A helpful tip is to compare it with the opposite limb. For example, if the I.V. is in the right hand, you can see how that right hand looks compared to the left hand.

I.V. Infiltration Treatment

The most important thing you can do is immediately stop the infusion and discontinue the I.V. catheter. Elevating the patient's limb may also help to decrease the discomfort. Warm compresses may be used.

Another intervention that may be used is the administration of an antidote. Hyaluronidase breaks down subcutaneous cellular components to promote the reabsorption of fluids and is often used in severe cases. You, as the nurse, will receive an order for the proper dose and administration of hyaluronidase. In the absolute worst cases, the patient will need surgical decompression with a fasciotomy immediately.

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