A nurse is preparing to initiate IV therapy for a client.
Which of the following sites should the nurse use to place the peripheral IV catheter?
A.
Dominant antecubital basilic vein.
B.
Nondominant dorsal venous arch.
C.
Dominant distal dorsal vein.
D.
Nondominant forearm basilic vein
The Correct answer and Explanation is:
The correct answer is B. Nondominant dorsal venous arch.
Explanation:
When selecting a site for peripheral intravenous (IV) catheter insertion, several factors must be considered to ensure the best outcomes and reduce complications. The nurse should prioritize choosing a site that is easy to access, relatively pain-free, and less likely to be affected by the client’s daily activities.
Option B: Nondominant dorsal venous arch is the most appropriate choice for several reasons:
- Accessibility and Visibility: The dorsal venous arch, located on the back of the hand, is often easily visible and palpable, making it a common and accessible site for IV insertion. The veins in this area tend to be superficial, which facilitates easier catheter placement.
- Reduced Risk of Complications: Choosing the nondominant hand minimizes the likelihood of the IV being disturbed by the patient’s activities, such as writing, eating, or other daily tasks. This can help reduce the risk of dislodgement, infiltration, or phlebitis. Additionally, the veins in the hand are less likely to be involved in movements that can lead to catheter-related complications.
- Distal Placement: Initiating IV therapy in a distal site, such as the dorsal venous arch, is advisable because if the IV site becomes compromised (e.g., infiltration or phlebitis), the nurse can choose a more proximal site for reinsertion. Starting distally also allows for potential escalation to higher or more central veins if necessary, without compromising future IV access options.
Incorrect Options:
- Option A: Dominant antecubital basilic vein: While the antecubital vein is large and often easy to access, it is located near a joint, making it prone to complications like phlebitis and discomfort due to movement. Additionally, using the dominant arm can interfere with daily activities.
- Option C: Dominant distal dorsal vein: Though distal sites are preferred, using the dominant hand increases the risk of dislodgement due to frequent movement and use, making it less ideal.
- Option D: Nondominant forearm basilic vein: Although a good option for longer-term therapy, the forearm veins are usually reserved for larger gauge catheters or when more distal sites are not viable. Starting distally is always preferred.
In summary, the nondominant dorsal venous arch is the most appropriate site for initial peripheral IV catheter insertion because it minimizes complications, preserves vein options for future use, and ensures patient comfort and mobility.