Final answer:
Avoid initiating an intravenous infusion in the foot of a child, the left arm after a mastectomy, areas with venous bifurcation or valves, proximal to previous venipuncture sites, sclerosed veins, the side of paralysis, and extremities with dialysis shunts. Prefer the median cubital vein, inner arm, or dorsal surface of the hand in adults.
Step-by-step explanation:
When initiating an intravenous infusion, certain sites should be avoided to prevent complications such as infection, thrombosis, or inadequate perfusion. According to best practices in health care, the following sites should be avoided:
- The foot of a child due to the risk of injury and complications.
- The left arm of a patient who has had a left mastectomy because lymph drainage has likely been compromised.
- An area of venous bifurcation or palpation of valves to prevent damage to venous structures.
- A site proximal to a previous venipuncture to avoid the risk of phlebitis or infiltration.
- Sclerosed or hardened cordlike veins, which may be difficult to access and could harm the patient.
- The side of paralysis, which can lead to further complications due to possibly impaired circulatory or lymphatic flow.
- An extremity with a dialysis shunt, as it could damage the shunt and impair its function.
It is generally recommended to utilize the median cubital vein or other accessible veins in the inner arm or on the dorsal surface of the hand in adults for venipuncture or intravenous infusion. Such veins are typically easier to access and display fewer complications.