Question

After inserting an intravenous catheter into a client's vein, the nurse does not obtain blood return. What is the appropriate nursing action?

a) Obtain larger bore catheter.
b) Change catheter insertion site.
c) Gently insert the IV catheter further into the vein.
d) Begin infusion IV fluids and document procedure.

Answer 1

If a nurse does not obtain a blood return after inserting an IV catheter, reassessing placement and patency is crucial. Changing the catheter insertion site is generally recommended to ensure effective delivery of IV fluids and medications.

Step-by-step explanation:

When a nurse does not obtain a blood return after inserting an intravenous catheter, the appropriate action is not to insert the catheter further or to begin infusion right away. Instead, the nurse should first assess the situation, considering whether the catheter may not be in the vein or may be occluded. It is critical to ensure proper catheter placement to prevent complications, such as infiltration or a failed infusion. The correct action would be changing the catheter insertion site after ensuring that the initial placement was not successful. This minimizes the risk of infection and ensures that medications and fluids are delivered effectively. Reassessing catheter placement and verifying its patency is essential before proceeding with any infusions.

If after reassessment the nurse still does not get blood return, and the patient's situation permits, removing the IV catheter and choosing another site, or potentially selecting a different type of catheter, may be necessary. It is crucial to follow infection control guidelines, as bloodstream infections can have serious consequences, and the risks increase with improper catheter management.