Discontinuing Intravenous Fluids and a Peripheral Intravenous Line

Source: Madeline Lassche, MSNEd, RN and Katie Baraki, MSN, RN, College of Nursing, University of Utah, UT

Intravenous (IV) fluid administration and peripheral IV catheters (PIVs) may be discontinued for a number of reasons. The most common reason for discontinuing IV fluids is that the patient has returned to normal body fluid volume (euvolemia) and is able to maintain adequate oral fluid intake or is being discharged from the hospital. In addition, the Centers for Disease Control Guidelines for the Prevention of Intravascular Catheter-Related Infections (2011) recommends replacing PIVs every 72-96 h in adults to prevent the risk of infection or phlebitis. If the PIV becomes dislodged or if the insertion site demonstrates the signs and symptoms of infection, infiltration, extravasation, or phlebitis, the PIV should be discontinued and replaced. For pediatric patients, the Infusion Nurses Society recommends replacing the PIV only when the IV infusion site is no longer patent or when it demonstrates the signs and symptoms of complications.

This video describes the approach to discontinue IV fluid administration and PIVs.

1. General IV fluid infusion discontinuation and PIV removal considerations (review in the room, with the patient).

Upon first entering the patient's room, clean your hands with a sanitizer or with soap and warm water, applying vigorous friction for at least 20 s.
Review the patient's electronic health record for fluid volume status. This includes intake and output total volumes, serum laboratory results, vital sign assessments, skin turgor, mucus membranes, and the patient's ability to

While the discontinuation of IV fluids and the removal of a PIV appears to be a straightforward process, the nurse should ensure adequate preparation and assessment prior to the procedure and should closely monitor the patient afterwards. Prior to discontinuing IV fluids and removing the PIV, the nurse must verify that the patient no longer requires IV therapy and educate the patient to ensure that he/she understands his/her responsibilities to maintain adequate hydration. Both the nurse and the patient need to continue

Policies and procedures for infusion nursing, Fourth Edition. Chapter 5: Vascular access device site selection and placement. Infusion Nurses Society. (2011).
Potter, P. A., Perry, A. G. Fundamentals of Nursing, Seventh Edition. Elsevier. St. Louis, MO. (2009).
Grady, N. et al. Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention. (2011).

Transcript

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