The nurse preparing to insert an IV on an older adult client notices that the client's skin is extremely fragile. Which action by the nurse is best?
a. Use a blood pressure cuff to cause the vein to distend.
b. Slap the skin vigorously to cause the vein to rise.
c. Place a gauze pad under the tourniquet before tightening.
d. Avoid the use of a tourniquet if the vein is already hard.
A
The skin of older adults is often fragile, and a tourniquet may leave an ecchymotic area after the IV insertion. One option for fragile skin is to inflate a blood pressure cuff to a reading just slightly less than the client's diastolic pressure. Tapping the skin lightly may help distend a vein, but avoid slapping vigorously. Gauze padding would not prevent bruising. Veins that are already distended may be cannulated without using a tourniquet, but they must be assessed first, and hard or cordlike veins need to be avoided.
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