To minimize the risk of client injury, which site does the nurse use for an IV insertion after discontinuing a leaking IV?
1. Right arm of a client closer to the heart
2. Left arm of a client with a left hemiparesis
3. Right arm of client with a right mastectomy
4. Left arm of client with a left arteriovenous shunt
1
1. The nurse can use the same extremity but must choose a site closer to the client's heart to avoid leakage and prolonged irritation from the old IV site thus helping to prevent thromboembolic and infectious complications and client discomfort.
2, 3, and 4. The nurse avoids inserting IVs into arms with hemodialysis shunts or on the same side as a mastectomy or hemiparesis because these extremities are at high risk for vascular complications already.
3. A mastectomy tends to impair lymphatic drainage and venous return from the af-fected side. IV fluid infusions overwhelm the lymphatic and venous reserves of the client on the affected side and increase the risk of impaired tissue integrity and client injury.
4. Dialysis shunts and fistulas are delicate structures, so the nurse avoids any unne-cessary manipulation of the arm.
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