The nurse is preparing to start an IV on a 92-year-old patient. The nurse realizes that she may need to take which of the following actions? (Select all that apply.)
a. Avoid using veins in the hand.
b. Avoid using veins in the dominant arm.
c. Use the largest-gauge catheter possible for maximum flow.
d. Avoid using a tourniquet.
A, B, D
In older patients, use the smallest gauge possible. For example, a 22-gauge needle is adequate for fluid and medication therapy; use a 24-gauge in frail, older adults. Smaller-gauge catheters are less traumatizing to the vein but still allow blood flow to provide increased hemodilution of IV fluids or medications. If possible, avoid the back of the older adult's hand or the dominant arm for venipuncture because they interfere with the older adult's independence. Minimize pressure from tourniquets, or avoid them if possible. Apply a blood pressure cuff in place of a tourniquet.
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