ISDH - CNA

Indiana State Department of Health

Certified Nursing Assistant

Lesson 20

Lesson 20

Special Care Needs - IV fluids, Non-Pharmacological Pain Interventions

Lesson 20 Objectives

• The student will be able to explain the purpose of IV/PICC lines.
• The student will be able to describe the importance of observing and reporting complications related to IV/PICC lines.
• The student will be able to explain the signs/symptoms of pain and acknowledge interventions to be attempted to relieve resident pain.

RCPs NONE

Curriculum pages 99 - 102

• What are possible signs/symptoms of pain?

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• What are the reasons for an IV or PICC line?

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• Why would a resident not admit to having pain?

• Medication administration, such as antibiotics

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• Nutrition administration

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• Hydration

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• Blood products

• Solutions are administered by gravity or through a portable pump

Purpose of IV or PICC line

Role of Nurse Aide in Caring for IV/PICC

• Observe and Report
• Line found out or is removed by resident, or accidentally by staff when providing care
• Blood present anywhere in the tubing
• Tubing is disconnected
• Complaint of pain
• Fluid in bag is not observed dripping
• Fluid in bag is nearly gone or finished
• Pump is alarming
• Site is swollen or discolored
• Dressing is wet or soiled
• Take special caution when moving or caring for resident – avoid pulling or catching of tubing
• Never disconnect IV or PICC from pump
• Never lower bag below IV/PICC site
• Do not take blood pressure in arm with IV or PICC
• NEVER change the flow rate

What is the difference between

IV and PICC

https://www.mayoclinic.org/tests-procedures/picc-line/about/pac-20468748

Peripherally

Inserted

Central

Catheter

IntraVenous

Considerations

Infection Control IV/PICC

• Use proper hand hygiene
• Observe site for signs of infections and report to the nurse if observed
• Redness
• Swelling
• Pain

Port Catheter

Pain Factors

• Change in vital signs - increased HR/RR/bp
• Nausea &/or vomiting
• Seating
• Grimacing/Frowning
• Crying/Tears in eyes
• Moaning/Groaning/Sighing
• Difficulty breathing
• Restlessness
• Guarding or difficulty moving
• Rubbing or holding body part
• Grinding teeth or clenching jaw
• Increased anxiety

Pain Observations - Verbal or Nonverbal

Report any of these findings to the nurse

Nurse Aide Role in Pain Management

Vital Signs should be taken, if directed by nurse to do so

Information related to pain

• Location
• When did it start
• What was resident doing when pain started
• Rate the pain, i.e., mild, moderate or severe on scale of 1-10
• How long has the resident been having pain
• Describe the pain, i.e., ache, stabbing, crushing, dull, constant, burning,
• Use resident’s words/description to report to nurse

• Report complaints of pain or unrelieved pain (after having been given a pain medication) to the nurse
• Position the resident’s body in good alignment or assist to reposition the resident at the resident’s direction in regard to a comfortable position
• Offer a back rub to the resident
• Assist the resident to the bathroom or offer the bedpan or urinal
• Encourage the resident to take slow, deep breaths
• Provide a quiet and calm environment
• Use soft music to distract the resident
• Be patient, caring, gentle and sympathetic in assisting the resident
• Observe the resident’s response to interventions attempted and report to the nurse

Interventions to Reduce Pain

Barriers for Resident Pain

• Fear of addiction to pain medication

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• Feeling caregivers are too busy to deal with pain

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• Fear pain medication will cause other problems, i.e. drowsiness, sleepiness, constipation

End of ISDH CNA Lesson 20

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