There are several factors you need to consider before initiating venipunctures:

 Type of solution to be infused. Hypertonic solutions and

medications are irritating to vein.
 Condition of vein. Use soft, straight, bouncy vein; if you run your
finger down the vein and it feels like a cat’s tail — avoid! Avoid veins
near previously infected areas.
 Duration of therapy. Choose a vein that can support IV therapy for
72–96 hours.
 Catheter size. Hemodilution is important.The gauge of the catheter
should be as small as possible.
 Patient age. Elderly and children need additional time
for assessment and management of insertion.
 Patient activity. Ambulatory patients using crutches or walker need
catheter placement above the wrist.
 Presence of disease or previous surgery. Patients with vascular
disease or dehydration may have limited venous access. If a patient
has a condition causing poor vascular return (mastectomy, stroke),
the affected side must be avoided.
 Presence of shunts or graft. Do not use the arm or hand that has a
patent graft or shunt for dialysis.
 Patient receiving anticoagulation therapy. Patients receiving
anticoagulant therapy have a propensity to bleed. Local ecchymoses
and major hemorrhagic complications can be avoided if the nurse is
aware of the anticoagulant therapy.
Precautions: Minimal tourniquet pressure; use the smallest catheter
that is appropriate for therapy; use care in removing dressing.
 Patient with allergies. Question regarding allergies to medications,
foods, animals, and environmental substances. Identify the allergens:
 Iodine. Avoid povidone-iodine as skin preparation
 Latex. Set up latex allergy cart