Name: ______________________________________________ Date: ________________
Course: _____________________________________ ________ Grade:_______________
SETTING UP/ CHANGING/ DISCONTINUING IV INFUSION
STEPS YES NO REMARKS
A. SETTING UP:
1. Verify doctor’s order and make IV label.
2. Explain procedure to patient / SO.
3. Assess patient’s vein: choose appropriate vein,
location, size condition.
4. Wash hands before and after procedure. Maintain
asepsis throughout the preparation and during therapy.
5. Prepare necessary materials for procedure (IV tray
with IV solution, IV set, IV cannula/insyte, forcep
soaked in antiseptic solution, alcohol
swabs or cotton balls soaked with alcohol in a
