Infusion Therapy Fluids
Before the administration of intravenous fluid, it is most important for the nurse to obtain which information fro the health care provider's orders?
a. Intravenous catheter size
b. Osmolarity of the solution
c. Vein to be used for therapy
d. Specific type of IV fluid
d. Specific type of IV fluid
What is the best choice of cannula size?
A. The largest one you feel you can successfully insert in the patient.
B. The smallest one you can find.
C. The smallest guage to accommodate therapy.
D. The largest guage your facility has.
C. The smallest guage to accommodate therapy
A nurse is caring for a client who has just had a central venous access line inserted. Which action should the nurse take next?
a. Begin the prescribed infusion via the new access.
b. Ensure an x-ray is completed to confirm placement.
c. Check medication calculations with a second RN.
d. Make sure the solution is appropriate for a central line.
b. Ensure an x-ray is completed to confirm placement
A patient who was involved in a high-speed motor vehicle crash has just arrived in the ED. You are the nurse who will be placing the IV catheter. You choose which size catheter?
a. 18 g catheter because you do not want to start more than one.
b. 22 g catheter because the patient will likely be in the hospital for a long time.
c. 22 g catheter because the patient will need some irritating medications that will harm the patient less if diluted.
d. 18 g because blood and IVF will need to be administered quickly.
d. 18G because blood and IV fluids will need to be administered quickly.
Nursing administrator is concerned about the incidence of complications related to IV therapy, including bloodstream infection. Which action by the administrator would have the biggest impact on decreasing complications?
a. Investigate initiating a dedicated IV team.
b. Require inservice education for all RNs.
c. Limit IV starts to the most experienced
nurses.
d. Perform quality control testing on skin
preparation products.
a. Investigate initiating a dedicated IV team.
The nurse is caring for a client that is hypovolemic and plasma expanders are not available. The nurse would correctly anticipate that which type of solution would be ordered?
A. TPN
B. Isotonic
C. Hypertonic
D. Hypotonic
B. Isotonic
After 2 unsuccessful attempts at insertion of an IV, the best thing for a health care professional to do would be:
A. Call the doctor to tell him you can't get the IV
B. Keep trying until you get the IV
C. Consult another professional to initiate therapy
D. Hydrate the patient with oral fluids and try again in a few hours
C. Consult another professional to initiate therapy
A nurse is assessing clients who have intravenous therapy prescribed. Which assessment finding for a client with a peripherally inserted central catheter (PICC) requires immediate attention?
a.The initial site dressing is 3 days old.
b.T he PICC was inse d 4 weeks ago.
c. A securement device is absent.
d. Upper extremity swelling is noted.
d. Upper extremity swelling is noted
The nurse has obtained a unit of blood from the blood bank and has checked the blood bag properly with another nurse. Just before beginning the transfusion, the nurse assesses which priority item?
a. Vital signs
b. Skin color
c. Urine output
D. Latest hematocrit level
a. Vital signs
When assessing the client's peripheral IV site, the nurse observes a streak of red along the vein path and palpates a 4-cm venous cord. What is the most accurate documentation of this finding?
a. Grade 3 phlebitis at IV site
b. Infection at IV site
c. Thrombosed area at IV site
d. Infiltration at IV site
a. Grade 3 phlebitis at IV site
An 72 year old patient was admitted to the hospital after daughter found her to be lethargic. Daughter states that she is concerned because her mother has not eaten for 2 weeks. Vital signs are as follows: T 99F (37.2 C), B/P 102/70, HR 78, RR 18. Labs: K 4.3, Na, 138, blood cultures (positive), chest x-ray (P). Provider ordered TPN (Total Parenteral Nutrition) to be started. What action by the nurse is most appropriate?
a. Prepare to administer TPN
b. Request liquid diet dinner tray
c. Call provider
d. Verify PICC line placement
c.
While checking on the patient, the nurse sees that his IV is not running. To troubleshoot, the nurse might (Select all that apply.)
A. lower the container to see if there is a blood return.
B. discontinue the infusion and restart at a new IV site.
C. undo the dressing and rotate the needle or cannula.
D. attempt to aspirate a clot from the IV cannula.
E. check for kinks in the intravenous tubing.
A, C, D, E
The nurse is teaching a hospitalized client who is being discharged about how to care for a peripherally inserted central catheter (PICC) line. Which client statement indicates a need for further education?
a. "I can continue my 20-mile (32Km) running schedule as I have for the past 10 years."
b. "I can still go about my normal activities of daily living".
c. "I have less chance of getting an infection because the line is not in my hand".
d. "The PICC line can stay in for months".
a. "I can continue my 20-mile (32 Km) running schedule as I have for the past 10 years."
A nurse is assisting with caring for a client who has received a transfusion of platelets. The nurse determines that the client is benefiting most from this therapy if the client exhibits which of the following?
1. An increased Hct level
2. An increased Hgb level
3. A decline of the temperature to normal
4. A decrease in oozing from puncture sites and gums
4. A decrease in oozing from puncture sites and gums.
After discontinuing a nontunneled, percutaneous central catheter, it is most important for the nurse to record which information?
a. Application of a sterile dressing
b. Length of the catheter
c. Occurrence of venospasms
d. Type of ointment used to seal the tract
b. Length of the catheter
A nurse is making initial rounds at the beginning of the shift and notice that the parenteral nutrition (PN) bag of an assigned client is empty. Which of the following solutions readily available on the nursing unit should the nurse hang until another PN solution is mixed and delivered to the nursing unit?
A. 10% dextrose in water.
B. 5% dextrose in water.
C. 5% dextrose in normal saline.
D. 5% dextrose in lactated Ringer solution.
A.
A client had a 20-gauge short peripheral catheter (SPC) inserted for antibiotic administration 48 hours ago. Whic nursing intervention is appropriate?
A. Discontinue SPC
B. Relocate the SPC for infection control
C. Assess the SPC for redness, swelling, or pain
D. Change the occlusive dressing covering the SPC
C. Assess the SPC for redness, swelling, or pain
A nurse is caring for a client who is receiving an epidural infusion for pain management. Which assessment finding requires immediate intervention from the nurse?
a. Redness at the catheter insertion site
b. Report of headache and stiff neck
c. Temperature of 100.1° F (37.8° C)
d. Pain rating of 8 on a scale of 0 to 10
b. Report of headache and stiff neck
A patient is scheduled to get a unit of Packed Red Blood Cells (PRBCs) because of anemia of chronic disease. What is the smallest sized IV catheter that can be used in this patient to administer the blood?
a. 18G
b. 20G
c. 16G
d. 22G
d. 22G
A patient is receiving a chemotherapy drug that is a known vesicant. Which type of line is most appropriate? Select all that apply:
A. Peripheral
B. Midline
C. Hickman catheter
D. PICC
C. Hickman catheter
D. PICC
A client involved in a motor vehicle crash presents to the emergency department with severe internal bleeding. The client is severly hypotensive and unresponsive. The nurse anticipates which intravenous (IV) solution will most likely be prescribed to increase intravascular volume, replace immediate blood loss volume, and increase blood pressure?
a. 5% dextrose in Lactated Ringer's
b. 0.33% sodium chloride (1/3 normal saline)
c. 0.225% sodium chloride (1/4 normal saline)
d. 0.45% sodium chloride (1/2 normal saline)
a. 5% dextrose in lactated Ringer's
Which statement is true about the special needs of older adults receiving IV therapy?
a. Placement of the catheter on the back of client's dominant hand is preferred.
b. Skin integrity can be compromised easily by the application of tape or dressings.
c. To avoid rolling the veins, a greater angle of 25 degress between the skin and the catheter will improve success with venipuncture.
d. When the catheter is inserted into the forearm, excess hair should be shaved before insertion.
b. Skin integrity can be compromised easily by the application of tape or dressings.
A nurse is caring for a client who is having a subclavian central venous catheter inserted. The client begins to report chest pain and difficulty breathing. After administering oxygen, which action should the nurse take next?
a. Administer a sublingual nitroglycerin tablet.
b. Prepare to assist with chest tube insertion.
c. Place a sterile dressing over the IV site.
d. Re-position the client into the Trendelenburg position.
b. Prepare to assist with chest tube insertion
A client who is receiving a blood transfusion rings the call bell for the nurse. When entering the room, the nurse notes that the client is flushed, dyspneic, and complaining of generalized itching. The nurse interprets that the client is experiencing:
1. Bacteremia
2. Fluid overload
3. Hypovolemic shock
4. A transfusion reaction
A. A transfusion reaction
The nurse is making initial rounds on the nursing unit to assess the condition of assigned clients. The nurse notes that a client's IV site is cool, pale, and swollen, and the solution is not infusing. The nurse concludes that which of the following complications has occurred.
1. Infection
2. Phlebitis
3. Infiltration
4. Thrombosis
3. Infiltration