Question 1

The nurse is caring for a patient who is receiving intravenous (IV)fluids at a rate of 150 mL per hour.During her assessment,the nurse notes that the patient is having more labored respirations,and that crackles have developed in the patient's lungs.The nurse reduces the IV rate and notifies the physician.She does this while recognizing that the patient is experiencing signs of _______________.

Accepted Answer

The answer of The nurse is caring for a patient...

Question 2

The patient is on daily weights and is receiving intravenous therapy.The nurse notices that the patient has gained 2 kg since the previous morning.What else would the nurse expect to observe? (Select all that apply. )
A)Dry skin and mucous membranes
B)Distended neck veins
C)Tenting of the skin
D)Crackles or rhonchi in the lungs

Accepted Answer

A change in body weight of 1 kg corresponds to 1 L of fluid retention or loss.Dry skin and mucous membranes suggest fluid volume deficit (FVD).Distended neck veins suggest fluid volume excess (FVE).Poor skin turgor is seen when after pinching,the skin fails to return to normal position within 3 seconds.With FVD,the pinched skin stays elevated for several seconds.This is called tenting.Auscultation of crackles or rhonchi in the lungs may signal fluid buildup in the lungs caused by FVE.

Question 3

The nurse is preparing to start an intravenous (IV)infusion 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.

Accepted Answer

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.

Question 4

Which of the following are central venous access devices (CVADs)? (Select all that apply. )
A)Implanted subcutaneous ports
B)Peripherally inserted central catheter (PICC)lines
C)Saline locks
D)Heparin locks

Accepted Answer

Four types of CVADs are available: nontunneled percutaneous central venous catheters,tunneled central venous catheters,peripherally inserted central catheters (PICCs),and implanted subcutaneous ports.

Question 5

While assessing the patient's intravenous (IV)catheter site,the nurse notes that the site is reddened and warm.The patient states that it is "sore." The nurse recognizes these as signs of ____________.

Accepted Answer

The answer of While assessing the patient's intravenous (IV)catheter site,the...

Question 6

Fluids that have the same osmolality as body fluids are used most often to replace extracellular volume and are known as _______________ fluids.

Accepted Answer

The answer of Fluids that have the same osmolality as...

Question 7

For which patients are electronic infusion devices (EIDs)used? (Select all that apply. )
A)Those who require low hourly rates
B)Those who are at risk for volume overload
C)Those who have impaired renal clearance
D)Those who are receiving fluids that require a specific hourly volume

Accepted Answer

Infusion pumps are necessary for patients requiring low hourly rates,at risk for volume overload,with impaired renal clearance,or receiving medications or fluids that require a specific hourly volume.

Question 8

The nurse assigns nursing assistive personnel (NAP)to care for several patients with continuous IV infusions.Which of the following can NAP assist with?
A)Changing empty IV solution containers
B)Confirming the correct IV drip rate
C)Assessing the patient for response to IV therapy
D)Informing the nurse if they notice anything abnormal

Accepted Answer

If nursing assistive personnel (NAP)notice anything they consider abnormal,they should notify the nurse.It is the nurse's responsibility to inform the NAP of specific things to look for.Changing empty intravenous (IV)solution containers cannot be delegated to NAP because the procedure requires knowledge of sterile technique.Confirming the correct IV drip rate is the nurse's responsibility.Assessment is not the responsibility of NAP;it is the responsibility of the nurse.

Question 9

Central venous access devices (CVADs)can be used in the home,in the hospital,and in long-term care facilities for patients who require which of the following? (Select all that apply. )
A)Supplemental nutrition
B)Blood and blood products
C)Hemodynamic monitoring
D)Blood sampling

Accepted Answer

Central venous access devices (CVADs)can be used in the home,in the hospital,and in long-term care facilities for patients who require supplemental nutrition,blood and blood products,continuous fluids,medications,hemodynamic monitoring,and blood sampling.

Question 10

___________________ is manifested by decreased urine output,dry mucous membranes,decreased capillary refill,a disparity in central and peripheral pulses,tachycardia,hypotension,and shock.

Accepted Answer

The answer of ___________________ is manifested by decreased urine output,dry...

Question 11

Which of the following patients would the nurse anticipate requiring the placement of a central venous catheter?
A)A patient in same-day surgery who might require blood transfusions
B)A patient in the intensive care unit requiring multiple simultaneous intravenous medications
C)A patient in the cardiac care unit diagnosed with possible myocardial infarction
D)A patient on the surgical unit recovering from hernia repair

Accepted Answer

The most likely candidate for a central venous catheter is the patient in intensive care requiring the administration of multiple medications.The central venous catheter will simplify the administration of multiple medications to this critically ill patient.Because same-day surgery patients are expected to go home at the end of the day,it would be unlikely this patient would need a central catheter.A patient diagnosed with myocardial infarction would be unlikely to need a central line unless his condition deteriorated.A patient post hernia repair would be unlikely to require a central venous line unless complications arose,which is not indicated in this scenario.

Question 12

The nurse is caring for a patient with a continuous intravenous infusion of 0.9% normal saline with 40 mEq of potassium chloride added to each liter.During a routine hourly check of the infusion,the nurse discovers that 4 hours of fluid has infused in the past 1 hour.The nurse's first action should be to:
A)notify the primary care provider.
B)assess the patient.
C)reduce the infusion rate.
D)notify the charge nurse.

Accepted Answer

If the intravenous fluid is infusing 4 times faster than ordered,the first intervention should be to reduce the infusion rate.Notification of the primary care provider and the charge nurse would occur after the flow rate is reduced and an assessment of the patient is performed.Although assessing the patient is vitally important,you do not want to allow the fluid to continue infusing at a rapid rate while you are performing the assessment.

Question 13

The nurse is caring for a patient who has experienced hypovolemia secondary to acute vomiting and diarrhea.The nurse anticipates what type of intravenous fluid to be ordered by the health care provider?
A)Hypotonic or isotonic solutions
B)Hypertonic or isotonic solutions
C)Hypertonic solutions only
D)Whole blood

Accepted Answer

Hypotonic solutions are administered for cellular dehydration,whereas isotonic solutions replace intravascular fluid,so both of these might be appropriate for this patient.Hypertonic solutions pull fluid from extravascular spaces and would not be appropriate for this patient.Whole blood is not indicated because there is no evidence of blood loss.

Question 14

What should the nurse do upon noting that the patient's intravenous (IV)catheter site is pale,cool,and edematous? (Select all that apply. )
A)Stop the infusion.
B)Elevate the extremity.
C)Start a new IV.
D)Flush the IV site.

Accepted Answer

Infiltration is indicated by swelling and possible pitting edema,pallor,coolness,pain at the insertion site,and a possible decrease in flow rate.The nurse should stop the infusion and should discontinue the intravenous (IV)catheter,elevate the affected extremity,start a new IV if continued therapy is necessary,and document the degree of infiltration and nursing intervention.Flushing the IV site is not recommended.

Question 15

What should the nurse do to decrease the potential for infection related to intravenous (IV)infusion therapy?
A)Use the clean technique for dressing changes.
B)Change the IV tubing every 12 hours.
C)Palpate the insertion site daily through the intact dressing.
D)After cleansing the skin,dab it dry with a sterile gauze pad.

Accepted Answer

Palpate the catheter insertion site for tenderness daily through the intact dressing.Perform hand hygiene before and after palpating,inserting,replacing,or dressing any intravascular device.Maintain use of sterile dressings.Replace intravenous (IV)tubing no more frequently than at 72-hour intervals unless clinically indicated.Allow the site to air-dry before proceeding with the procedure.

Question 16

The nurse is caring for a patient who will be on long-term antibiotic therapy.The patient has had numerous intravenous (IV)catheters in the past,but because the upcoming therapy will be given on a long-term basis,the nurse suggests that a _________________ be inserted.

Accepted Answer

The answer of The nurse is caring for a patient...

Question 17

The nurse is preparing to draw blood from a central venous access device for blood cultures.Which of the following steps is part of that process?
A)Apply sterile gloves.
B)Flush the port with 5 to 10 mL of 0.9% sodium chloride.
C)Slowly aspirate 5 mL of blood and discard the syringe.
D)Use the distal lumen to draw blood.

Accepted Answer

Use the distal (red or brown)lumen to draw blood if the device has more than one lumen.The distal (red or brown)lumen typically is the largest-gauge lumen.Apply clean gloves to prevent transfer of body fluids.Do not flush before drawing blood for blood cultures.If blood cultures have been ordered,do not discard any blood.Use the initial specimen for blood cultures.

Question 18

_________________________ pull fluid into the vascular space by osmosis,resulting in an increased vascular volume that possibly will result in pulmonary edema.

Accepted Answer

The answer of _________________________ pull fluid into the vascular space...

Question 19

An electronic device that delivers a measured amount of intravenous fluid over a specified period (e.g. ,100 mL/hr)using positive pressure is called an ___________________.

Accepted Answer

The answer of An electronic device that delivers a measured...

Question 20

The nurse is caring for a patient who has a peripheral intravenous (IV)catheter.While performing her routine assessment,she notes that the insertion site is pale,cool,and edematous.The patient indicates that the site is also painful to the touch.The nurse recognizes these symptoms as revealing a possible _______________.

Accepted Answer

The answer of The nurse is caring for a patient...

Quiz 29: Intravenous and Vascular Access Therapy

The patient is on daily weights and is receiving intravenous therapy.The nurse notices that the patient has gained 2 kg since the previous morning.What else would the nurse expect to observe? (Select all that apply. )

The nurse is preparing to start an intravenous (IV) infusion on a 92-year-old patient.The nurse realizes that she may need to take which of the following actions? (Select all that apply. )

Which of the following are central venous access devices (CVADs) ? (Select all that apply. )

While assessing the patient's intravenous (IV)catheter site,the nurse notes that the site is reddened and warm.The patient states that it is "sore." The nurse recognizes these as signs of ____________.

Fluids that have the same osmolality as body fluids are used most often to replace extracellular volume and are known as _______________ fluids.

For which patients are electronic infusion devices (EIDs) used? (Select all that apply. )

The nurse assigns nursing assistive personnel (NAP) to care for several patients with continuous IV infusions.Which of the following can NAP assist with?

Central venous access devices (CVADs) can be used in the home,in the hospital,and in long-term care facilities for patients who require which of the following? (Select all that apply. )

___________________ is manifested by decreased urine output,dry mucous membranes,decreased capillary refill,a disparity in central and peripheral pulses,tachycardia,hypotension,and shock.

Which of the following patients would the nurse anticipate requiring the placement of a central venous catheter?

The nurse is caring for a patient who has experienced hypovolemia secondary to acute vomiting and diarrhea.The nurse anticipates what type of intravenous fluid to be ordered by the health care provider?

What should the nurse do upon noting that the patient's intravenous (IV) catheter site is pale,cool,and edematous? (Select all that apply. )

What should the nurse do to decrease the potential for infection related to intravenous (IV) infusion therapy?

The nurse is caring for a patient who will be on long-term antibiotic therapy.The patient has had numerous intravenous (IV)catheters in the past,but because the upcoming therapy will be given on a long-term basis,the nurse suggests that a _________________ be inserted.

The nurse is preparing to draw blood from a central venous access device for blood cultures.Which of the following steps is part of that process?

_________________________ pull fluid into the vascular space by osmosis,resulting in an increased vascular volume that possibly will result in pulmonary edema.

An electronic device that delivers a measured amount of intravenous fluid over a specified period (e.g. ,100 mL/hr)using positive pressure is called an ___________________.