Question 1

A diabetic patient requires the administration of insulin continuously at home. Which system would most likely be used in this instance?

Accepted Answer

A syringe pump would be the best choice for administering insulin continuously at home as it can deliver small, precise doses of insulin and can be programmed to adjust for changes in the patient's blood glucose levels. Central line catheters are typically used for long-term administration of medications or IV fluids, but are not necessary for insulin administration. Microdrip sets and piggyback systems are designed for intermittent administration of medications and would not be suitable for continuous insulin infusion.

Question 2

A patient is diagnosed with cancer and requires 6 months of chemotherapy infusions. Which type of intravenous access device will likely be used?

Accepted Answer

An implantable venous infusion port is the best choice for a patient requiring long-term chemotherapy infusions as it provides reliable and durable vascular access, reducing the need for repeated needle sticks and potential complications of other types of access devices. It is placed surgically under the skin and can remain in place for years, allowing for repeated chemotherapy cycles. Peripheral venous access devices may be used for short-term chemotherapy infusions, but are not ideal for prolonged use. Midline catheters and winged-needle venous access devices are also not typically used for long-term chemotherapy infusions, as they have a higher risk of complications and may require frequent replacement.

Question 3

Which condition would the nurse expect to be treated with an isotonic solution?

Accepted Answer

Isotonic solutions have a concentration of electrolytes and water similar to that of the body's extracellular fluid. As a result, they are ideal for treating conditions such as hemorrhagic shock, in which a patient has lost significant amounts of blood and needs volume replacement without altering the concentration of their electrolytes. This helps to maintain the patient's blood pressure and overall perfusion. Isotonic solutions would not be appropriate for fluid overload, which requires a diuretic to remove excess fluid. They would also not be appropriate for cellular dehydration, which would require a hypotonic solution to rehydrate cells, or cerebral edema, which would require a hypertonic solution to draw fluid out of the brain.

Question 4

An elderly patient receiving an infusion of an isotonic fluid at 100 mL/hr complains of dyspnea. The nurse notes shallow rapid respirations and a cough that produces frothy sputum. Which is the priority nursing action?

Accepted Answer

The patient is exhibiting signs of fluid overload and potential pulmonary edema. The priority nursing action is to elevate the head of the bed to decrease venous return and reduce the workload on the heart. Assessing urine output is important but should be done after the immediate intervention of elevating the head of the bed. Encouraging the patient to cough may worsen the symptoms and maintaining the IV rate may contribute to further fluid overload.

Question 5

Which technique by the nurse accurately maintains asepsis of a peripheral intravenous (IV) access device?

Accepted Answer

Changing the fluid administration sets according to institutional policy helps to maintain the asepsis of the peripheral IV access device by preventing bacterial growth and contamination. It is important to follow institutional policies to promote safe and effective patient care. Wearing gloves, applying topical antibiotic ointment, and flushing with heparin are important interventions but do not maintain asepsis alone.

Question 6

What is the composition of hypotonic intravenous solutions such as 0.45% NaCl?

Accepted Answer

Hypotonic solutions have fewer dissolved particles than blood. 0.45% NaCl contains only 0.45 g of salt in 100 mL of water, which is significantly less than the concentration of salt in blood.

Question 7

What will the nurse explain when teaching a patient about a PICC line? (Select all that apply.)

Accepted Answer

The answer of What will the nurse explain when teaching...

Question 8

The nurse determines that an elderly patient's IV of D₅0.2NS with 20 mEq KCl at 75 mL/hr is running 3 hours behind. After determining the IV site is patent, what action will the nurse take?

Accepted Answer

The answer of The nurse determines that an elderly patient's...

Question 9

The nurse assesses erythema, warmth, and burning pain along the patient's IV site. Which complication is this patient most likely experiencing?

Accepted Answer

Erythema (redness), warmth, and burning pain along the IV site are classic signs of phlebitis, which is inflammation of the vein due to mechanical or chemical irritation.

Question 10

A patient has a peripherally inserted central catheter (PICC) line inserted to continue IV antibiotic therapy at home. With proper care, how long can this type of venous access device remain in place?

Accepted Answer

The answer of A patient has a peripherally inserted central...

Question 11

In assessing a patient with a central venous access device, which sign or symptom indicates that the patient is experiencing an air embolism?

Accepted Answer

Chest pain is a common symptom of air embolism, which occurs when air enters the bloodstream and forms a blockage in the blood vessels. Other possible symptoms include shortness of breath, sudden low blood pressure, rapid heart rate, confusion, and loss of consciousness. Erythema is a skin symptom characterized by redness and inflammation, while frothy sputum and sweating are more indicative of respiratory or cardiovascular issues unrelated to air embolism.

Question 12

Following the insertion of a central venous access device, the nurse notes a weak, thready pulse and decreased blood pressure. The patient complains of shortness of breath and palpitations. Which action will the nurse take first?

Accepted Answer

The answer of Following the insertion of a central venous...

Question 13

Which potential complication will the nurse expect in patients with a venous access device?

Accepted Answer

Patients with a venous access device are at risk for infection due to the direct access to their bloodstream. Circulatory overload, extravasation, and pain are also potential complications, but they are not specific to venous access devices.

Question 14

The nurse notes that a patient with cardiac disease has intravenous (IV) heparin infusing and that it is behind by 2 hours. What is the best nursing action?

Accepted Answer

Heparin is a high-alert medication used to prevent blood clots in patients with cardiac disease. The nurse should not increase the rate of infusion or discontinue the solution without first consulting with the healthcare provider. Changing the infusion rate to TKO is not appropriate as it would interrupt the therapeutic effect of the heparin. Therefore, the best nursing action is to contact the healthcare provider for consultation about how to manage the delayed infusion.

Question 15

Which patient assessment findings suggest extravasation of an IV solution? (Select all that apply.)

Accepted Answer

Extravasation of an IV solution can cause coolness and edema due to fluid leakage into surrounding tissues, pain at the venipuncture site, and redness due to irritation or inflammation. Fever and shortness of breath are not typical signs of extravasation.

Question 16

A patient is admitted with hypovolemia due to lack of fluid intake and requires an infusion of isotonic fluids. Which IV solution will the nurse administer?

Accepted Answer

0.9 NS (normal saline) is the best choice for hypovolemia because it is isotonic and will help restore fluid balance. D50.2 NS and D5W are hypotonic solutions and 0.45 NS is a hypotonic solution. These solutions are not ideal for hypovolemia as they could further dilute the patient's already decreased blood volume.

Question 17

Which needle is used to access implanted infusion devices?

Accepted Answer

Huber needles are specifically designed for accessing implanted infusion devices. Jamshedi needles are used for bone marrow biopsies, Gigli wires for cutting bone, and Crutchfield tongs for skull traction in neurosurgery.

Quiz 12: Parenteral Administration: Intravenous Route