Question 1

An intravenous (IV)administration of doxycycline (Vibramycin)has extravasated.What nursing action should be implemented after stopping the IV line?

Accepted Answer

Notifying the physician is crucial for appropriate management of the extravasation, and restarting the IV in another site ensures continued treatment.

Question 2

As part of a written standard protocol for the unit, a nurse adds that irrigation of an occluded cannula is not recommended.What is the rationale against performing this procedure?

Accepted Answer

Forcing fluid through an occluded cannula can dislodge any clots that are present, potentially pushing them into the main bloodstream where they can cause serious complications, such as a pulmonary embolism.

Question 3

Using an IV infusion system that delivers 60 drops/mL, a nurse hangs a 500-mL bag of normal saline (NS)at 0800.The physician has ordered a rate of 20 mL/hr.What should the nurse set the roller clamp to deliver?

Accepted Answer

B

Question 4

Using an intravenous (IV)infusion system that delivers 60 drops/L, a nurse hangs a 1000-mL bag of 5% dextrose in water (D₅W), which the physician has ordered to infuse at 80 mL/hr.It is now 1000.What time should the nurse anticipate the IV will need to be changed?

Accepted Answer

To calculate the time the IV will need to be changed, divide the total volume of the IV bag by the infusion rate: 1000 mL / 80 mL/hr = 12.5 hours. Since the infusion started at 1000 (10:00 AM), adding 12.5 hours brings us to 2230 (10:30 PM).

Question 5

How often should intravenous (IV)rounds be performed during a nursing shift?

Accepted Answer

IV rounds should typically be performed every 60 minutes, or according to the healthcare facility's policy or the patient's condition. This ensures that the IV catheter is functioning properly and that the patient is receiving the correct amount of fluids or medication. Checking the IV site every 15 or 30 minutes would be excessive and may interrupt the patient's rest or care unnecessarily. Checking only twice per shift may not be frequent enough to catch any issues that may arise.

Question 6

What is a major advantage when medication is administered intravenously?

Accepted Answer

When medication is administered intravenously, it goes directly into the bloodstream and is quickly distributed throughout the body. This allows for better maintenance of a therapeutic blood level because the medication is immediately available for use by the body.

Question 7

A nurse is choosing an intravenous cannula for an older adult patient and will choose the smallest size that will deliver the appropriate fluid.What size cannula is the most appropriate choice?

Accepted Answer

The smallest size cannula that will deliver the appropriate fluid is the 22 gauge. Smaller sizes cause less damage to veins and are less likely to cause phlebitis, which is a risk in older adults.

Question 8

What instruction should a nurse provide to a patient when removing a central catheter?

Accepted Answer

Taking a deep breath and bearing down helps to prevent air from entering the bloodstream, which can happen during removal of a central catheter. The other options are not appropriate instructions for catheter removal.

Question 9

What signs of infiltration should be assessed by a nurse?

Accepted Answer

Burning sensation, pain, and puffy are signs of infiltration.

Question 10

A physician orders an infusion of 1000 mL of 5% dextrose in 0.45% NS to be completed in 8 hours.The IV delivery system's drop factor is 20 gtt.How many mL/hr should the nurse set the electronic infusion pump to deliver the infusion?

Accepted Answer

To calculate the mL/hr for the infusion, divide the total volume (1000 mL) by the total time in hours (8 hours). 1000 mL / 8 hours = 125 mL/hr.

Question 11

Where should a nurse inject medication when administering an intravenous (IV)push medication to a patient who is receiving a continuous infusion?

Accepted Answer

When administering an IV push medication to a patient who is receiving a continuous infusion, the medication should be injected into the port nearest to the insertion site. This ensures quick delivery of the medication directly into the bloodstream, utilizing the existing IV line without the need for additional painful procedures. Injecting into the port closest to the patient allows for immediate action of the medication, which is crucial for certain treatments and emergency situations.

Question 12

Where is the best place to begin to select a vein for an initial intravenous (IV)site in a left-handed patient?

Accepted Answer

For a left-handed patient, it is generally preferable to use the non-dominant arm for IV access to allow the patient more freedom and comfort with their dominant hand. Therefore, the right forearm is a suitable choice.

Question 13

A patient is to receive ampicillin (Unasyn)IV piggyback in 100 mL of fluid every 8 hours.The main intravenous (IV)line of D₅W is running at 80 mL/hr and is on time.A nurse's responsibility is to calculate the total 24-hour intake.At the end of the 24-hour shift, how much IV intake should the nurse document that the patient has received?

Accepted Answer

To calculate the total 24-hour intake, we need to first calculate how much the patient will receive in one dose:

100 mL (ampicillin) + 80 mL (main IV line) = 180 mL per dose

Since the patient will receive this dose every 8 hours, we can multiply by 3 to get the total for 24 hours:

180 mL/dose x 3 doses = 540 mL/day

Therefore, the total IV intake over 24 hours would be:

80 mL main IV line x 24 hours = 1920 mL

Plus the ampicillin every 8 hours:

540 mL ampicillin x 3 doses = 1620 mL

Total IV intake = 1920 mL + 1620 mL = 3540 mL or 2220 mL depending on whether the question is asking for the total volume including the ampicillin or just the main IV line.

The answer choice D is the most accurate as it includes both the main IV line and the ampicillin doses.

Question 14

A nurse has a patient with a central line.The insertion site is covered by an occlusive dressing with yesterday's date.The nurse is to give an intravenous drug through the central line.What should be the initial action of the nurse?

Accepted Answer

The answer of A nurse has a patient with a...

Question 15

In an assessment of a patient who has been receiving intravenous (IV)fluids for the past 6 hours, a nurse finds that the pulse is now bounding, the blood pressure is more than 15 mm Hg higher than the last reading, and pedal edema has developed.What should the nurse suspect?

Accepted Answer

The symptoms described (bounding pulse, elevated blood pressure, and pedal edema) are consistent with an excess of fluid in the vascular system, a condition known as vascular fluid volume excess or hypervolemia. This could be due to excessive administration of IV fluids, or a condition such as heart failure or kidney disease. Infiltration of the IV site, pulmonary air embolism, and phlebitis of the leg veins would likely present with different symptoms.

Question 16

A nurse assesses an area where an intravenous (IV)line had been recently removed.The area has redness, swelling, and warmth.What should the nurse suspect as the cause?

Accepted Answer

The redness, swelling, and warmth of the area suggest inflammation and possibly phlebitis, which are common complications of IV therapy. Infiltration and air embolus usually present with mild discomfort and can cause coolness at the site, while hemorrhage presents with bleeding and a hematoma. Embolus from the former catheter is unlikely to cause local redness, swelling, and warmth.

Question 17

A physician prescribes a hypertonic intravenous line for an extremely edematous patient.What solution should the nurse anticipate to be prescribed?

Accepted Answer

A hypertonic solution is one that has a higher concentration of solutes than the normal concentration in the body, causing fluid to move from areas of lower concentration to higher concentration, hence reducing edema. 10% glucose in water (D) is a hypertonic solution commonly prescribed for edematous patients. Choices A, B, and C are isotonic or hypotonic solutions, which would not effectively reduce edema.

Question 18

A nurse assesses for signs of infected phlebitis.How should the nurse most accurately describe this complication when documenting?

Accepted Answer

Infected phlebitis is characterized by redness, warmth, and potentially oozing drainage at the puncture site, indicating infection and inflammation.

Question 19

What is the source of calories in IV solutions?

Accepted Answer

Dextrose, a form of sugar, is the source of calories in IV solutions. Electrolytes, vitamins, and water are important components of IV solutions, but they do not provide calories.

Question 20

A patient with a subclavian line complains of shortness of breath after an infusion.The patient is diaphoretic, and the blood pressure is 168/100 mm Hg, higher than a previous reading of 140/86 mm Hg.What should the nurse assess these symptoms as indicating?

Accepted Answer

The symptoms are indicative of a possible embolus from an introduced air or blood clot, which can cause shortness of breath, diaphoresis, and sudden elevation in blood pressure. The subclavian line is a risk factor for embolus formation, and immediate intervention is necessary to prevent further complications like pulmonary embolism or stroke. Fluid overload, incorrect dilution, and infection can also cause adverse reactions but are less likely to present with these specific symptoms.

Quiz 16: Intravenous Therapy

An intravenous (IV) administration of doxycycline (Vibramycin) has extravasated.What nursing action should be implemented after stopping the IV line?

As part of a written standard protocol for the unit, a nurse adds that irrigation of an occluded cannula is not recommended.What is the rationale against performing this procedure?

Using an IV infusion system that delivers 60 drops/mL, a nurse hangs a 500-mL bag of normal saline (NS) at 0800.The physician has ordered a rate of 20 mL/hr.What should the nurse set the roller clamp to deliver?

Using an intravenous (IV) infusion system that delivers 60 drops/L, a nurse hangs a 1000-mL bag of 5% dextrose in water (D₅W) , which the physician has ordered to infuse at 80 mL/hr.It is now 1000.What time should the nurse anticipate the IV will need to be changed?

How often should intravenous (IV) rounds be performed during a nursing shift?

What is a major advantage when medication is administered intravenously?

A nurse is choosing an intravenous cannula for an older adult patient and will choose the smallest size that will deliver the appropriate fluid.What size cannula is the most appropriate choice?

What instruction should a nurse provide to a patient when removing a central catheter?

What signs of infiltration should be assessed by a nurse?

A physician orders an infusion of 1000 mL of 5% dextrose in 0.45% NS to be completed in 8 hours.The IV delivery system's drop factor is 20 gtt.How many mL/hr should the nurse set the electronic infusion pump to deliver the infusion?

Where should a nurse inject medication when administering an intravenous (IV) push medication to a patient who is receiving a continuous infusion?

Where is the best place to begin to select a vein for an initial intravenous (IV) site in a left-handed patient?

A nurse has a patient with a central line.The insertion site is covered by an occlusive dressing with yesterday's date.The nurse is to give an intravenous drug through the central line.What should be the initial action of the nurse?

In an assessment of a patient who has been receiving intravenous (IV) fluids for the past 6 hours, a nurse finds that the pulse is now bounding, the blood pressure is more than 15 mm Hg higher than the last reading, and pedal edema has developed.What should the nurse suspect?

A nurse assesses an area where an intravenous (IV) line had been recently removed.The area has redness, swelling, and warmth.What should the nurse suspect as the cause?

A physician prescribes a hypertonic intravenous line for an extremely edematous patient.What solution should the nurse anticipate to be prescribed?

A nurse assesses for signs of infected phlebitis.How should the nurse most accurately describe this complication when documenting?

What is the source of calories in IV solutions?

A patient with a subclavian line complains of shortness of breath after an infusion.The patient is diaphoretic, and the blood pressure is 168/100 mm Hg, higher than a previous reading of 140/86 mm Hg.What should the nurse assess these symptoms as indicating?

Quiz 16: Intravenous Therapy

An intravenous (IV) administration of doxycycline (Vibramycin) has extravasated.What nursing action should be implemented after stopping the IV line?

As part of a written standard protocol for the unit, a nurse adds that irrigation of an occluded cannula is not recommended.What is the rationale against performing this procedure?

Using an IV infusion system that delivers 60 drops/mL, a nurse hangs a 500-mL bag of normal saline (NS) at 0800.The physician has ordered a rate of 20 mL/hr.What should the nurse set the roller clamp to deliver?

Using an intravenous (IV) infusion system that delivers 60 drops/L, a nurse hangs a 1000-mL bag of 5% dextrose in water (D5W) , which the physician has ordered to infuse at 80 mL/hr.It is now 1000.What time should the nurse anticipate the IV will need to be changed?

How often should intravenous (IV) rounds be performed during a nursing shift?

What is a major advantage when medication is administered intravenously?

A nurse is choosing an intravenous cannula for an older adult patient and will choose the smallest size that will deliver the appropriate fluid.What size cannula is the most appropriate choice?

What instruction should a nurse provide to a patient when removing a central catheter?

What signs of infiltration should be assessed by a nurse?

A physician orders an infusion of 1000 mL of 5% dextrose in 0.45% NS to be completed in 8 hours.The IV delivery system's drop factor is 20 gtt.How many mL/hr should the nurse set the electronic infusion pump to deliver the infusion?

Where should a nurse inject medication when administering an intravenous (IV) push medication to a patient who is receiving a continuous infusion?

Where is the best place to begin to select a vein for an initial intravenous (IV) site in a left-handed patient?

A nurse has a patient with a central line.The insertion site is covered by an occlusive dressing with yesterday's date.The nurse is to give an intravenous drug through the central line.What should be the initial action of the nurse?

In an assessment of a patient who has been receiving intravenous (IV) fluids for the past 6 hours, a nurse finds that the pulse is now bounding, the blood pressure is more than 15 mm Hg higher than the last reading, and pedal edema has developed.What should the nurse suspect?

A nurse assesses an area where an intravenous (IV) line had been recently removed.The area has redness, swelling, and warmth.What should the nurse suspect as the cause?

A physician prescribes a hypertonic intravenous line for an extremely edematous patient.What solution should the nurse anticipate to be prescribed?

A nurse assesses for signs of infected phlebitis.How should the nurse most accurately describe this complication when documenting?

What is the source of calories in IV solutions?

A patient with a subclavian line complains of shortness of breath after an infusion.The patient is diaphoretic, and the blood pressure is 168/100 mm Hg, higher than a previous reading of 140/86 mm Hg.What should the nurse assess these symptoms as indicating?

Using an intravenous (IV) infusion system that delivers 60 drops/L, a nurse hangs a 1000-mL bag of 5% dextrose in water (D₅W) , which the physician has ordered to infuse at 80 mL/hr.It is now 1000.What time should the nurse anticipate the IV will need to be changed?