Question 1

A patient with an IV complains of pain and tenderness at the IV site.The practitioner notes swelling at the IV site.Why should these findings be investigated thoroughly?

Accepted Answer

Any complaint of pain,tenderness,or swelling at the IV site should be investigated thoroughly and evaluated for the possibility of thrombus formation.Gentle palpation at the site may reveal a mass or lump around or near the end of the catheter.

Question 2

A patient is admitted to the MICU with a closed head injury with cerebral edema.What type of IV solution will cause water to be drawn from inside the cell and into the vascular space and is desirable in cases of cerebral edema?

Accepted Answer

A hypertonic solution will cause water to be drawn from inside the cell and into the vascular space.This effect may be desirable in cases of cerebral edema.

Question 3

The patient complains of tenderness at the IV site in his lower arm.The practitioner notes swelling and redness at the IV site.The site feels very warm but the IV is still running.What is the most likely cause of these findings?

Accepted Answer

Cellulitis can be present with symptoms of tenderness,swelling,and possibly heat at the site.In these cases,the intravenous infusion may continue to run at its normal rate.

Question 4

What happens when the fluid or medication that is being infused through an IV leaks out of the blood vessel that was cannulated?

Accepted Answer

Infiltration occurs when the fluid or medication that is being infused leaks out of the blood vessel that was cannulated.This results in a swelling at the site,which can be quite painful.This problem may be caused by a small laceration or puncture to the vessel incurred during the process of inserting the needle,the vessel's inability to maintain its integrity owing to previous medications (i.e. ,steroids),or the structure of the vessel itself.

Question 5

When applying a tourniquet to help with the insertion of an IV on a patient,where should the tourniquet be placed?

Accepted Answer

A tourniquet is applied above or proximal to the intended insertion site.

Question 6

Which of the following solutions is/are the most desirable for maintaining a normal environment for cellular function?

Accepted Answer

With the administration of an isotonic solution,there is very little if any net movement of fluid into or out of the cells.This is most desirable for maintaining a normal environment for cellular function.

Question 7

What is the advantage of an isotonic solution?

Accepted Answer

With the administration of an isotonic solution,there is very little if any net movement of fluid into or out of the cells.This is most desirable for maintaining a normal environment for cellular function

Question 8

What is inflammation of the vein called?

Accepted Answer

Inflammation of the vein is defined as phlebitis.

Question 9

What does the medical abbreviation 'prn' mean after an order for administer a medication to a patient?

Accepted Answer

PRN means "as needed".

Question 10

If a blood pressure cuff is used as a tourniquet,how should the cuff be inflated?

Accepted Answer

A blood pressure cuff can also be used to occlude venous flow.The cuff is inflated so that it reads 20 to 30-mm Hg below the systolic number of the patient's blood pressure.After the placement of the tourniquet,you should be able to palpate the radial pulse distal to the tourniquet placement site.

Question 11

A 0.225% NaCl solution is classified as which type of solution?

Accepted Answer

A 0.225% NaCl solution is considered a hypotonic solution.

Question 12

Which of the following is an example of a hypertonic solution?

Accepted Answer

An example of a hypertonic solution is mannitol.

Question 13

What is the purpose of a tourniquet when attempting to start an IV on a patient?

Accepted Answer

Once the tourniquet has been properly applied,the restriction of venous flow will cause the veins of the arm to distend and become engorged with blood.Visualization and palpation of the vessels will make the selection of a proper site possible.

Question 14

With some medical conditions,a tourniquet cannot be applied to the patient's arm.Which of the following are conditions where tourniquet application should not be applied?

Accepted Answer

With some medical conditions,a tourniquet cannot-be applied to the patient's arm.These include a)the placement of a shunt for renal dialysis and b)a previous mastectomy.The extremity opposite the side affected by these conditions should be selected.

Question 15

What is the preferred IV site on an adult patient?

Accepted Answer

In choosing a site,it is preferable to select the nondominant hand or arm of the patient (i.e. ,the left arm of a right-handed patient).

Question 16

What is an IV solution called that has the same tonicity as measured by solute concentration?

Accepted Answer

An isotonic fluid has the same tonicity as measured by solute concentration.

Question 17

What is another name for 0.9% sodium chloride in water?

Accepted Answer

Normal (physiologic)saline is also known as 0.9%-sodium chloride [NaCl] in water.

Question 18

A patient has been brought to the emergency department suffering from heat exhaustion and dehydration.Which of the following fluids would enhance the function of cells that are hampered owing to the absence of necessary intracellular fluid?

Accepted Answer

A hypotonic solution,which has a solute concentration lower than that of the fluid inside the cells,will result in a net movement of water from the vascular space to inside the cell.This effect may be helpful in cases of severe dehydration where the function of cells is hampered owing to the absence of necessary intracellular fluid.

Question 19

A patient with pneumonia has an IV started to administer antibiotics.After 24 hours the patient develops a hematoma at the IV site.Which of the following is the most likely cause of this complication?

Accepted Answer

Infiltration of the IV may occur prior to attaching the IV fluids if the needle has been passed entirely through the vessel during the insertion,so that blood flows out of the puncture site.Many times,this will appear as a hematoma or bruise that is visible beneath the skin.

Question 20

After starting an IV,the practitioner is concerned about preventing an air embolism.Which of the following will best prevent an air embolism in the patient?

Accepted Answer

a)Maintaining the IV bag in an upright (vertical orientation)position at all times will reduce the possibility of air entering the tubing,causing an air embolism.Care must be taken to ensure that all air is removed before the tubing is connected to the catheter.

Quiz 23: Insertion and Maintenance of Intravenous Lines