CH. 13: Intravenous Therapy PREP U Qs

The nurse is preparing to administer the solution in the attached image to a client. Which of the following types of solution is the nurse going to administer?

Isotonic

Which of the following clients would be a candidate for total parenteral nutrition?

A client with colitis and bloody diarrhea

The nurse is caring for a healthy adult client who developed a gastrointestinal virus in the last 24 hours that has caused vomiting and diarrhea and now has a diagnosis of dehydration. The nurse should know that a health care provider's order to initiate intravenous therapy is given primarily for which reason(s)? Select all that apply.

-Replace fluids. -Replace electrolytes.

The nurse is caring for a client who has experienced an isotonic fluid deficit caused by vomiting and expects the healthcare provider to order which intravenous fluid?

0.9% saline

A client is receiving IV fluid administration and consuming a rather large amount of fluids orally. In calculating the client's fluid intake for the past 24 hours, the nurse notes the amount and immediately notifies the physician of this finding. Notification of a physician regarding fluid intake should occur after exceeding how many milliliters in 24 hours?

3000

A nurse is preparing a dose of furosemide for an older adult with heart failure. The health care provider orders furosemide 1 mg/kg to be given intravenously. The client weighs 50 kg. The concentration of the drug is 40 mg/4mL (10 mg/mL). How many milliliters would the nurse administer? Record your answer using a whole number.

5 mL

A nurse is administering total parenteral nutrition (TPN) solution to a severely dehydrated client at the healthcare facility. Which of the following nutrients should the nurse add to the TPN solution as a carbohydrate source?

5% dextrose solution

A physician orders an infusion of 250 mL of NS in 100 minutes. The set is 20 gtt/mL. What is the flow rate?

50

A nurse is preparing to use microdrip tubing. What is the standard volume that this device delivers?

60

A client has been a client in the ICU for 17 days, seriously ill. A multitude of medications are ordered for the client's treatment regimen, most of which are administered intravenously. What is an indication for the use of IV medications? Select all that apply.

All options are correct.

An interdisciplinary team has been commissioned to create policies and procedures aimed at preventing acute hemolytic transfusion reactions. What action has the greatest potential to reduce the risk of this transfusion reaction?

Be vigilant in identifying the client and the blood component.

A nurse needs to administer a prescribed dosage of antineoplastic drugs to a client with cancer. Which of the following pieces of medical equipment is used to administer antineoplastic drugs?

Central venous catheter

When you complete the initial postoperative assessment for a client aged 55 years, you note that his IV is on time and infusing at 33 gtts/min (administration set - 10 gtts/ml). You check the order, which reads: "IV of 1000 cc D5S to infuse over 8 hours." What actions would you take?

Change the rate to 21 gtts/min and observe for fluid overload.

A client is receiving the first of two prescribed units of PRBCs. Shortly after the initiation of the transfusion, the client reports chills and experiences a sharp increase in temperature. What is the nurse's priority action?

Discontinue the transfusion.

The nurse has received a health care provider's order to initiate intravenous therapy and will check the client's medical record for what prior client condition that would impact placement of the client's intravenous site?

History of a mastectomy for breast cancer

A nursing responsibility in managing IV therapy is to monitor the fluid infusions and to replace the fluid containers as needed. Which of the following is an accurate guideline for IV management that the nurse should consider?

It is the responsibility of the nurse to provide ongoing verification of the IV solution and the infusion rate with the physician's order.

A nurse is assigned to care for a client who is bleeding severely following an accident and has been ordered transfusion of blood components. Which of the following should the nurse do to reduce the risk of septic reactions?

Refrigerate red blood cells and thawed fresh frozen plasma until use.

The nurse is preparing to administer a unit of blood to a client and should know that which is the FIRST action of the nurse prior to the administration?

The nurse will check that the numbers of the client's wrist band and the unit of blood match and that this information is confirmed by another nurse.

A client with ascites is receiving TPN until the condition clears. IV lipid emulsions would be contraindicated in a client with which condition?

egg allergy

A home healthcare client who is in a coma requires extended IV fluid therapy. Which peripheral access device would be most appropriate for administering this therapy?

midline catheter

A client has a history of congestive heart failure (CHF) and arthritis that causes significant discomfort. The physician has prescribed daily doses of NSAIDS to fight inflammation and pain. The client has developed a GI bleed as a result of the medication, and blood values indicate the need for a transfusion. Considering the client's history, which colloid solution would the nurse expect to be administered?

packed cells

A nurse needs to perform venipuncture on a client who has poor skin turgor. To prevent skin trauma at the venipuncture site, the nurse should:

place a soft cloth between the tourniquet and the skin.

The nurse in the emergency department has just administered a plasma expander to a client who is experiencing hypovolemic shock and who will not allow the administration of blood or blood products. The nurse is aware that which assessments will take priority in this client? Select all that apply.

-Urine output -Jugular venous distention -Development of rash or hives -Signs and symptoms of bleeding

The nurse is caring for a client who has been NPO since admission two days ago and was admitted with vomiting as a primary symptom. The client has been receiving intravenous therapy at 100 mL/hr. since admission with Lactated Ringers (LR) as the intravenous solution. What nursing diagnosis is most appropriate for this client?

Altered Nutrition: Less than body requirements R/T lack of adequate caloric intake

Assessing a client at 4:00 PM, a nurse notes that 800 ml of normal saline solution has been infusing since it was hung at 4:00PM yesterday. What would be the nurse's next action?

Replace the IV solution.

A client is receiving a blood transfusion and reports a new onset of slight dyspnea. The nurse's rapid assessment reveals bilateral lung crackles and elevated BP. What is the nurse's most appropriate action?

Slow the infusion rate and monitor the client closely.

A physician orders IV solution for a 92-year-old client to treat dehydration. The order was written to administer the fluid at a slower rate than what the nurse expected. Why would the physician designate the slower infusion rate for this client?

The client may have cardiac or renal disorders.

A client is being treated in the ICU after a medical error resulted in an acute hemolytic transfusion reaction. What was the etiology of this client's adverse reaction?

The donor blood was incompatible with that of the client.

A client comes to the emergency department and is bleeding profusely. Blood transfusion is ordered and the client is being typed and cross-matched. While awaiting the results, the physician orders a unit of packed red blood cells to administered stat. Which blood type would the nurse expect to be used?

Type O

A client has hypertonic solution running via gravity at 100 mL/hour to decrease postoperative edema. Before transporting the client, the nurse sets the IV pole at the proper height to overcome the pressure within the client's veins. What is that height?

at least 18 to 24 inches above infusion site