IV Therapy

Order: 500 ml D5W with 20 mEq KCL KCL Available: 15 mEq / 7.5ml How many ml of the KCL must be added to the IV bag?

10 mL 20mEq / 15 mEq x 7.5mL

During your assessment of a patient taking heparin, which of the following side effects is most likely to be seen? acute pancreatitis dysuria hearing loss gout excessive flatulaence hemorrhage

hemorrhage

A nurse is administering a piggyback infusion to a client with partial-thickness or second-degree burns. Which describes the most important feature of a piggyback infusion? A parenteral drug is given in tandem with an IV solution. Medication is given all at one time as quickly as possible. The primary IV solution is infused by gravity. Medication locks are changed every 72 hours.

A parenteral drug is given in tandem with an IV solution.

IV documentation

-Date and time of administration -Type of solution -Volume of solution -Rate of solution -Assessment of IV site -Tubing and dressing changes -Complications, if present

phlebitis nursing interventions

-Remove the IV -Place a new IV access in a different location -Apply warm compresses to previous site -Notify physician -Document your assessment and interventions

A child is to receive dexamethasone intravenously at the ordered dosage of 7.6 mg. The drug concentration in the vial is 4 mg/ml. How many milliliters should the nurse administer? Record the answer using one decimal place.

1.9 mL 7.6mg/4mg x 1mL

Order: Add 2 grams Thiamine to 1000 ml IV fluids Thiamine available: 500 mg per 5 ml Volume in IV fluid bag: 500 ml How many ml of Thiamine should be added to the current IV bag?

10mL

Order: 1500 ml of D5LR over 12 hours. What is the hourly IV rate? Answer in whole numbers, round up if appropriate.

125 mL/hr 1500 / 12

Order: 2400 ml 0.45% saline /24 hrs Drop factor = 10 Calculate the number of drops / minute Answer in whole numbers only - round up as appropriate.

17 gtts/min 2400mL x 10 / 24h x 60m

A nurse is to give a client an I.V. infusion of 3,000 ml of dextrose and normal saline solution over 24 hours. The nurse observes that the infusion rate is 150 ml/hour. If the solution runs continuously at this rate, the infusion will be completed in 12 hours. 24 hours. 50 hours. 20 hours.

20 hours 3000/150

A client is to receive 1,000 mL of lactated Ringer's over 10 hours. The drip factor is 15 drops (gtt)/mL. How many gtt per minute should the client receive? 25 gtt/min 33 gtt/min 14 gtt/min 28 gtt/min

25 gtts/min 1000mL x 15 / 10h x 60m = 15,000/600 = 25

Order: 100 ml D5W over 20 minutes What is the hourly rate for this fluid? Answer in whole numbers, round up if appropriate.

300 mL/hr 100 x 60 / 20 x 1

Order: 150 ml over 30 minutes What is the hourly rate for this fluid? Answer in whole numbers, round up if appropriate.

300 mL/hr 150 x 60 / 30 x 1

The health care provider orders 1,000 mL D5W to be infused over 8 hours. The IV tubing delivers 15 drops/mL. The nurse should run the IV infusion at a rate of: 15 drops/minute. 125 drops/minute. 31 drops/minute. 21 drops/minute.

31 drops/minute. 1000 x 15 / 8h x 60m = 31.25

Order: 1000 ml D5W over 8 hours. Drop factor = 15 What is the number of drops / minute? Answer in whole numbers, round up if appropriate.

31 gtts/min 1000 x 15 / 8 x 60

Order: 3000 ml 0.9% saline over 24 hours Drop factor: 15 What is the number of drops per minute? Answer in whole numbers, round up if appropriate

31 gtts/min 3000 x 15 / 24 x 60 = 31.25

A physician orders cefoxitin, 1 g in 100 ml of 5% dextrose in water, to be administered I.V. A nurse determines that the recommended infusion time is 15 to 30 minutes. The available infusion set has a calibration of 10 drops/ml. To infuse cefoxitin over 30 minutes, which drip rate should the nurse use? 66 drops/minute 10 drops/minute 33 drops/minute 30 drops/minute

33 gtts/min 100mL x 10 / 30

Client complains of the IV site hurting. IV of 1000 mL 0.9% saline is infusing at 100 mL/hour via infusion pump. The left hand site shows signs of phlebitis. The nurse discontinues the IV and notifies the IV team for a restart. (Note: use actual date/time and current status as student)

6/12/23 @ 1541 Patient c/o of IV site pain 7/10. 1LNS currently infusing at 100 mL/hr via pump. Left hand observed with redness and warmth. IV discontinued and warm compress applied to site per policy. IV team notified to restart IV. 6/12/23 @ 1640 Discontinued IV observed with reduced redness. Patient states pain at site improved; 3/10. New IV access site obtained by IV team in right hand. Patient tolerated well. Dressing clean, dry and intact; no s/s of infiltration, phlebitis, extravasation. 0.9% NS infusing via pump at 100 mL/hr.

Match the assessment data with the appropriate complication of IV therapy. A. - IV site swollen and cool D.- IV site warm, red, vein above site edematous or firm to touch B - Redness and drainage at IV site, fever C - Pounding headache, rapid pulse rate, chills, dyspnea E - Engorged neck veins, increased BP, dyspnea

A. Infiltration D.Phlebiits B.Infection C.Speed shock E.Fluid overload

A nurse has been asked to insert peripheral I.V. lines in several clients on the nursing unit. Which site would the nurse need to avoid in order to maintain client safety? the sunburned arm of a teenager admitted for hydration therapy the tattooed arm of a motorcycle rider diagnosed with kidney failure the arm of a client where an arteriovenous shunt has been inserted the unaffected arm of a woman who has had a radical mastectomy

the arm of a client where an arteriovenous shunt has been inserted

When assessing a client's I.V. insertion site, a nurse notes normal color and temperature at the site and no swelling. However, the I.V. solutions haven't infused at the ordered rate; the flow rate is slow even with the roller clamp wide open. When the nurse lowers the I.V. fluid bag, no blood returns to the tubing. What should the nurse do first? Discontinue the I.V. infusion at that site and restart it in the other arm. Elevate the I.V. fluid bag. Irrigate the I.V. tubing with 1 ml of normal saline solution. Check the tubing for kinks and reposition the client's wrist and elbow.

Check the tubing for kinks and reposition the client's wrist and elbow.

Heparin is most likely indicated for which of the following conditions? Ataxia Telangiectasia Deep Vein Thrombosis (DVT) Atrial Septal Defect (ASD) Decreased Heme Synthesis Ventricular Arrhythmia Pulmonary Fibrosis

Deep Vein Thrombosis (DVT)

When assessing an intravenous site, the nurse observes edema and a red line. The client also reports pain at the insertion site. What actions would be appropriate? Apply antibacterial ointment to the I.V. site and slow the I.V. infusion. Discontinue the infusion and apply a warm compress to the I.V. site. Slow the infusion rate and apply warm compresses to the site. Reposition the I.V. access device to lessen the vein irritation.

Discontinue the infusion and apply a warm compress to the I.V. site.

The nurse is administering an intravenous (IV) replacement of 5% dextrose in water with potassium chloride. What should the nurse do first? Evaluate laboratory results for electrolytes. Check the rate for IV push administration. Add potassium chloride to the bag at the bedside. Prime tubing using sterile technique.

Evaluate laboratory results for electrolytes. IV solutions are prescribed based upon the fluid and electrolyte status of the client, so laboratory results should be monitored first. Safety recommendations are for standard premixed solutions. If solutions are not premixed, additives are completed by the pharmacy, not at the bedside. Potassium chloride is never given by IV push because this could be fatal. Administration guidelines require no more than 10 mEq (10 mmol/L) of potassium chloride be infused per hour on a general medical-surgical unit. An infusion device or pump is required for safe administration.

During your assessment of a patient taking heparin which of the following side effects is most likely to be seen? Heparin-Induced Tracheitis (HIT) Heparin-Induced Cytopenia (HIC) Heparin-Induced Thrombocytopenia (HIT) Heparin-Induced Thrombosis (HIT) Heparin-Induced myocarditis (HIM) Heparin-Induced Pancreatitis (HIP)

Heparin-Induced Thrombocytopenia (HIT)

Which of the following should be monitored in a patient taking heparin? Bleeding time lab values Monitor aPTT Creatinine Lab Values C-reactive Protein (CRP) Monitoring Leukocyte Differential PT/INR levels

Monitor aPTT

Which of the following considerations is most applicable to heparin? Avoid Antibiotics Alleviated with Leucovorin Rescue Avoid Alcohol Avoid Diuretics Prolonged Therapeutic Onset Preferred (SAFE) During Pregnancy

Preferred (SAFE) During Pregnancy

Which of the following medications is most likely the reversal agent or antidote used with heparin? Eculizumab Protamine Sulfate Vitamin K Fresh Frozen Plasma Alteplase Whole Blood

Protamine Sulfate

A nurse is caring for a client with a central venous catheter and notices redness and tenderness at the catheter insertion site. Which assessment finding would indicate possible systemic infection? respiratory rate of 32 breaths/minute heart rate of 55 beats/minute temperature of 97.3 degrees Fahrenheit (36.3 degrees Celsius) blood pressure of 122/78 mm Hg

respiratory rate of 32 breaths/minute

A client is receiving intravenous fluids and upon assessment presents with increased pulse, increased respirations, and jugular vein distension. What is the priority action by the nurse? Administer oxygen and encourage the client to breathe deeply. Repeat the vital signs in 1 hour. Lower the head of the bed. Slow the intravenous rate and notify the physician.

Slow the intravenous rate and notify the physician.

What mechanism of action or pharmacological action is best associated with heparin? ADP Receptor Antagonist Blocks Na+ Channels Suppresses Coagulation Inhibits 50S Pepridyltransferase Activity Tissue Plasminogen Activator Blocks Glycine and GABA Release

Suppresses Coagulation

The nurse is preparing to start an intravenous (IV) infusion. Before inserting the needle into a vein, the nurse applies a tourniquet to the client's arm. Which finding indicates the tourniquet has been applied correctly? The veins do not "roll." The veins are distended. Arterial circulation is occluded. The arm is immobilized.

The veins are distended.

A nurse is using an IV port when administering medication to a client. Which IV administration has the greatest potential to cause life-threatening changes? electronic infusion device bolus administration secondary administration continuous administration

bolus administration

A nurse needs to administer a prescribed medication to a client using IV push. In which way is the medication being administered to the client? bolus administration gravity infusion continuous drip electronic infusion device

bolus administration

A client with a deficient fluid volume is receiving an I.V. infusion of dextrose 5% in water and lactated Ringer's solution at 125 ml/hour. Which assessment finding indicates the need for additional I.V. fluids? dark amber urine temperature of 99.6° F (37.6° C ) jugular vein distention serum sodium level of 135 mEq/L

dark amber urine

A nurse is administering daunorubicin through a peripheral I.V. line when the client complains of burning at the insertion site. The nurse notes no blood return from the catheter and redness at the I.V. site. The client is most likely experiencing which complication? flare extravasation erythema thrombosis

extravasation

A client has an intravenous line in place for 3 days and begins to state discomfort at the insertion site. Based on the nurse's progress note, what condition has most likely occurred? infection infection and infiltration phlebitis infiltration

infiltration

The sudden onset of which sign indicates a potentially serious complication for the client receiving an IV infusion? pupillary constriction halitosis moist skin noisy respirations

noisy respirations

A client is to receive intravascular chemotherapy for 10 days. Which equipment should the nurse use for this procedure? central venous access in the femoral vein peripherally inserted central catheter (PICC) short peripheral catheter intravenous catheter insertion device

peripherally inserted central catheter (PICC)

Heparin is most likely indicated for which of the following conditions? myocarditis pulmonary fibrosis pulmonary embolism chronic kidney disease ventricular arrhythmia atropine overdose

pulmonary embolism

A client's intravenous catheter has become occluded. The nurse knows that the reason for the occlusion is: localized infection. an I.V. infusion rate of 75 mL per hour. thrombosis at the site. dressing and tape above the I.V. insertion site.

thrombosis at the site.