ATI: parenteral (iv) meds

prac: a nurse is reviewing the label afficed to a bag of iv med to be given as intermittent iv bolus. which info meets ismp recommendations?

-pt. med record number -infusion time for med -diluent solution -expiration date of med

prac: which of the following is the abbreviation for the iv solution half normal saline

0.45% NaCl

prac: which of the following iv solutions should nurse use when preparing to administer a blood transfusion?

0.9% sodium chloride (nacl) (ns - normal saline) explanation: to prevent hemolysis of RBC

prac: how many calories does 1 L of 5% dextrose in water (D5W) provide?

170 cal explanation: is not a significant factor in providing necessary nutrition to a client. it is used to primarily correct serum osmolality and supply water

prac: a nurse is administering lactated ringer's (LR), which contains lactate. LR is used to treat a pt. who has which of the following disorders?

acidosis explanation: the nurse should administer LR to pt. who have acidosis. when a pt. receives lactate intravenously, the liver metabolizes it to form bicarbonate, which helps correct the acidosis. LR should not be used to treat alkalosis, caloric deficit, or caloric excess

prac: a nurse is preparing to use the piggyback method to administer a secondary iv med. where should the nurse place the second bag?

higher than primary bag explanation: the primary bag will begin to infuse after the secondary back is empty (secondary bag is going to be smaller)

prac: a nurse administers a sol of 3% nacl to client. what type of solution is this?

hypertonic

prac: a nurse administers dextrose 5% in water (d5w) iv solution. after the dextrose is metabolized, what type of solution is this?

hypotonic explanation: after a pt. receives d5w intravenous infusion, the dextrose is quickly metabolized, leaving only free water, which is hypotonic solution

prac: hemolysis can occur with administration of which of the following types of solution?

hypotonic explanation: move fluid from veins into cells, which can cause hemolysis, or rupture of cells

prac: nurse is caring for pt. who is receiving antibiotic by intermittent iv infusion. the pt. reports SOB and wheezing. actions?

initiate o2, call rapid response team, elevate head of bed to 45 degrees explanation: a pt. who starts to have sob and wheezing while receiving antibiotic by intermittent bolus is likely experiencing anaphylaxis. First, stop the infiltration. Then initiate o2 using a nonrebreater mask to treat dyspnea. call the rapid response team for help and raise head of bed to facilitate gas exchange. prepare to admin epinephrine, which reverses manifestations of anaphylaxis. (acetylcysteine is the antidote for acetaminophen overdose). leave the cath in place to facilitate the admin of emergency med and iv fluids. replace the iv tubing and infuse 0.9 % NaCl

prac: a nurse administers lactated ringers by continuous IV infusion. what type of solution is this?

isotonic

prac: a nurse is observing a newly licensed nurse administer an intermittent iv bolus to a client who has continuous iv. the iv bolus is compatible with the continuous iv fluids.

it is not necessary to flush the line with 0.9% nacl prior to admin a med that is compatible with the iv solution. use the port closest to the pt. to ensure rapid infusion of med. pinching the iv tubing above the port will allow the med to flow toward the client instead of back up into the tubing. follow standard procedure and wear clean gloves.

hypotonic

moves fluid from veins to cells and ICS

prac: what is a common name for the 0.9% sodium chloride?

normal saline (ns)

hypertonic

pulls fluids out of the cells and into veins

prac: a nurse is caring for a client who has FLUID OVERLOAD following continuous IV infusion of 200 ml/hr. Which of the following actions by nurse is appropriate?

reduce the iv fluid rate explanation: the nurse should reduce the iv rate and notify provider immediately. to facilitate breathing, elevate head to high-fowlers position (45 degrees). the. client might need IV meds. to treat fluid overload

isotonic

remains in the intravascular space

prac: the nurse is monitoring. a client who is receiving an iv med. the client reports dizziness and feeling of chest tightness. the nurse notes the client face is flushed. these findings indicate which of the following systemic complications of iv therapy?

speed shock explanation: speed shock occurs when. pt. receives an IV med too rapidly, causing dizziness, chest tightness, flushed face, and other effects due to toxic level of med in body. Extravasion causes pallor, swelling, and pain @ iv site, which can extend to extensive tissue damage over time. Anaphylactic shock causes bronchospasms, wheezing, SOB, severe hypotension, tachycardia, and resp or cardiac arrest. Fluid overload causes SOB, increased bp hr rr, crackles, JVD, and edema in extremities.

prac: a nurse is caring for a client who is receiving norepinephrine by continuous iv infusion. During routine assessment of site, nurse notes the catheter is no longer in vein. and vesicant med has infused into subcutaneous tissue. actions?

stop the infusion and prepare to administer an antidote explanation: the nurse should stop the iv infusion and prepare to administer phentolamine (an antidote for extravasion ischemia due to norepinephrine), which prevents damage to surrounding tissues. the nurse should call rapid response team and start o2 if they. suspect anaphylactic shock. the nurse should prepare to administer a diuretic if they suspect fluid overload

prac: a nurse is preparing to administer an iv med using iv tandem method. the nurse should attach the secondary tubing to which port on the primary set?

the nurse should attach the secondary tubing at the LOWER port. the nurse then regulates the secondary flow rate by adjusting the roller clamp on the primary tubing

prac: nurse is planning care for pt. who is receiving iv therapy. which of the following should nurse include to prevent PHLEBITIS?

use a small-gauge cath when initiating iv therapy explanation: should use a cath with smallest gauge possible to prevent irritation of vein and subsequent phlebitis. The nurse. should change the iv site only as clinically indicated by signs of phlebitis or infiltration. The nurse should use a warm compress to treat phlebitis, not prevent it. the nurse should use sterile technique when replacing the transparent dressing over site