Funds IV Therapy Review Questions

A nurse is caring for a patient who has developed hypernatremia. For which intravenous solution would the nurse anticipate a prescription? a. 5% dextrose in 0.9% NaCl b. 0.9% NaCl (normal saline) c. 0.45% NaCl (½-strength normal saline) d. 5% dextrose in lactated Ringer's solution

c. 0.45% NaCl (½-strength normal saline)

A nurse is performing physical assessments for patients with fluid imbalance. Which findings indicate a fluid volume excess? Select all that apply. a. Pinched and drawn facial expression b. Deep, rapid respirations c. Moist crackles heard upon auscultation d. Tachycardia e. Distended neck veins f. Sluggish skin turgor

c. Moist crackles heard upon auscultation d. Tachycardia e. Distended neck veins

A nurse on the IV team is making rounds to assess patients receiving IV therapy. Under which circumstance will the nurse recommend an intravenous catheter be discontinued? a. The area surrounding the catheter is bruised. b. The patient's extremity is cool to touch. c. The site is red, warm, and swollen. d. Part of the catheter (1 mm) is visible under the dressing.

c. The site is red, warm, and swollen.

Low back pain, fever, tachycardia, tachypnea, are signs of what blood transfusion reaction? a. anaphylactic b. septic c. acute hemolytic d. circulatory overload

c. acute hemolytic

What do you use to prime the blood transfusion administration set?

0.9% NaCl (Normal Saline)

Which of the following situations indicates discontinuation of peripheral IV access?(Select all that apply.) A. The patient is being discharged to home on PO medications. B. The health care provider has ordered normal saline at 100 mL per hour and the patient's bag of IV fluids is empty. C. The patient is drinking fluids well postoperatively and has an order for morphine IV every 3 hours as needed. D. The electronic infusion pump alarm keeps sounding, indicating 'occlusion' on its screen and the nurse is unable to flush the IV. E. The patient's arm is swollen and cool to the touch; the patient complains of pain at the IV site. F. The patient's arm appears reddened and is tender to the touch. G. The IV access site is dated 4 days ago.

A. The patient is being discharged to home on PO medications. D. The electronic infusion pump alarm keeps sounding, indicating 'occlusion' on its screen and the nurse is unable to flush the IV. E. The patient's arm is swollen and cool to the touch; the patient complains of pain at the IV site. F. The patient's arm appears reddened and is tender to the touch. G. The IV access site is dated 4 days ago.

How will the nurse minimize the risk for infection when changing a patient's IV catheter site dressing? A. Use aseptic technique throughout the process. B. Pull the tape toward the insertion site. C. Remove both the gauze dressing and the tape one layer at a time. D. Explain the process to the patient.

A. Use aseptic technique throughout the process.

A crucial point the nurse must remember about IV administration sets is that the drops delivered by drip chambers vary. A microdrip chamber delivers: a) 10 drops/mL. b) 15 drops/mL. c) 20 drops/mL. d) 60 drops/mL.

d) 60 drops/mL.

How often should peripheral catheters be changed to prevent infection and phlebitis? a) 8 to 12 hours b) 12 to 48 hours c) 48 to 72 hours d) 72 to 96 hours

d) 72 to 96 hours

You received a report on a 65-year-old patient who underwent resection of an abdominal aortic aneurysm. The nurse told you that he has lactated Ringer's solution infusing at 150 ml/hour. When you enter his room to perform your assessment, you note that he's in respiratory distress. You check his blood pressure and find that it's elevated. You also note bilateral jugular vein distension. This patient is most likely experiencing a) Hypersensitivity c) sensory overload b) Systemic infection d) circulatory overload.

d) circulatory overload.

A nurse is assessing infants in the NICU for fluid balance status. Which nursing action would the nurse depend on as the most reliable indicator of a patient's fluid balance status? a. Recording intake and output b. Testing skin turgor c. Reviewing the complete blood count d. Measuring weight daily

d. Measuring weight daily

A nurse is caring for an older adult with a fluid volume deficit related to decreased thirst sensation. For which signs and symptoms of this health problem will the nurse assess? a. Dependent edema b. Crackles in the lungs c. Neck vein distention d. Weight loss

d. Weight loss

What IV complication can cause crackles and SOB and requires the infusion rate to be decreased? a. phlebitis b. extravasation c. air embolus d. fluid overload

d. fluid overload

Where does the tip of the Central Venous Catheter terminate?

the superior vena cava just above the right atrium

A client rings the call bell and complains of pain at the site of an intravenous (IV) infusion. The nurse assesses the site and determines that phlebitis has developed. The nurse should take which action(s) in the care of this client? Select all that apply. 1. Notify the health care provider (HCP). 2. Remove the IV catheter at that site. 3. Apply warm moist packs to the site. 4. Start a new IV line in a proximal portion of the same vein. 5. Document the occurrence, actions taken, and the client's response.

1. Notify the health care provider (HCP). 2. Remove the IV catheter at that site. 3. Apply warm moist packs to the site. 5. Document the occurrence, actions taken, and the client's response.

The nurse notes that the site of a client's peripheral intravenous (IV) catheter is reddened, warm, painful, and slightly edematous proximal to the insertion point of the IV catheter. After taking appropriate steps to care for the client, the nurse should document in the medical record that the client experienced which condition? 1. Phlebitis of the vein 2. Infiltration of the IV line 3. Hypersensitivity to the IV solution 4. Allergic reaction to the IV catheter material

1. Phlebitis of the vein Rationale: Phlebitis at an IV site can be distinguished by client discomfort at the site and by redness, warmth, and swelling proximal to the catheter. If phlebitis occurs, the nurse should discontinue the IV line and insert a new IV line at a different site. Coolness at the site would be noted if the IV catheter was infiltrated. An allergic reaction produces a rash, redness, and itching. A major reaction, such as hypersensitivity, can cause dyspnea, a swollen tongue, and cyanosis.

A client had a 1000-mL bag of 5% dextrose in 0.9% sodium chloride hung at 3 PM. The nurse making rounds at 3:45 PM finds that the client is complaining of a pounding headache and is dyspneic, is experiencing chills, and is apprehensive, with an increased pulse rate. The intravenous (IV) bag has 400 mL remaining. The nurse should take which action first? 1. Slow the IV infusion. 2. Sit the client up in bed. 3. Remove the IV catheter. 4. Call the health care provider (HCP).

1. Slow the IV infusion. Rationale: The client's symptoms are compatible with circulatory overload. This may be verified by noting that 600 mL has infused in the course of 45 minutes. The first action of the nurse is to slow the infusion. Other actions may follow in rapid sequence. The nurse may elevate the head of the bed to aid the client's breathing, if necessary. The nurse also notifies the HCP. The IV catheter is not removed; it may be needed for the administration of medications to resolve the complication.

The nurse is making initial rounds on the nursing unit to assess the condition of assigned clients. The nurse notes that a client's intravenous (IV) site is cool, pale, and swollen, and the solution is not infusing. The nurse concludes that which complication has occurred? 1. Infection 2. Phlebitis 3. Infiltration 4. Thrombosis

3. Infiltration Rationale: An infiltrated IV is one that has dislodged from the vein and is lying in subcutaneous tissue. Pallor, coolness, and swelling are the results of IV fluid being deposited in the subcutaneous tissue. When the pressure in the tissues exceeds the pressure in the tubing, the flow of the IV solution will stop. The corrective action is to remove the catheter and start a new IV line at another site. Infection, phlebitis, and thrombosis are likely to be accompanied by warmth at the site, not coolness.

A blood transfusion needs to be completed within ____ hrs

4 hours

A client with the recent diagnosis of myocardial infarction and impaired renal function is recuperating on the step-down cardiac unit. The client's blood pressure has been borderline low and intravenous (IV)fluids have been infusing at 100 mL/hour via a central line catheter in the right internal jugular for approximately 24 hours to increase renal output and maintain the blood pressure. Upon entering the client's room, the nurse notes that the client is breathing rapidly and is coughing. The nurse determines that the client is most likely experiencing which complication of IV therapy? 1. Hematoma 2. Air embolism 3. Systemic infection 4. Circulatory overload

4. Circulatory overload

Match the correct catheter size to the appropriate patient situation.( A) Adult patient scheduled for major surgery (B) Older adult requiring IV medications (C) Infant requiring IV fluids (D) Young adult requiring fluid maintenance (1) 18- gauge (2) Butterfly needle (3) 20-gauge (4) 22-gauge

A) Adult patient scheduled for major surgery w (1) 18- gauge B) Older adult requiring IV medications w (4) 22-gauge C) Infant requiring IV fluids w (2) Butterfly needle D) Young adult requiring fluid maintenance w (3) 20-gauge

An adult patient developed a complication with his IV and it had to be removed, yet continued IV fluids were needed. Which site would be most appropriate for the nurse to choose? A. Proximal to the previous IV site. B. Distal to the previous IV site. C. In the antecubital fossa. D. In the foot.

A. Proximal to the previous IV site.

The nurse is using chlorhexidine to prepare the site before inserting a venous access device into the median cubital vein of a 60-year-old patient. Which action is correct? A. Wash the site with soap and water. B. Allow the site to dry 1 to 2 minutes after cleansing it with chlorhexidine. C. Cleanse the site using a circular motion, starting at the insertion site and working outward. D. Cleanse the area by first swabbing horizontally, then vertically with the applicator for about 30 seconds.

D. Cleanse the area by first swabbing horizontally, then vertically with the applicator for about 30 seconds.

Which of the following would be consistent with infiltration? (Select all that apply.) A. Redness B. Cool to touch C. Warm to touch D. Swelling around insertion site E. With or without pain

B. Cool to touch D. Swelling around insertion site E. With or without pain

An elderly patient is receiving 0.9% normal saline at 125 mL/hr. The NAP reports the patient is complaining of feeling short of breath. The nurse determines the patient is experiencing fluid volume excess. What other symptoms would lead the nurse to this conclusion? (Select all that apply.) A. Decreased skin turgor B. Crackles in lungs C. Peripheral edema D. Hypotension E. Dyspnea

B. Crackles in lungs C. Peripheral edema E. Dyspnea

Which of the following veins should be avoided when initiating an IV? (select all that apply) A. Dorsal surface of the hand of a middle-aged adult B. Inner arm C. Foot of an adult D. Site distal to a previous venipuncture site E. Inner wrist F. Areas of venous bifurcation G. Foot of a child

C. Foot of an adult D. Site distal to a previous venipuncture site E. Inner wrist F. Areas of venous bifurcation

The nurse is assessing the patient for signs and symptoms of fluid volume excess. Which of the following would indicate the patient is experiencing this complication and should be reported? (Select all that apply.) A. Skin turgor good and capillary refill less than 3 seconds B. Decreased urine output and dry mucous membranes C. Shortness of breath and crackles in lungs D. Elevated blood pressure and edema

C. Shortness of breath and crackles in lungs D. Elevated blood pressure and edema

Which of the following technique(s) is/are best for minimizing a patient's risk for injury when inserting a venous access device? A. Inserting the needle with the bevel up B. Using a vein on the dorsal surface of the arm C. Holding the skin taut directly below the site D. All of the above

D. All of the above

The nurse knows to monitor the patient's IV site for signs of phlebitis. Why is it most important to discontinue the IV site if phlebitis is evident? A. Because it will cause the patient pain. B. In order to prevent the spread of infection to the other extremity. C. Phlebitis will eventually result in infiltration. D. Phlebitis can be dangerous because blood clots can occur.

D. Phlebitis can be dangerous because blood clots can occur.

The student nurse is watching the staff nurse discontinue a peripheral IV. The staff nurse removes the catheter and then looks at it. The student asks the nurse what she is looking for. The correct response by the nurse is "I am: A. looking to see if there is any clot formation on the tip." B. looking for exudate at the catheter tip." C. noting the gauge of the catheter so I can document removal accurately." D. inspecting the catheter for intactness."

D. inspecting the catheter for intactness."

A nurse is flushing a patient's peripheral venous access device. The nurse finds that the access site is leaking fluid during flushing. What action will the nurse take next? a. Removing the IV from the site and start at another location b. Immediately notifying the primary care provider c. Outlining the affected area in ink and monitoring for changes d. Aspirating the catheter and attempting to flush again

a. Removing the IV from the site and start at another location

The extracellular compartment contains about how much of the total body water? a) 1/3 b) 1/2 c) 2/3 d) 3/4

a) 1/3

A 39-year-old patient returns from the OR after undergoing a right thoracotomy. An I.V. solution of 5% dextrose in 0.45% sodium chloride solution is infusing. Which type of I.V. solution is the patient receiving? a) Hypertonic c) Isotonic b) Hypotonic d) Bolus

a) Hypertonic

An 85-year-old patient with a history of abdominal aortic aneurysm resection is admitted to the ED with dehydration. Which of the following contraindicates insertion of an I.V. catheter in his arm? a) hemodialysis arteriovenous (AV) fistula c) Previous IV site b) non-dominant arm or hand. d) "rolling" veins

a) hemodialysis arteriovenous (AV) fistula

A nurse is caring for a group of patients. The patient with which problem would the nurse identify is at high risk for fluid volume excess? a. Renal failure b. Vomiting c. Hypernatremia d. NPO for surgery

a. Renal failure

A nurse is administering a blood transfusion for a patient following surgery. During the transfusion, the patient displays signs of dyspnea, dry cough, and pulmonary edema. What would be the nurse's priority actions related to these symptoms? a. Slowing or stopping the infusion; monitoring vital signs, notifying the health care provider, and placing the patient in an upright position with their feet dependent b. Stopping the transfusion immediately and keeping the vein open with normal saline, notifying the health care provider immediately, and administering antihistamine parenterally as needed c. Stopping the transfusion immediately and keeping the vein open with normal saline, notifying the health care provider, and treating symptoms with acetaminophen d. Stopping the infusion immediately, obtaining a culture of the patient's blood, monitoring vital signs, notifying the health care provider, and administering antibiotics immediately

a. Slowing or stopping the infusion; monitoring vital signs, notifying the health care provider, and placing the patient in an upright position with their feet dependent

A nurse is caring for a patient experiencing a fluid volume deficit. What should be included in the recorded intake and output for the patient? Select all that apply. a. Urine b. Carbonated beverage c. Formed stool d. Vomitus e. Chicken noodle soup f. Pressure wound irrigant

a. Urine b. Carbonated beverage d. Vomitus e. Chicken noodle soup

After cleansing the IV site with the proper antiseptic, the nurse should a) Blow on the cleanse site to facilitate drying c) Pat the site dry with a regular gauze pad b) Allow to air dry d) Fan the cleanse IV site with gloved hand

b) Allow to air dry

What is the first step in the insertion of a peripheral IV line or saline lock? a) Get permission from the patient/family member. c) Educate the patient about the need for an IV b) Obtain a physician's order. d) gather all supplies

b) Obtain a physician's order.

When an IV drug is administered too rapidly into the circulation, most commonly by IV push, a systemic reaction can occur called: a) anaphylaxis. b) speed shock. c) hemolysis. d) extravasation.

b) speed shock.

What IV complication requires aspiration of any remaining drug and administration of an antidote? a. phlebitis b. extravasation c. air embolus d. fluid overload

b. extravasation

Which of the following statements about solutes in diffusion is accurate? a) They move against the concentration gradient. c) They move from higher to lower concentration b) They move from lower to higher concentration. d) The do not move across a gradient

c) They move from higher to lower concentration

Access devices that are inserted into intermediate-sized vessels and advanced into central veins where the tip of the catheter typically will be in the superior vena cava are called: a) peripheral devices. b) midline catheters. c) central devices. d) venous infusion ports.

c) central devices.

The central veins that are most commonly used for central venous catheters are: a) femoral and popliteal. b) radial and brachial. c) subclavian and jugular. d) cephalic and basilic.

c) subclavian and jugular.