Safety Video Questions
Which instruction might the nurse give to nursing assistive personnel (NAP) when caring for a patient whose IV access device is to be removed?
"Let me know if you notice any bleeding on the site dressing."
A patient is prescribed 1000 mL of intravenous (IV) normal saline to run over 8 hours. The initial fluid is hung at 0800. How many milliliters of fluid will have infused by 1200?
500 mL
Which action will best minimize the patient's risk for vein injury when removing an IV access device from a patient's arm?
Keep the hub parallel to the skin.
What is the best way to prevent infection and conserve resources when terminating an IV piggyback medication infusion in a patient who also has a primary fluid infusion?
Leave both the piggyback tubing and the bag attached to the primary line Y-site port until the next scheduled dose.
Which action would the nurse perform to best ensure effective insertion of a venous access device into a patient's arm?
Anchor the vein by placing a thumb 1 to 2 inches below the site.
Which patient safety issue is specific to administration of medication by IV bolus?
Determining that the medication is compatible with the IV solution
Which action by the nurse helps to ensure patient safety when administering IV fluids by gravity to very young children?
Using a volume-control device for the infusion
Which action can the nurse take to minimize the patient's risk for infection when applying new tubing to a primary IV infusion?
Using aseptic technique and changing the tubing at the same time a new primary fluid bag is hung are both appropriate to minimize the patient's risk for infection
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 (correct)
It is determined that a patient who received a blood transfusion received an infection from the blood. Whom should the nurse notify of this infection?
Blood bank and infection control department
How can the nurse best minimize the patient's risk for infection when administering an IV bolus of an analgesic?
Follow aseptic technique during the entire process.
The provider has ordered that a patient be 1000 mL of IV normal saline to run over 12 hours. What is the first step in the calculation of the rate of infusion?
Calculate the hourly volume of normal saline the patient should receive.
Which response might the nurse give to nursing assistive personnel (NAP) who reports that the alarm is sounding on a patient's electronic infusion device (EID)?
"I'll check the IV site and pump."
Which instruction reflects the nurse's correct understanding of the role of nursing assistive personnel (NAP) in caring for a patient receiving an intravenous (IV) antibiotic medication by piggyback?
"Let me know immediately if the patient complains of pain at the IV site."
Which statement might a nurse make to nursing assistive personnel (NAP) when caring for a patient prescribed an intravenous (IV) bolus of analgesic medication?
"Let me know immediately if the patient complains of pain at the insertion site."
Which instruction might the nurse give to nursing assistive personnel (NAP) regarding the care of a patient with a CVAD?
"Let me know immediately if the patient's dressing becomes damp."
Which instruction would the nurse give to nursing assistive personnel (NAP) when caring for a patient who is receiving IV fluids?
"Let me know when the IV bag is almost empty."
Which instruction to nursing assistive personnel (NAP) reflects the nurse's correct understanding of the NAP's role in caring for a patient receiving intravenous (IV) fluids by gravity drip?
"Let me know when you notice that the IV bag contains less than 100 mL."
Which instruction might the nurse give to nursing assistive personnel (NAP) regarding the care of a patient with an intravenous access device?
"Let me know when you notice that the IV bag contains less than 100 milliliters."
The nurse is preparing equipment to administer a unit of blood to a patient. Which type of fluid would the nurse piggyback with the blood transfusion?
0.9% normal saline
A patient received two 300-mL units of packed red blood cells, and the line was flushed with 25 mL of solution between the units. What is the total amount of fluid the nurse will document having provided to the patient?
625 mL
A patient is to receive one unit of packed red blood cells over 2 hours. Which rate is the usual flow rate for the first 15 minutes of a blood transfusion?
2 mL/min
The provider orders that a patient be given 1000 mL of IV normal saline to run over 10 hours. The drop factor of the selected tubing is 15. What is the correct rate of infusion in drops per minute?
25 drops/minute
What will the nurse do to prevent possible complications after removing an IV access device in a patient on anticoagulant therapy?
Apply firm pressure to the site with sterile gauze for 10 minutes.`
What is the best way to protect a patient from an IV site injury when giving an antibiotic medication by piggyback?
Assess the IV site before initiating the IV piggyback medication.
If the nurse does not see blood return when aspirating the saline lock in preparation for an IV bolus medication, what is the next step?
Assess the site for swelling or coolness while flushing the saline lock with normal saline.
While changing a patient's hospital gown, the extension set on the IV infusion becomes disconnected and ends up on the bed linens. What would the nurse do?
Change the extension set tubing
How would the nurse assess a patient's central venous access device (CVAD) for damage or breakage?
Check the catheter for pinholes and tears.
After drawing blood from a central venous access device (CVAD), which action would minimize the patient's risk for infection when reconnecting prescribed intravenous fluids?
Cleansing the IV needleless connector and the end of the IV tubing with a 2% chlorhexidine swab
After changing the intravenous (IV) tubing on a patient's primary infusion, the nurse notes air bubbles in the tubing. How would the nurse remove them?
Close the clamp, stretch the tubing downward, and flick the tubing.
What might the nurse do to improve a patient's cooperation during the removal of an IV access device?
Describe the entire procedure to the patient.
Which action can the nurse take to ensure a quality blood sample when drawing blood from a patient's central venous access device (CVAD) site?
Discard the first 4 to 5 mL of blood drawn.
A patient receiving a unit of blood begins to show signs of a transfusion reaction. How frequently should the nurse monitor the patient's vital signs after stopping the transfusion?
Every 15 minutes
The nurse calculates that the patient is to receive 125 mL of intravenous (IV) normal saline per hour. After programming the infusion pump to deliver at that rate, how would the nurse ensure accurate fluid administration?
First verify that the fluid is dripping, and then check the level of fluid remaining in the container every hour.
After drawing blood from a patient's central venous access device (CVAD), what would the nurse do to ensure that the device resumes proper functioning?
Flush the catheter with preservative-free 0.9% sodium chloride, per agency policy.
Which nursing intervention is most important in ensuring safe infusion of a medication delivered by IV piggyback through a saline lock?
Flush the saline lock with sodium chloride solution before initiating the infusion.
When administering an IV piggyback medication to infuse by gravity, how can the nurse ensure that the medication will flow properly?
Hang the piggyback medication higher than the primary fluid.
A patient is to receive 3 units of packed red blood cells over 8 hours. What will the nurse do to maintain the patency of the patient's IV access line after each of the first two units of blood has transfused?
Infuse 0.9% normal saline at the KVO rate.
The nurse receives an order to infuse 1000 mL of D5W at 125 mL continuously. Which of the following actions by the nurse indicates correct interpretation of this order?
Infusing D5W at a rate of 125 mL/hr until the health care provider changes the order
What is the most important action the nurse can take to protect the patient when administering a narcotic analgesic by IV bolus?
Injecting the medication at the prescribed rate
How might the nurse prepare a patient to anticipate some discomfort when inserting a venous access device?
Instruct the patient to expect a sharp, quick stick.
The nurse is inserting an over-the-needle catheter into a newly admitted patient. What will the nurse do after confirming blood return?
Lower the catheter until it is flush with the skin.
The nurse is concerned that a patient's central venous access device (CVAD) may have become dislodged. How might the nurse assess for this complication?
Palpate the skin for coiling.
When caring for a patient who has a CVAD, which sign may indicate infection at the insertion site?
Patient's oral temperature gradually increases
Which information is not necessary for the nurse to include when documenting the use of an EID for an intravenous infusion?
Patient's pulse and heart rate
What would the nurse do to ensure the correct administration of gravity drip intravenous (IV) fluid after changing the tubing on a patient's primary infusion?
Recheck the drip rate by counting the drops for 1 full minute.
A patient has a blood transfusion reaction, and the transfusion is stopped. What should the nurse do with the remaining blood and transfusion administration set?
Return both to the blood bank.
A patient receiving a unit of blood complains of feeling cold and begins to have shaking chills. What is the nurse's first action?
Stop the transfusion.
While palpating the skin around a patient's CVAD insertion site, the nurse elicits a crackling sound. What might this finding indicate?
Subcutaneous emphysema
When drawing blood from a central venous access device (CVAD) in which all ports are patent, it is recommended that the nurse select which lumen?
The distal port
How would the infusion of the IV fluids be affected if the tubing were unintentionally dislodged from the chamber of the control mechanism of the EID?
The flow of fluid would stop.
A patient prescribed to receive two units of packed red blood cells is to receive a dose of intravenous medication between the two units. How would the nurse administer the medication?
Through another IV line
A patient experiencing a blood transfusion reaction is prescribed to receive epinephrine. What is the purpose of this medication when given for this indication?
To relieve respiratory distress
When drawing blood from a patient's central venous access device (CVAD), what can the nurse do to minimize pressure on the device during flushing?
Use a 10-mL syringe for the flush.
What would the nurse do to assess a patient's risk for embolus when removing a venous access device?
Visualize the tip of the IV device.
