Adaptive Quiz: Basic Pharmacology for Nurses Ch. 11

Which steps would a nurse follow when discontinuing an intravenous (IV) infusion? Select all that apply.

- Apply a small dressing or adhesive bandage at the site in accordance with institution policy - Put on gloves to loosen the tape at the site and at the same time stabilize the needle - Help the patient flex the elbow and hold the gauze in place if the venipuncture site is in the antecubital fossa

Which steps would a nurse follow when discontinuing an intravenous (IV) infusion when the IV site is to be converted to a saline lock? Select all that apply.

- Attach the flush syringe to the extension tubing - Stabilize the catheter hub when disconnecting the primary IV tubing - Shut off the infusion equipment after clamping the tubing on the IV line

Which veins would a nurse use of intravenous (IV) medication administration in infants? Select all that apply.

- Back of the hand - Dorsum of the food - Temporal region of the scalp

Which terms are tunneled central venous catheters? Select all that apply.

- Broviac - Hickman - Groshong

Which term is a winged needle also known as? Select all that apply.

- Butterfly - Scalp cath

Which nursing actions are specific to the administration of physiologic fluids through an intravenous (IV) device? Select all that apply.

- Change the administration set every 72 hours - Monitor the patient's intake and output carefully - Report decline in hourly outputs to the primary healthcare provider

A nurse flushing an intravenous (IV) line is unable to aspirate blood during the procedure. Which steps would the nurse take to address the situation? Select all that apply.

- Check whether the clamp on the IV tubing is open - Remove the injection cap and aspirate the blood clot - Reposition the patient's upper body and help perform Valsalva maneuver

Which steps would the nurse follow to change the container of the intravenous (IV) solution if the same tubing will be used? Select all that apply.

- Clamp the tubing on the primary IV line before changing the container - Use aseptic technique to change the container quickly for the empty one - Ensure that the compatibility of the new IV solution is checked with the current solution

When educating a patient regarding the SASH guideline for administering intravenous (IV) medications, which explanations given by the nurse are accurate? Select all that apply.

- Heparin flush is used after the second saline flush - Saline flush is used before administering the drug - Saline flush is used before and after administering the drug

Which situation associated with intravenous therapy can cause thrombophlebitis? Select all that apply.

- Irritation of the vein by the catheter - Infection - Chemical irritation from medication

Which information would the nurse include when explaining the features and usage of a Groshong catheter to a patient? Select all that apply.

- It contains one to three lumens - Its lumens have rounded valved tips - Its valve remains closed when not in use

Which symptoms would the nurse expect to observe when a patient develops a pulmonary embolism? Select all that apply.

- Tachycardia - Pleuritic pain - Unexplained hemoptysis

When educating a patient regarding the use of over-the-needle catheters, which information would the nurse include in the teaching plan? Select all that apply.

- Teflon-like plastic is used to make over-the-needle catheters - The metal needle is removed after the catheter is inserted into the veins - Over-the-needle catheters should ideally be changed every 72 to 96 hours

Which points would the nurse keep in mind regarding hypertonic solutions? Select all that apply.

- They should not be administered in peripheral veins if the osmolalities are more than approximately 600 to 700 mOsm/L - They are administered through central infusion lines, where the solution can be rapidly diluted by large volumes of rapidly flowing blood - They cause cellular dehydration and vascular volume overload, by pulling fluid from the intracellular and interstitial compartments into the intravascular compartment

When providing intravenous (IV) therapy to an elderly patient, excess fluid is accidentally administered. Which symptoms does the nurse expect in the patient as a result of the error? Select all that apply.

- Thready pulse - Frothy sputum - Cardiac dysrhythmias

Which steps of initiating intravenous (IV) therapy in a patient are incorrect? Select all that apply.

- Use the veins of the lower extremities - Use the veins of the hand in older adults - Initiate an IV in an arm with a dialysis catheter inserted

When are central intravenous (IV) access devices indicated? Select all that apply.

- When long-term therapy is required - When total parenteral nutrition (TPN) is provided - When emergency situations require adequate vascular access

Which fluid may be used to maintain vascular volume in a patient who is hypovolemic and hypotensive?

0.9% normal saline

Which minimal rate of intravenous infusion is maintained for a keep open (TKO) infusion?

10 ml/hr

A patient's skin is blanched, edema is greater than 6 inches in a particular direction, and the area is cool to touch. The patient experiences mild to moderate pain and numbness at the site. Which grade would the nurse use to describe the patient's condition in the infiltration scale?

3

How many drops of solution does the microdrip chamber deliver?

60 drops/ml

Which possible complication of intravenous therapy would the nurse expect when a patient complains of palpitations, chest pain and shortness of breath?

Air embolism

Which situation would be the primary indicator for hypotonic solutions?

Cellular dehydration

Which fluid is an example of a hypotonic solution?

Dextrose 5% in water (D5W)

When would the intravenous (IV) administration set used for total parenteral nutrition (TPN) be changed by the nurse?

Every 24 hours

Which precaution would the nurse take when changing the dressing covering a patient's intravenous (IV) site?

Examine the area carefully for tenderness, irritation or swelling

Which type of central venous catheter gives the greatest flexibility to the patient?

Implantable infusion ports

Which intravenous access device is placed into central veins for long-term therapy?

Implantable venous infusion port

Which type of central venous catheters can last for more than a year if properly flushed with saline-heparin solution after every access or once monthly?

Implanted central venous access

For a patient who is hemorrhaging after a head-on car collision, which intravenous (IV) fluid does the nurse anticipate will be prescribed?

Lactated Ringer's

When administering medication through an implanted venous access device, which step prevents the backflow of blood in the catheter?

Maintaining firm pressure on the plunger of the syringe when withdrawing the needle from the access device

Which devices are used for intravenous therapy lasting from 2 to 4 weeks?

Midline catheters

Which intravenous access device is inserted into intermediate-sized veins and advanced into larger vessels?

Midline catheters

Which intervention does the nurse include in a care plan for a patient receiving intravenous (IV) therapy?

Monitoring the patient's intake and output

Which intervention is essential for the prevention of pulmonary embolism?

Refrain from forcing the flush solution into the IV catheter

When a nurse is inserting an intravenous (IV) device into an older adult, which special precaution would the nurse take?

Refrain from inserting the IV catheter in the hands

Which course of action would the nurse take to prevent thromboemboli?

Refrain from using the veins in the lower extremities of an adult

Which principle would the nurse follow to prevent fungal infection at the intravenous (IV) insertion site?

Refrain from using topical antibiotic ointment or cream

Which course of action would the nurse take if a patient with an intravenous (IV) line has signs of pulmonary edema?

Slow the IV infusion immediately to a keep open (TKO) rate

Which action is priority when speed shock is suspected in a patient?

Stop the infusion

Which veins are most commonly used for central venous catheters?

Subclavian

Which infusion control device is used to administer morphine through a patient-controlled analgesia (PCA) pump?

Syringe pump

When teaching a patient about midline access catheters, which information would the nurse provide?

They are used if it is anticipated that IV access will be needed for 7 days or more

Which intravenous (IV) site is at greatest risk for the development of thrombi?

Veins of the lower extremities