PU IV’s

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Your client is receiving IV fluid administration and consuming a rather large amount of fluids orally. In calculating the client's fluid intake for the past 24 hours, you note the amount and immediately notify the physician of your findings. Notification of a physician regarding fluid intake should occur after exceeding how many milliliter in 24 hours?

3000

A nurse is preparing a dose of furosemide for an older adult with heart failure. The health care provider orders furosemide 1 mg/kg to be given intravenously. The client weighs 50 kg. The concentration of the drug is 40 mg/4mL (10 mg/mL). How many milliliters would the nurse administer? Record your answer using a whole number.

5

interdisciplinary team has been commissioned to create policies and procedures aimed at preventing acute hemolytic transfusion reactions. What action has the greatest potential to reduce the risk of this transfusion reaction?

Be vigilant in identifying the patient and the blood component.

A client suffers from a genetic bleeding deficiency. What blood product will be administered?

A client suffers from a genetic bleeding deficiency. What blood product will be administered?

The nurse is caring for a client who has been NPO since admission two days ago and was admitted with vomiting as a primary symptom. The client has been receiving intravenous therapy at 100 mL/hr. since admission with Lactated Ringers (LR) as the intravenous solution. What nursing diagnosis is most appropriate for this client?Fluid overload R/T excess intravenous fluidsPain R/T intravenous insertion siteAnxiety R/T extended hospitalizationAltered Nutrition: Less than body requirements R/T lack of adequate caloric intake

Altered Nutrition: Less than body requirements R/T lack of adequate caloric intake

A nurse needs to administer a prescribed dosage of antineoplastic drugs to a client with cancer. Which of the following pieces of medical equipment is used to administer antineoplastic drugs?

Central venous catheter

A client with aplastic anemia is going to receive a blood transfusion. In addition to taking vital signs and verifying that the unit of blood cells is matched to the client, what other assessments/actions would you take?

Check the client regarding chills, low back pain, dyspnea, and skin itching during the transfusion.

A client with type O blood and a history of anemia is scheduled for a blood transfusion. To avoid a transfusion reaction, this client must receive which blood type?OABAll blood types would work for this client.B

O

Assessing a client at 4:00 PM, a nurse notes that 800 ml of normal saline solution has been infusing since it was hung at 4:00PM yesterday. What would be the nurse's next action?

Replace the IV solution.

Fresh-frozen plasma (FFP) has been ordered for a hospital patient. Prior to administration of this blood product, the nurse should prioritize what patient education?

Signs and symptoms of a transfusion reaction

A patient is receiving a blood transfusion and complains of a new onset of slight dyspnea. The nurse's rapid assessment reveals bilateral lung crackles and elevated BP. What is the nurse's most appropriate action?

Slow the infusion rate and monitor the patient closely.

A client receiving intravenous therapy is experiencing circulatory overload. Which of the following nursing actions is correct? Select all that apply. Slow the infusion rate. Elevate the client's head. Discontinue any oxygen. Contact the physician. Apply warm compresses at the site.

Slow the infusion rate.-Elevate the client's head.-Contact the physician.

The nurse is monitoring a client receiving a unit of packed red blood cells (PRBCs) who develops a fever, shaking chills, headache, rapid pulse, and muscle aches. Which action(s) should the nurse take? Select all that apply.

Stop the infusion .Measure vital signs .Infuse normal saline. Notify the health care provider.

The nurse is caring for an older adult client who is receiving intravenous therapy (IV). Which assessment data would indicate that the client is experiencing a complication of IV therapy?

The client's jugular veins are distended.

A client is being treated in the ICU after a medical error resulted in an acute hemolytic transfusion reaction. What was the etiology of this client's adverse reaction?

The donor blood was incompatible with that of the patient

The nurse is preparing to administer a unit of blood to a client and should know that which is the FIRST action of the nurse prior to the administration?

The nurse is preparing to administer a unit of blood to a client and should know that which is the FIRST action of the nurse prior to the administration?

When capping a primary line for intermittent use, a nurse notices local, acute tenderness; redness, warmth, and slight edema of the vein above the insertion site. What is the most likely complication that has occurred?

Thrombus Phlebitis and thrombus present as local acute tenderness, redness, warmth, and slight edema of the vein above the site. Sepsis manifests as a red and tender insertion site with fever, malaise, and other vital sign changes. Infiltration or the escape of fluid into the subcutaneous tissue manifests as swelling, pallor, coldness, or pain around the infusion site and significant decrease in the flow rate. The signs of speed shock are pounding headache, fainting, rapid pulse rate, apprehension, chills, back pains, and dyspnea.

A client requires a blood transfusion, and the nurse is preparing the blood transfusion equipment. Which item will the nurse need?Y-administration tubing22-gauge catheterprimary tubingpressure infusion sleeve

Y-administration tubing

A client has hypertonic solution running via gravity at 100 mL/hour to decrease postoperative edema. Before transporting the client, the nurse sets the IV pole at the proper height to overcome the pressure within the client's veins. What is that height?

at least 18 to 24 inches above infusion site


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