ATI - IV Therapy and Peripheral Access

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A nurse is caring for a client who is in early stage renal failure and has a prescription for the infusion of IV fluids. Which of the following IV fluids does the nurse anticipate a prescription for an why?

0.45% sodium chloride because it dilutes extracellular fluid and rehydrates cells. Infusing a hypotonic solution, such as 0.45% sodium chloride, moves fluid into the cells, thus enlarging and rehydrating them.

A nurse assesses a client's IV insertion site and finds that it is red, warm, and slightly edematous. Which of the following actions should the nurse take?

1. Check for a blood return 2. Elevate the extremity ****3. Discontinue the IV line**** The client has classic signs of phlebitis, an inflammation of the vein. The IV line must be discontinued immediately to reduce the risk of thrombophlebitis and embolism. 4. Apply warm, moist heat.

A nurse has just initiated an IV infusion and is teaching the client about possible complications. The nurse should include that which of the following findings is an indication of early infiltration?

1. Moisture 2. Bruising 3. Tingling ****4. Coolness**** Coolness is a classic sign of infiltration, along with swelling, pallor, and possibly tenderness. Infiltration is a leakage of IV solution out of the intravascular compartment and into the surrounding tissue.

A nurse has just inserted a peripheral IV catheter. Which of the following actions should the nurse take to secure the catheter?

****1. Apply an IV securement device**** An IV securement device will help the IV to stay in place and prevent dislodgement. 2. Wrap tape around the circumference of the client's arm 3. Tape the IV catheter's hub securely to the client's skin. 4. Place a piece of paper over the insertion site.

A nurse is discontinuing a peripheral IV catheter. Upon removal, the nurse should assess the catheter for which of the following?

****1. an intact catheter tip**** **The tip of the catheter can break off, thus creating an embolus. To limit the movement of the embolus, the nurse should apply a tourniquet high on the extremity where the IV line was located and notify the provider immediately.** 2. catheter erosion 3. blood within the catheter 4. discoloration of the catheter

A nurse has just initiated a new peripheral IV infusion with 5% dextrose in water for continuous infusion. How often should the nurse plan to replace the primary infusion tubing?

1. Every 24 hr 2. Every 48 hr 3. Every 72 hr ****4. Every 96 hr**** The Centers for Disease Control and Prevention and the Infusion Nurses' Society recommend changing the IV tubing no more than once every 96 hr unless the tubing has been contaminated, punctured, or obstructed.

A client is to receive a 1,000 mL bag of 5% dextrose in lactated Ringer's over 8 hours. Using tubing with a drop factor of 15 gtt/mL, the nurse should reuglate the fluid to infuse at how many drips per minute?

31 gtt/min

A nurse is inserting a peripheral IV catheter and observes a blood return in the flashback chamber after puncturing the skin and selected vein. Which of the following actions should the nurse perform next?

1. Secure the catheter to the skin with a transparent dressing ****2. Advance the catheter into the vein with a finger hub**** Once blood return is observed in the flashback chamber, the over-the-needle catheter should be advanced into the vein using the finger hub. 3. Release the tourniquet from the client's arm 4. attach a primed piece of extension tubing to the catheter

A nurse is removing a client's IV catheter. Which of the following actions should the nurse take?

1. apply firm pressure over the vein. 2. Leave the roller clamp slightly open. ****3. Pull the catheter straight back from the insertion site.**** With the catheter stabilized and using a slow, steady movement, the nurse should withdraw the catheter straight back and away from the insertion site, making sure to keep the hub parallel to the skin. 4. Lift the hub slightly upward away from the skin.

Which of the following actions should a nurse take when converting an IV infusion to a saline lock?

1. open the roller clamp of the primary infusion to prime the saline lock 2. Apply pressure with a syringe to clear resistance in the IV catheter 3. attach secondary tubing to allow mobility ****4. flush the IV catheter to confirm patency**** It is essential to attach the primed saline lock adapter to the extension tubing and to flush the tubing with normal saline to confirm patency.


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