FUNDS - chapter 35

Where do arteries take blood & where do veins take blood?

- arteries take blood away from the heart - veins return deoxygenated blood to the heart

In reference to the blood vessels, a word that means "hardened" is __________________.

- calcified

The interaction between the two drugs that causes a change in the activity or components of one or more of the drugs is known as a __________________

- drug-drug interaction

The word that means similar to infiltration but involves leakage of vesicant IV fluid medication into the tissue surrounding the IV insertion site is known as __________________.

- extravasation

The following solutions have what tonicity? D5 1/2 NS D5NS

- hypertonic

The following solutions have what tonicity? 0.45% NS 1/2 NS

- hypotonic

Where does O2 and CO2 exchange take place?

- in the alveoli

The following solutions have what tonicity? 0.9% NS D5W LR D5 1/4 NS Normosol R

- isotonic

Name 2 types of O2 delivery systems?

- nasal cannula - simple face mask - partial rebreathing mask - nonrebreathing mask - Venturi mask - face tent - tracheostomy collar - T-piece

What is hypoxemia?

- oxygen levels in the blood drop below normal range

What does a pulse oximetry measure?

- oxygen saturation in blood

The red blood cells that have been separated from plasma for transfusion are called __________________

- packed RBCs

The liquid portion of the blood is known as __________________.

- plasma

A __________________ forms when one of the agents in a solution separates from the solvent and becomes a solid, insoluble product that looks cloudy, hazy, or like fine floating crystals

- precipitate

The plastic projection that provides a place for your fingers to push the piercing pin into the solution bag port without contaminating the sterile piercing pin is known as the __________________.

- spike

Another term for "blood clot" is __________________

- thrombus

__________________ refers to a type of medication that causes blistering, necrosis, and sloughing of tissue when allowed to enter the subcutaneous tissue

- vesicant

To administer the first unit of blood over the ordered time frame, how many milliliters per hour should you set the infusion pump to deliver?

120 ml/hr

A client is to receive a 1000ml bag of 5% dextrose in Lactated Ringer's over 8hr. Using tubing with a drop factor of 15 gtt/ml, the nurse should regulate the fluid to infuse at how many drops per minute? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero)

31 gtt/min

Which type of fluid is not usually used for a patient with heart failure? A. 3% NS B. D5W C. NS D. LR

A. 3% NS

When explaining the advantages of a PICC, which of the following teaching points should you include? (SELECT ALL THAT APPLY) A. a PICC can be used for the blood sampling you will require while on TPN B. a PICC does not have to be replaced every few days C. a PICC can be used for TPN because it is a larger vein D. a PICC does not require routine flushing with a saline solution E. a PICC cannot become occlude

A. a PICC can be used for the blood sampling you will require while on TPN B. a PICC does not have to be replaced every few days C. a PICC can be used for TPN because it is a larger vein

A nurse is discontinuing a peripheral IV catheter. Upon removal, the nurse should assess the catheter for which of the following? A. an intact catheter tip B. catheter erosion C. blood within the catheter D. discoloration of the catheter

A. an intact catheter tip

A nurse has just inserted a peripheral IV catheter. Which of the following actions should the nurse take to secure the catheter? A. apply an IV securement device B. wrap tape around the circumference of the client's arm C. tape the IV catheter's hub securely to the client's skin D. place a piece of paper tape over the insertion site

A. apply an IV securement device

To minimize personal risk of injury while inserting an IV access device into a client's hand, you should stabilize the vein at which of the following locations? A. below the proposed insertion site B. above the proposed insertion site C. at either side of the proposed insertion site

A. below the proposed insertion site

A nurse is caring for a client who has a central venous catheter. When flushing the catheter, the nurse should use a 10ml syringe to prevent which of the following complications associated with central vascular access devices? A. catheter rupture B. catheter migration C. pneumothorax D. phlebitis

A. catheter rupture

Because of the fluid shifts in the previous question, prolonged infusion of this type of solution when it is not needed can result in which of the following? (SELECT ALL THAT APPLY) A. cerebral cells swelling B. increased intracranial pressure C. dehydration of cells D. edema

A. cerebral cells swelling B. increased intracranial pressure D. edema

When discontinuing an IV infusion, you should minimize the client's risk of infection by doing which of the following? A. covering the venipuncture site with a sterile dressing B. wearing a face mask during the intervention C. applying an antibacterial ointment to the venipuncture site

A. covering the venipuncture site with a sterile dressing

To verify the safe removal of an IV device, which of the following actions should you take? A. examine the catheter to make sure that it is intact B. ask the client to rate the pain of removal on a 0 to 10 scale C. check for bleeding 3 to 5 minutes after you have removed the device

A. examine the catheter to make sure that is is intact

Identify the correct sequence of steps you must take prior to obtaining a blood specimen. A. flush with 10ml of sterile 0.9% sodium chloride and withdraw a discard sample B. attach a 10ml syringe and aspirate for a blood return C. swab the hub of the extension tubing with antiseptic D. perform hand hygiene and apply gloves

A. flush with 10ml of sterile 0.9% sodium chloride and withdraw a discard sample B. attach a 10ml syringe and aspirate for a blood return C. swab the hub of the extension tubing with antiseptic D. perform hand hygiene and apply gloves

Which of the following is the most important concept related to IV therapy? A. maintain strict asepsis B. monitor IV infusion rate C. maintain fluid balance D. educate the patient about the IV therapy

A. maintain strict asepsis

Based on the client's diagnosis and history, you anticipate that he will need a blood transfusion. To access the port, which of the following will you use? A. noncoring needle B. angiocatheter C. winged infusion device

A. noncoring needle

You explain to the nurse that, before using the line, it is essential to do which of the following? A. obtain a chest x-ray B. flush the line with heparin C. obtain a central venous pressure (CVP) reading

A. obtain a chest x-ray

A client receiving D5W intravenously reports that the peripheral IV insertion site has become painful, warm and reddened. No drainage is present. What complication does the nurse suspect? A. phlebitis B. infiltration C. extravasation D. air embolism

A. phlebitis

Which of the following immediate complications should you monitor the client for during the insertion of the CVAD? (SELECT ALL THAT APPLY) A. pneumothorax B. bloodstream infection C. lumen occlusion D. hematoma

A. pneumothorax D. hematoma

Which of the following are included in the LPN scope of practice in Iowa? (SELECT ALL THAT APPLY) A. removing a peripheral IV B. inserting a peripheral IV C. hanging the second bag of NS D. hanging the second bag of NS with 20 mEq of KCl E. monitoring opioid medication administered via PCA pump

A. removing a peripheral IV C. hanging the second bag of NS E. monitoring opioid medication administered via PCA pump

You should teach the client that which of the following is a manifestation of a DVT? A. swelling of the forearm B. absence of blood return from the line C. bruising at the insertion site

A. swelling of the forearm

The client calls your attention to the "little bubbles" in the IV tubing. You should address the client's concern by stating which of the following? A. "It's all right. The IV pump will sound an alarm if there is too much air in the intravenous line." B. "Bubbles this small aren't a problem. The IV filter in the tubing will remove them." C. "Little bubbles don't cause a problem. It's the large ones that have to be removed."

B. "Bubbles this small aren't a problem. The IV filter in the tubing will remove them."

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 and why? A. 10% dextrose in water because it pulls from the cells and increases vascular volume B. 0.45% sodium chloride because it dilutes extracellular fluid and rehydrates the cells C. 0.9% sodium chloride because it replaces extracellular volume and maintains intravascular volume D. 3% sodium chloride because it draws fluid into blood vessels and reduces interstitial compartments

B. 0.45% sodium chloride because it dilutes extracellular fluid and rehydrates the cells

The nurse is administering NS at 100/hr. The drop factor on the tubing is 15 gtt/min. What is the correct rate? A. 15 gtt/min B. 25 gtt/min C. 50 gtt/min D. 60 gtt/min

B. 25 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? A. secure the catheter to the skin with a transparent dressing B. advance the catheter into the vein with the finger hub C. release the tourniquet from the client's arm D. attach a primed piece of extension tubing to the catheter

B. advance the catheter into the vein with the finger hub

A nurse is caring for a client who requires long-term central venous access and is an avid swimmer. Which of the following central venous access devices is the best choice for this client? A. a tunneled central catheter B. an implanted port C. a nontunneled percutaneous central catheter D. a peripherally inserted central catheter

B. an implanted port

To control bleeding after removing an IV catheter, you should immediately take which of the following actions? A. place an ice pack on the site B. apply pressure to the site with sterile gauze C. elevate the limb above the level of the heart

B. apply pressure to the site with sterile gauze

Which of the following cleansing solutions should you select when preparing to change the CVAD dressing? A. 0.9% sodium chloride B. chlorhexidine C. hydrogen peroxide

B. chlorhexidine

Joan is a nursing student who has been studying the cardiopulmonary system. She has been explaining to a patient with chronic obstructive lung disease about how the gasses in the lungs move between the airspaces and the bloodstream. This is best described as which of the following? A. ventilation B. diffusion C. respiration D. perfusion

B. diffusion

The nurse is assessing a 25-year-old woman's IV site. Which of the following findings are indicative of infiltration? (SELECT ALL THAT APPLY) A. warm B. edema C. cool D. pale E. taut skin

B. edema C. cool D. pale E. taut skin

A nurse caring for a patient with pneumonia notes which of the following as an early symptoms of hypoxia? A. retractions B. headache C. cyanosis D. bradypnea

B. headache

People who have severe chronic lung disease gradually develop a different stimulus to breathe. Chemoreceptors detect what? A. low carbon dioxide in the blood B. high carbon dioxide in the blood C. low oxygen in the blood D. high oxygen in the blood

B. high carbon dioxide in the blood

Which solution is best when an individual needs only simple water replacement because of lack of fluid intake or loss of body water without loss of electrolytes, known as 'hypertonic dehydration'? A. isotonic solution B. hypotonic solution C. hypertonic solution

B. hypotonic solution

A pale, cool IV insertion site that is both tender and edematous most likely indicates that the client has developed which of the following? A. phlebitis B. infiltration C. embolus

B. infiltration

You determine that you will need IV access for this client for 1 to 3 days and that the fluid to be infused is neither caustic nor viscous. Which of the following devices should you prepare to insert? A. midline catheter B. intravenous peripheral line C. peripherally inserted central catheter (PICC)

B. intravenous peripheral line

The 0.9% sodium chloride (normal saline) solution prescribed for the client preoperatively is for which of the following reasons? A. moving fluid out of the client's intravascular compartment B. maintaining the volume of the client's intravascular compartment C. drawing fluid into the client's intravascular compartment

B. maintaining the volume of the client's intravascular compartment

A nurse is caring for a client who has a central venous catheter and suddenly develops dyspnea, tachycardia, and dizziness. The nurse suspects an air embolism and clamps the catheter immediately. The nurse should reposition the client into which of the following positions? A. supine with a pillow between the knees B. on their left side in Trendelenburg position C. upright and leaning over the overbed table D. on their right side with the head of the bed elevated 15*

B. on their left side in Trendelenburg position

The nurse is evaluating a post-thoracotomy patient who has a chest tube. To properly maintain chest tube function, the nurse's best option is to... A. strip the tube every hour to maintain drainage B. place the device below the patient's chest C. double clamp the tubes except during assessments D. remove the tubing from the drainage device to check for proper suctioning

B. place the device below the patient's chest

Before you can safely administer IV medications, there are several things that you must know, including... (SELECT ALL THAT APPLY) A. if the patient has ever had IV medications before B. the patient's medication allergies C. the patient's disease or condition D. sterile technique

B. the patient's medication allergies C. the patient's disease or condition D. sterile technique

Which of the following criteria should you use to determine the type of vascular access device to use for this client? A. general health and condition of the client at the time of insertion B. type of fluid ordered and length of expected IV therapy C. physical size and preference of the client

B. type of fluid ordered and length of expected IV therapy

Which of the following solutions is hypotonic? A. 10% dextrose B. D5NS C. 0.45% NS D. 3% NS

C. 0.45% NS

When flushing a PICC lumen with heparin, it is appropriate to use which of the following? A. 3ml syringe B. 5ml syringe C. 10ml syringe

C. 10ml syringe

A nurse is preparing to administer 500ml of D5NS to infuse over 4 hours. The nurse should set the pump up deliver how many ml/hr? A. 40 B. 83.3 C. 125 D. 250

C. 125

If 1000ml of IV fluid starts infusing at 100ml/hr at 1200 (noon), you must be prepared to hand the next liter (1000ml) of fluid at approximately what time? A. 1800 B. 2000 C. 2200C.

C. 2200

You are about to attempt to initiate an IV on a 97-year-old female with tiny, fragile veins. Which of the following access devices would most likely be your best choice? A. 27 g x 1 in winged butterfly without cannula B. 22 g x 1 1/4 in intracath C. 25 g x 1 in winged butterfly with cannula D. 23 g x 1 in intracath

C. 25 g x 1 in winged butterfly with cannula

Which of the following is microdrip tubing? A. 10 gtt/min B. 20 gtt/min C. 60 gtt/min D. 160 gtt/min

C. 60 gtt/min

A nurse in the emergency department is caring for a client who was in a motor-vehicle crash. The provider determines that the client needs immediate central venous access for fluid and blood replacement. Which of the following central venous access devices should the nurse anticipate being inserted? A. a tunneled central catheter B. an implanted port C. a nontunneled percutaneous central catheter D. a peripherally inserted central catheter

C. a nontunneled percutaneous central catheter

To monitor the client for fluid overload while receiving intravenous fluids, you assess the client frequently for which of the following? A. chills and fever B. tachycardia and weak, thready pulse C. abnormal breath sounds and difficulty breathing

C. abnormal breath sounds and difficulty breathing

What complication does the nurse monitor for when administering blood by taking vitals before and after 15 minutes? A. infection B. fluid overload C. allergic reaction D. hypertension

C. allergic reaction

When securing the catheter after a successful insertion, you should facilitate visualization of the insertion site by doing which of the following? A. creating a tape chevron that covers the catheter hub but not the insertion site B. placing a small gauze pad under the hub of the IV catheter C. applying a transparent sterile dressing over the site while avoiding the hub

C. applying a transparent sterile dressing over the site while avoiding the hub

You are most likely to be successful in accessing a superficial vein with an 18-gauge catheter by inserting the catheter which of the following ways? A. using your dominant hand B. while stretching the skin in the direction of insertion C. at a 10* to 30* angle to the skin

C. at a 10* to 30* angle to the skin

A nurse caring for a patient with a productive cough with greenish sputum. What condition does the nurse suspect? A. pulmonary edema B. viral infection C. bacterial infection D. tuberculosis

C. bacterial infection

When you are administering hypotonic IV solutions, you know that the fluids are going to... A. cause shifting of body fluids into the intravascular space B. cause shifting of body fluids from the intracellular spaces into the interstitial spaces C. cause shifting of body fluids out of the intravascular space and into the interstitial spaces, and then eventually into the intracellular spaces, rehydrating the cells D. remain in their original fluid compartments

C. cause shifting of body fluids out of the intravascular space and into the interstitial spaces, and then eventually into the intracellular spaces, rehydrating the cells

To prepare the insertion site effectively while minimizing the client's risk for infection, which of the following actions should you take? A. shave the area carefully prior to cleansing it with an antiseptic solution B. apply sterile gloves prior to proceeding with the antiseptic skin preparation C. cleanse the site with an antiseptic prep using a firm, circular motion from the insertion site outward

C. cleanse the site with an antiseptic prep using a firm, circular motion from the insertion site outward

Which of the following is not a complication of IV therapy? A. speed shock B. extravasation C. dehydration D. septicemia

C. dehydration

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? A. check for a blood return B. elevate the extremity C. discontinue the IV line D. apply warm, moist heat

C. discontinue the IV line

After finding the client's IV insertion site pale and cool, your first step should be to do which of the following? A. check for blood return B. notify the provider immediately C. discontinue the infusion

C. discontinue the infusion

During the sterile procedure, everyone present in the room is required to wear which of the following? A. sterile gown B. sterile gloves C. face mask

C. face mask

Which type of IV solution will cause cellular dehydration if infused unnecessarily? A. isotonic solution B. hypotonic solution C. hypertonic solution

C. hypertonic solution

Based on your knowledge of central venous access devices (CVADs), which of the following would be appropriate for this client? A. nontunneled percutaneous central catheter B. implanted infusion port C. peripherally inserted central catheter (PICC) D. tunneled central venous access device

C. peripherally inserted central catheter (PICC)

A nurse is removing a client's IV catheter. Which of the following actions should the nurse take? A. apply firm pressure over the vein B. leave the roller clamp slightly open C. pull the catheter straight back from the insertion site D. lift the hub slightly upward away from the skin

C. pull the catheter straight back from the insertion site

To minimize the risk of contamination to the solution when hanging the container, you should perform which of the following actions? A. check the container for damage that could result in leaks B. use new tubing each time you hang a new container of solution C. remove the protective cover on the container's port just prior to inserting the tubing spike

C. remove the protective cover on the container's port just prior to inserting the tubing spike

Which of the following explanations of the differences between IV push and IVPB routes of administration are correct? (SELECT ALL THAT APPLY) A. the IV push route of administration allows direct infusion from the bag of solution at a rapid rate, which pushes the medication in quickly B. the IVPB route of administration allows medications to infuse over a 1- to 2-minute interval C. the IVPB route of administration requires that the medication be dissolved in a volume of liquid, ranging between 50 and 250ml D. the IV push route of administration provides for direct injection of medication into the port closest to the IV site

C. the IVPB route of administration requires that the medication be dissolved in a volume of liquid, ranging between 50 and 250ml D. the IV push route of administration provides for direct injection of medication into the port closest to the IV site

A nurse is caring for a client who has a central venous access device in place. Which of the following routine interventions should the nurse use to prevent lumen occlusion? A. apply a skin securement device to the catheter B. remove the dressing from the insertion site slowly and carefully C. use a pulsatile action while flushing D. have the client lie flat when changing administration sets or injection caps

C. use a pulsatile action while flushing

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? A. moisture B. bruising C. tingling D. coolness

D. coolness

A nurse is caring for a client who has an implanted port that needs to be accessed for an infusion. Which of the following actions should the nurse take? A. use a standard medium-gauge needle to access the port B. insert the primed needle into the port at a 45* angle C. withdraw the needle after insertion, leaving the needle's sheath in place for the infusion D. cover the device and the needle with a sterile transparent dressing

D. cover the device and the needle with a sterile transparent dressing

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? A. every 24hr B. every 48hr C. every 72hr D. every 96hr

D. every 96hr

Which of the following actions should a nurse take when converting an IV infusion to a saline lock? A. open the roller clamp of the primary infusion to prime the saline lock B. apply pressure with a syringe to clear resistance in the IV catheter C. attach secondary tubing to allow mobility D. flush the IV catheter to confirm patency

D. flush the IV catheter to confirm patency

How does an intermittent PRN lock differ from a traditional IV site? A. the PRN lock is used for continual infusion of IV fluids or medications B. the patient with a PRN lock must be stuck each time medication needs to be administered C. the PRN lock provides subcutaneous access rather than IV access D. the PRN lock allows for intermittent infusion of IV fluids or medications without requiring a continual infusion of fluids

D. the PRN lock allows for intermittent infusion of IV fluids or medications without requiring a continual infusion of fluids

A nurse is preparing to obtain a blood sample from a client who have a triple-lumen central catheter in place. Which of the following actions should the nurse take? A. discard the first 35ml of aspirated blood before collecting the sample B. place the client in Trendelenburg position while withdrawing the blood sample C. withdraw the blood sample from the lumen that has the smallest diameter D. turn off the distal infusions for 1 to 5 min before obtaining the blood sample

D. turn off the distal infusions for 1 to 5 min before obtaining the blood sample

Which of the following is the catheter tip position for a properly placed CVAD? A. pulmonary vein B. subclavian vein C. left atrium D. vena cava

D. vena cava

Which of the following IV catheters with plastic cannulas are the smallest in diameter? A. 16 g B. 18 g C. 21 g D. 25 g E. 29 g

E. 29 g