IV Therapy Exam Chapter2&3

What information is most important to teach the patient going home with a peripherally inserted central catheter (PICC) line?

"Avoid carrying your grandchild with the arm that has the IV"

Before performing a venipuncture to initiate continuous IV therapy, a nurse should:

Inspect the IV solution and exp date

Everyone participating in the insertion of a CVAD is required to wear a cap, mask, gown, and gloves.

True

The palm side of the wrist should never be used for insertion of a peripheral catheter.

True

Your patient is to receive I.V. therapy at 0800. He is admitted to the outpatient unit at 0730 and you are to prep the patient for therapy. What is your priority nursing goal?

Ask the patient if he or she has ever received I.V. therapy before

The nurse is inserting an IV line into a client's vein. After the initial stick, the nurse continues to advance the catheter if:

Blood return shows in the backflash chamber of the catheter

How often should a nurse change the patient's peripheral device?

48-72 hours

The first step in performing a routine venipuncture is

Dilate vein

Which type of CVAD is described: Short-term CVAD for several days to weeks in hospitalized patients, may be used for 5 days or less for irritating and/or vesicant infusates not well tolerated through peripheral veins, and is used for patients with limited insertions sites who requires multiple infusions?

Nontunneled central venous catheter

This administration set is used to infuse the main IV fluids, which could be given continuously for hours or even days

Primary infusion set

What site must you avoid for a subsequent venipuncture?

Red, swollen areas

The client is receiving IV antibiotic therapy at home for 1 week via heprin lock. Which does thee nurse include in client teaching for the early detection of the complications of IV Therapy?

Report local pain, drainage, or edema

Short peripheral catheters should be removed

When s/s indicate a problem c catheter

What valve prevents backflow of the secondary solution into the primary solution?

backcheck valve

How often should you auscultate for breath sounds after CVAD catheter insertion due to possibility of pneumothorax?

every 8 hours

If you can't ______ a catheter, you cannot use it?

flush

Increased HR, decreased BP, cool clammy skin, obvious swelling in neck or chest, mental confusion and formation of a hematoma are signs and symptoms of what?

hypovolemic shock

Can you take blood pressures on the arm with a PICC line?

no

What is inflammation plus a clot in the vein?

Thrombophlebitis

What is an advantage of peripheral IV therapy?

It is easy to monitor and access

Which site may be the best place for insertion of IV?

Left non dominant forearm

After discontinuing a non tunneled, percutaneous central catheter, it is most important for the nurse to record which information?

Length of catheter

A nurse has been instructed to discontinue an IV line. The nurse removes the catheter by withdrawing the catheter while applying pressure to the site with:

Sterile 2x2 Gauze

In CV therapy, an access device is inserted with the tip in the

Superior or inferior Vena cava

The average amount of blood in the human body

5 liters

A client involved in a motor vehicle crash presents to the ER with severe internal bleeding. The client is severely hypotensive and unresponsive. The nurse anticipates that which IV solution will most likely be prescribed to increase intravascular volume, replace immediate blood loss volume, and increase blood pressure?

1. 5% dextrose in lactated ringers

Administration sets used to deliver fat emulsions that are infused seperately should be changed every

12 hours with each new container

Generally,PICCS are used when pts need infusions of drugs or solutions that are known irritants or vesicants, especially if these drugs are used for more than _______?

14 days

Which gauge is used for Neonates, infants, and toddlers and is suitable for most infusions, but flow rates are slower?

24

If patency is confirmed by aspiration of blood and no resistance when flushed, what appropriately sized syringes would you use for medication?

3-mL to 5-mL

Basic IV administration sets length range from?

70"-110"

The preferred skin antiseptic agent is

Alcoholic chlorexidine

A PICC may be unsuitable for a patient with?

Bruises

A client has an order to receive 1000 mL of 5% dextrose in 0.45% NaCl. After gathering the appropriate equipment, the nurse takes which action first before spiking the IV bag with the tubing?

Closes the roller clamp on the IV tubing

You have an order for NS @ 60gtt/hour. You gather supplies and notice fluid bag has floating particles in it and is discolored? What should you do?

Discard fluids because the are contaminated

A nurse is assigned to care for a patient with a peripheral IV infusion. The nurse is providing hygiene care to the client and would avoid which of the following while changing the clients hospital gown?

Disconnecting the IV tubing from the catheter in the vein

The nurse assesses a peripheral IV dressing and notes that it is damp, and the tape is loose. The best nursing actions is:

Ensure tight IV tubing connections

Administration set used to deliver PN should be changed every

Every 24 hrs

Administration sets used to deliver blood and blood components should be changed after each unit component or

Every 4 hrs

What is the first step in changing peripheral iv dressing?

Gather supplies

The nurse provides a list of instructions to a client being discharged to home with a peripherally inserted central catheter. The nurse determines that the client needs further instructions if the client made which statement?

I need to keep my activity level to a minimum while this catheter is in place.

The nurse is preparing a continuous IV infusion at the medication cart. As the nurse goes to attach the distal end of the IV tubing to a needleless device,the exposed tubing drops and hits the top of the medication cart. Which of the following is the appropriate action by the nurse?

Obtain new IV tubing

A 65-year old female receiving 500 mL of NS over 4 hours. The patient complains of discomfort at insertion site and when the nurse raises the IV container there is no increase in gravity flow rate. What could this indicate?

Occlusion

A patient has been vomiting for several days. What would the patient most likely be receiving?

Parental nutrition

A nurse is checking the insertion site of a peripheral IV catheter. The nurse notes the site to be reddened, warm, painful, and slightly edematous in the vein proximal the IV catheter. The nurse interprets that this is likely the result of:

Phlebitis of the vein

A client has just undergone insertion of a central venous catheter at the bedside. The nurse would be sure to check the results of which of the following before initiating the flow rate of the client's IV solution at 100 mL/hr?

Portable chest x-ray film

The nurse has a prescription to hang an IV bag of 1000 mL 5% dextrose in water with 20 mEq potassium chloride. The nurse should plan to do which of the following immediately after injecting the potassium chloride in to the port of the IV bag?

Rotate the bag gently.

A client had a 1000 mL bag of 5% dextrose in 0.9% sodium chloride hung at 3pm. The nurse making rounds at 3:45 pm finds that the client is complaining of a pounding headache and is dyspneic, is experiencing chills, and is apprehensive, with an increased pulse rate. The IV bag has 400 mL remaining. The nurse should take which action first?

Slow the IV infusion

What position should the pt be in when d/c a non-tunneled CVAD so the insertion site is below the level of the heart?

Supine

The correct pt position for removal of a CVAD from the jugular or subclavian vein is

Supine with head flat

Which of the following statements is true of the needle in an over-the-needle catheter?

The needle is inside the catheter

The following concerns could prohibit use of certain sites for CVAD insertion.

The presence of freckles or moles

For insertion of CVAD in the subclavian, internal, or external jugular veins which position should you place your patient in before the procedure?

Trendelenburg

Can you give a patient blood through a central line?

true

How often should you change the transparent semipermeable dressing on a CVAD?

when soiled or weekly

The nurse is making initial rounds on the nursing unit to assess the condition of assigned clients. The nurse notes that a client's IV site is cool, pale, and swollen, and the solution is not infusing. The nurse concludes that which of the following complications has occurred.

Infiltration

The smaller the gauge number of the needle means that the diameter of the needle will be?

Larger

Your patient is presenting with the following complications. Swelling at the IV site, discomfort, burning, decreased skin temperature, and blanching around the site. What do these indicate?

Infiltration