T2U2 Timby Chpt 13 IV Therapy`
A client suffers from infectious diarrhea. Based on her loss of fluid, her protein level is below normal. What blood product will the physician order to restore intravascular volume?
Albumin
A nurse assessing the IV site of a patient observes swelling and pallor around the site and notes a significant decrease in the flow rate. The patient complains of coldness around the infusion site. What IV complication does this describe?
Infiltration
The nurse is preparing to administer the solution in the attached image to a client. Which of the following types of solution is the nurse going to administer? (0.9% Saline)
Isotonic
A client with renal disease requires IV fluids. It is important for the nurse to
Place the fluids on an electronic device
A client who is receiving IV fluid therapy has localized edema. What has caused this complication?
fluid infiltration of the surrounding tissue
A client is prescribed 1 liter of 5% dextrose and 0.9% normal saline to be infused over 12 hours. The fluid will be infused by gravity, using tubing with a drop factor of 12 gtts/ml. How many drops per minute will the nurse set the solution to infuse? (Calculate to the nearest whole number.)
17
The physician has prescribed an IV of 3000 mL of 0.9% sodium chloride to be infused over the next 24 hours. The nurse uses IV tubing that has a drip factor of 10. How many drops per minute will deliver the correct amount of IV fluid? Record your answer using a whole number.
21
A 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, the nurse notes the amount and immediately notifies the physician of this finding. Notification of a physician regarding fluid intake should occur after exceeding how many milliliters in 24 hours?
3
A nurse is administering total parenteral nutrition (TPN) solution to a severely dehydrated client at the healthcare facility. Which of the following nutrients should the nurse add to the TPN solution as a carbohydrate source?
5% dextrose solution
A physician orders an infusion of 250 mL of NS in 100 minutes. The set is 20 gtt/mL. What is the flow rate?
50
A nurse is preparing to use microdrip tubing. What is the standard volume that this device delivers?
60
Which of the following clients would be a candidate for total parenteral nutrition?
A client with colitis and bloody diarrhea
A client has been a client in the ICU for 17 days, seriously ill. A multitude of medications are ordered for the client's treatment regimen, most of which are administered intravenously. What is an indication for the use of IV medications? Select all that apply.
All options are correct Consistent therapeutic blood level desired impaired gastrointestinal absorption restricted oral intake
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?
Altered Nutrition: Less than body requirements R/T lack of adequate caloric intake
A young woman has an IV infusing for magnesium sulfate to treat pre-term labor. The woman develops a fever. What is the first assessment the nurse should make?
Assess the IV site for redness
When you complete the initial postoperative assessment for a client aged 55 years, you note that his IV is on time and infusing at 33 gtts/min (administration set - 10 gtts/ml). You check the order, which reads: "IV of 1000 cc D5S to infuse over 8 hours." What actions would you take?
Change the rate to 21 gtts/min and observe for fluid overload.
A client with ascites is receiving TPN until the condition clears. IV lipid emulsions would be contraindicated in a client with which condition?
Egg allergy
The nurse is caring for a client who just received chemotherapy in the treatment of cancer and will administer filgrastim in approximately twenty-four hours to aid in the recovery of which blood component?
Granulocytes
A nursing responsibility in managing IV therapy is to monitor the fluid infusions and to replace the fluid containers as needed. Which of the following is an accurate guideline for IV management that the nurse should consider?
It is the responsibility of the nurse to provide ongoing verification of the IV solution and the infusion rate with the physician's order.
A client with malnutrition is receiving total parenteral nutrition. Which solution should the nurse expect to be prescribed when the client has had a minimal increase in body weight from the treatment?
Lipid emulsion
The nurse is caring for a client who is receiving total parenteral nutrition therapy (TPN) and should know that what else is usually infused regularly with the TPN?
Lipid emulsion
A client receiving IV fluid therapy suddenly becomes anxious and exhibits an elevated blood pressure, a bounding pulse, and shortness of breath. Which nursing action(s) would be most appropriate to assist this client? Select all that apply.
Slow the IV rate. Contact the physician. Provide oxygen to the client.
The nurse is observing a UAP provide basic comfort measures to a client who has recently returned from surgery. The client's IV is currently being infused by gravity because the electronic infusion device is not yet available. The UAP will correct the UAP's actions if which is noted by the nurse?
The UAP elevates the client's arm where the intravenous site is located on two pillows.
A physician orders IV solution for a 92-year-old client to treat dehydration. The order was written to administer the fluid at a slower rate than what the nurse expected. Why would the physician designate the slower infusion rate for this client?
The client may have cardiac or renal disorders.
The nurse reviews the above emergency department note in a client's medical record. Based upon this information, which type of intravenous solution should the nurse expect to be prescribed for this client?
colloidal
A client has experienced a closed head injury causing cerebral edema. Which fluid would the nurse expect to see administered to decrease the client's cerebral edema?
hypertonic solution
A client is hospitalized with dehydration secondary to gastroenteritis of 3 days' duration. The physician ordered IV fluids to combat dehydration. Which fluid would the nurse expect to administer to this client?
hypotonic solution
Which of the following solutions is a crystalloid solution that has the same osmotic pressure as that found within the cells of the body and is used to expand the intravascular volume?
isotonic Solution
The RN is processing the physician's orders and recognizes that Mr. Chorn is to receive normal saline to keep vein open. The nurse is aware that normal saline solution is categorized as one of the following?
isotonic solution
A home healthcare client who is in a coma requires extended IV fluid therapy. Which peripheral access device would be most appropriate for administering this therapy?
midline catheter
The nurse reviews the above chart notes for a client needing a colloid solution. Based upon this information, which type of colloid solution should the nurse anticipate being prescribed for the client?
packed red blood cells
A client is receiving chemotherapy through a central venous catheter into her right subclavian vein. The nurse observes that she is dyspneic and cyanotic; her blood pressure has dropped to 86/48 mm Hg and she has a weak, rapid pulse and temperature of 40C. The client reports pain in her chest and shoulder. What complication would the nurse suspect?
systemic infection
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
The nurse has received a health care provider's order to initiate intravenous therapy and will check the client's medical record for what prior client condition that would impact placement of the client's intravenous site?
History of a mastectomy for breast cancer
A client is hospitalized with dehydration secondary to gastroenteritis of 3 days' duration. The physician ordered IV fluids to combat dehydration. Which fluid would the nurse expect to administer to this client?
Hypotonic solution
During rounds, the nurse checks the initial date on the IV fluid container and tubing for a client on continuous fluid infusion. The date indicates the client has been on therapy for 2 full days. Based on this information, the nurse should change the:
IV solution container
A client is being treated for idiopathic thrombocytopenia purpura. Which blood component will the nurse expect to be prescribed to the client?
Immunoglobulin
Fresh-frozen plasma (FFP) has been prescribed for a hospital client. Prior to administration of this blood product, the nurse should prioritize which client education?
Signs and symptoms of a transfusion reaction
A client requires a blood transfusion, and the nurse is preparing the blood transfusion equipment. Which item will the nurse need?
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
A nurse needs to perform venipuncture on a client who has poor skin turgor. To prevent skin trauma at the venipuncture site, the nurse should:
place a soft cloth between the tourniquet and the skin.
An 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 client and the blood component.
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
The nurse has received a health care provider's order to infuse a unit of packed red cells into a client with a hemoglobin of 8.5 mg/dl. The nurse checks the client's current intravenous solution of Lactated Ringers and will take which next step?
Change the intravenous solution to 0.9% saline.
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.
The IV solution for a client has infused, and the physician's order indicates that no more fluid is required. To discontinue IV therapy for this client, which nursing action would the nurse complete first?
Don clean gloves
A client undergoing a hip replacement has autologous blood on standby if a transfusion is needed. What is the primary advantage of autologous transfusions?
Prevention of viral infections from another person's blood
A nurse is assigned to care for a client who is bleeding severely following an accident and has been ordered transfusion of blood components. Which of the following should the nurse do to reduce the risk of septic reactions?
Refrigerate red blood cells and thawed fresh frozen plasma until use.
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
A client is receiving a blood transfusion and reports 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 client closely.
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 client.
The nurse is supervising a new graduate nurse who is caring for a client receiving total parenteral nutrition for the last two weeks. The health care provider has just written an order to discontinue this therapy according to policy. What action by the new nurse would cause the supervising nurse to intervene in relation to intravenous therapy?
The new graduate replaces the total parenteral nutrition intravenous solution with 0.9% saline.
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 will check that the numbers of the client's wrist band and the unit of blood match and that this information is confirmed by another nurse.
The nurse in the emergency department has just administered a plasma expander to a client who is experiencing hypovolemic shock and who will not allow the administration of blood or blood products. The nurse is aware that which assessments will take priority in this client? Select all that apply.
Urine Output Jugular Venous Distention development of rash or hives signs and symptoms of bleeding
A client has a history of congestive heart failure (CHF) and arthritis that causes significant discomfort. The physician has prescribed daily doses of NSAIDS to fight inflammation and pain. The client has developed a GI bleed as a result of the medication, and blood values indicate the need for a transfusion. Considering the client's history, which colloid solution would the nurse expect to be administered?
packed cells
A client who is critically ill is receiving the above treatments. At which time should the access devices be replaced?
peripheral lock for medication every 72 hours
A client with cellulitis is being discharged and is to receive intravenous antibiotic therapy at home. Which type of access device should the client receive for this medication therapy?
peripherally inserted central catheter (PICC)
A client receiving intravenous therapy shows signs of swelling at the infusion site and says it is uncomfortable. The infusion is also slowing. Which of the following complications would the nurse most likely prepare to assist in managing?
thrombus formation
The nurse notes that intravenous fluid orders for a client have been discontinued. For which reason will the nurse convert the peripheral catheter site to a medication lock?
use for emergency medications
A client is receiving total parenteral nutrition. The physician order includes lipid emulsion administration (contained in glass bottles) on Monday, Wednesday, and Friday. What type of IV tubing would the nurse select for the lipid administration?
vented tubing
