Because of a communication error, the pharmacy says that there is a long delay for a replacement bag of total parenteral nutrition TPN to be mixed and delivered to the unit for the patient. The nurse recognizes that a physicians order is needed for which type of IV fluid while awaiting the replacement bag of TPN?
0.45% Saline
5% Dextrose in water
10% Dextrose water
Lactate ringer
A nurse is assessing the patient who has severe vomiting and diarrhea. The purpose of IV infusions for this patient is to:
Provide fluids to reduce elevation in temperature
Control the nausea and vomiting
Replenish fluids and correct dehydration
Deliver medication to stabilize blood pressure
What is the nurses primary responsibility in the daily care of a patient with a central line?
Use sterile technique during insertion
Flush the line according to agency policy
Verify catheter placement with an x-ray examination
Rotate the insertion site every 72 hours
A patient receives a total of 4000 ML's of D5W over 48 hours. How many calories will this fluid supply?
800
600
500
250
A nurse is adding a secondary piggyback to the patients existing IV. To use the gravity system, the nurse should hang:
The piggyback bag higher than the maintenance IV bag
The maintenance IV bag at the same height as the piggyback bag
The piggyback bag and the maintenance IV bag using Y tubing
The maintenance IV bag after the piggyback bag is completed
The nurse needs to establish a peripheral IV access on adult trauma patient. Which catheter is the best choice?
#24
#22
#20
#18
In which circumstance would be used of a burette be advised as a safety device
A trauma patient needs several units of packed red blood cells
The patient needs IV fluids, but no infusion pump is available
An infant is at risk for IV fluid overload
A confused patient keeps trying to unplug the infusion pump
The nurse must assess for complications of IV therapy signs of common complications include:
Swelling and coldness at the site
Redness along the vein
Pale skin at the insertion site
Immobility of the extremity
Erythema and tenderness
Vomiting and diarrhea
The patient is receiving a blood transfusion in and begins to have symptoms within 10 minutes after the start of the transfusion. What is the priority action?
Take vital signs and call the physician
Place the patient in a Supine position and start oxygen
Stop the blood and change the IV tubing
Slow the blood and check the vital signs
A patient returns from physical therapy, and her IV has a very sluggish flow, but it was functioning well before going to PT. What is the priority nursing action?
Call PT and ask if anything happened to the IV during the treatment session
Discontinue the IV and restart be IV at a new site
Assess the IV insertion site and tubing and try repositioning the extremity
Use a heparin flush to clear the line
The doctor orders the D5W (5 % dextrose in water) to infuse at 150 mL/hr the nurse is using macrodrop tubing (10 gtt/mL.) what is the drop rate? gtt/min
The doctor orders 1000 ML's of normal normal saline to infuse over eight hours. What is the pump setting? mL/hr.
This has greater concentration also having greater tonicity then blood, solution Enters the vessel.
Hypotonic
Hypertonic
Isotonic
This solution is of equal solute concentration; solutions that have the same concentration, or osmolality, as blood and are used to expand the fluid volume of the body. It stays where I put it.
This solution is lesser concentration; containing less solute than extravascular fluid. This solution goes Out of the vessels.
This route is the main method of supplying The patient with fluids and medications when the patient is unable to take them orally.
Intervenous
Rectally
Topically
Orally
This is a concentrated dose given in a short period of time intravenously.
Bolus
TPN
Colloids
Infusion
Solutions that are given intravenously must be sterile they are supplied in plastic bags that come in what mLs?
1000
700
300
This type of administration set consist of a bag a solution, a regular tubing set, and a needleless connector, and an IV stand.
Primary IV sets
Secondary IV sets
Y site sets
Controlled volume IV sets
This administration set, where medication is to be given intravenously and often added to an existing IV line by using what method.
Piggyback IV sets
This administration set is used to infuse certain blood products.
You can administer blood products with any type of medication.
This type of administration set has a dose of diluted medication that can also be given through and infusion pump a machine that delivers Abby fluids at a rate that is set by the nurse.
You should be checking your pumps how often?
1-2 hours
6-8 hours
Every shift
Once a day
You can use these to trap particles such as undissolved medication or salts that have precipitated from solution.
Filters
Cannula
Hubs
Aseptic
What is the slogan that was developed to emphasize the importance of using a sterile alcohol pad with friction and time when assessing a central line injection port for IV connection.
Scrub the hub
Start low go slow
Being clean is the way to be
Nurses are the greatest
What are some signs and symptoms of fluid overload
Weight gain
Weight loss
Crackles in the Lungs
Peripheral edema
Clear lungs on auscultation
Bradycardia
The wingtip or butterfly needle is meant for what type of therapy
Short term
Long term
Blood products
Viscous fluids
The wing tips for butterfly needles, and what type of gauges
Odd numbered
Even numbered
For clear aqueous solutions what size gauge needle is used
17-18 gauge
20 - 22 gauge
18 - 19 gauge
23-25 gauge
For a more viscous fluid, blood products or a rapid administration of large amounts of fluid what size gauge needle should you use?
18-19 gauge
20-22 gauge
Filtered needle
You should never take a blood pressure on the arm that has a Picc or ML catheter in place.
Correct placement of the subclavian catheter's must be verified by what type of procedure before any fluid is infuse through them?
X-ray
MRI
Ct scan
Palpation
Never use a syringe that is smaller than what mL for flushing a central line?
10
3
5
20
This is when a piece of the catheter travels through a vessel and lodges, obstructing blood flow.
Air embolus
Catheter embolus
Infiltration
Extravasation
This occurs when fluid or medication leaks out of the vein into the tissue with signs and symptoms including edema around the site and cool, pale tissue. The flow can be slow and sluggish.
This is the infiltration of the second drug from an IV line with the appearance of the site the patient's subjective complaints may initially be similar to those with infiltration the damage may go unnoticed for 48 to 72 hours.
Septicemia
Phlebitis
When administering blood products you must use a 20 gauge or larger needle
This is caused by irritation of the vein by the needle, the catheter, medications, or additives in the IV solution. The typical signs are your Erythema, warmth, swelling, and tenderness.
Thrombosis
Speed shock
This is a type a blood stream infection that occurs when infectious pathogens are introduced into the bloodstream.
Speed shark
Your patient has an air embolus which can occur when changing bags or an opening the line and the subclavian have a sudden drop in the blood pressure increase in the pulse, what would be a nursing implication?
Place in Trendelenburg with patient on their left side
Elevate the head of the bed keep warm assessed for Edema, slowdown infusion rate and notify the physician
Remove IV catheter and restart IV in the other extremity
Nothing this is a normal function of the body
This occurs when fluids or medications are given by bolus or administered to rapidly?
Circulatory overload
What is a nursing action if your patient has a catheter embolus?
Place a tourniquet it high on a limb above the IV site.
Place a tourniquet below the IV site
Nothing they will pass it themselves
Press the code button and start CPR
The primary fluid must be higher lower( higher, lower ) to flow before the secondary fluid.
Your flushing an IV after administering medications, how many mLs should you flush with?
3 mLs
5 mLs
2 mLs
You dont have to flush after
How long do signed consents for blood last?
48-72 hours
12-24 hours
They don't expire
6 months
Evidence based practice indicates that what type of solution is the only solution used in combination with infusion of a blood products.
Normal saline
D5W
D5LR
Dextrose 5%
TPN must be replaced every 24 hours 12 hours 36 hours 7 days( 24 hours, 12 hours, 36 hours, 7 days ).
Blood must be infused within how long of release from the blood bank.
4 hours
20 minutes
8 hours
After med pass
Your going to stay with your patient for the first little bit of blood administration, how long is minimum?
5 minutes
10 minutes
15 minutes
30 minutes
Your going to take your patient's vitals while administering blood at the beginning to get a baseline and again 15 10 30 60( 15, 10, 30, 60 ) minutes after start of administration.
What is the first nursing action when a transfusion reaction occurs?
Stop the IV infusion
Flush with normal saline and new IV tubing
Notify the physician
Start low-flow oxygen