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NCO Intravenous Flui
WEek 4 NCO Overview of IV Fluids 246 / quiz 1 -4
| Question | Answer |
|---|---|
| Which site should the nurse choose? | The most distal site in the nondominant arm |
| 1. 0.9% NaCl or D5W 2. Isotonic fluids are generally given to correct this problem 3. Administered to rehydrate cells (e.g., 0.45% NaCl) 4. Given carefully to renal and cardiac patients because it pulls fluid into the vascular space | - an isotonic solution - fluid volume deficit - a hypotonic solution - a hypertonic solution |
| - 0.9 % Sodium Chloride Injection USP - Lactated Ringers Injection USP - 0.45 % Sodium Chloride Injection USP - 5 % Dextrose and 0.9% Sodium Chloride Injection USP - 5% Dextrose and 0.45 % Sodium Chloride Injection USP | - isotonic - isotonic - hypotonic - hypertonic - hypertonic |
| The nurse is caring for a patient with a diagnosis of heart failure. With which of the following IV solutions should the nurse monitor this patient most closely? | D5 1/2 NS |
| A patient has been admitted with dehydration. Which of the following IV solutions would you expect to infuse? | 0.45% sodium chloride |
| A 40 year old patient is to have an IV started preoperatively. Which catheter would be most appropriate for this patient? | 16- to 18- gauge |
| The health care provider has ordered IV fluids for an elderly woman who is dehydrated. Which choice of tourniquet would be best for this patient? | Blood pressure cuff |
| With which of the following patients would it be preferable to use microdrip tubing rather than macrodrip tubing? (Select all that apply.) | - A 70-year-old with cardiac disease - A 3-year-old child with pneumonia - An infant with croup |
| Which of the following sites should be avoided for intravenous (IV) line insertion? (Select all that apply. | - foot of an adult - site distal to a previous venipuncture site - Ventral surface of wrist ( inner wrist) - areas of venous bifurcation |
| An adult patient developed a complication with his IV and it had to be removed, yet continued IV fluids were needed. Which site would be most appropriate for the nurse to choose? | Proximal to the previous IV site. |
| Which of the following sites should be avoided when initiating an intravenous infusion? (Select all that apply.) | - The left arm of a patient who has a history of a left-sided mastectomy. - An area of venous bifurcation or palpation of valves. - Side of paralysis |
| A busy medical-surgical unit is short staffed. It is time for routine vital signs. One patient's electronic infusion device is alarming because the IV bag is empty, and another patient has new orders for initiating an IV infusion. Which task(s) may be del | - taking routine vital signs - Getting the IV tray of IV supplies - Having the assistive personnel inform the nurse when IV fluids are low in volume. |
| FVE (Fluid volume excess) | - Peripheral edema - Increase in daily weight by 1 kg |
| FVD ( Fluid Volume Deficit) | - Behavioral changes - Dry skin and mucous membranes - Decrease in blood pressure |
| FVE ( Fluid Volume Excess) | -Distended neck veins - Increase in blood pressure - Abnormal lung sounds |
| FVD ( Fluid Volume Deficit) | - Thirst -Decreased skin turgor - Decreased urine output |
| Which findings are significant to the initiation of intravenous fluids? (Select all that apply.) | - The patient's age - Previous experience with IV therapy |
| Identify the additional supplies the nurse will require to carry out this order. (Select all that apply.) | - A 22 gauge catheter - An IV start kit (with antiseptic swabs, tourniquet, and sterile tape - Administration set (infusion tubing) - Transparent membrane dressing |
| - Image A _Image B - Image C - Image D _ Image E - Image F | - Allows continouus inpsection of site, provides barrier to moisture and microorganisms - Used to administer an IV infusion - Provides microbiciidal activity - Reduces venous return, causing dist - Used to flush or lock the IV - Used to prevent |
| Deficient knowledge related to lack of experience with IV therapy Risk for infection related to invasive procedure of IV catheter insertion Risk for excess fluid volume related to alteration in regulatory mechanisms of hydration Acute pain related to I | - Pt identifies one symptom - Pt is free of complications - Pt's fluid volume status is balanced - Pt verbalizes comfort at site |
| The nurse wishes to promote venous distention, making the vein larger and more visible for IV insertion. Which of the following measures would foster venous dilation and access to the vein? (Select all that apply.) | - lowering the patient's arm to a dependent position - gently stroking vein downward |
| Which of the following would be an inaccurate step in the procedure for inserting a peripheral intravenous device? | Insert over the needle catheter with bevel down at a 30- to 45-degree angle directly over venipuncture site. Observe for blood return in flashback chamber of catheter, release tourniquet, advance catheter into vein. Place needle into sharps container. |
| A patient has been receiving intravenous (IV) antibiotics and as a result has had several IV site locations. What action can the nurse take to promote venous distention in the patient? (Select all that apply.) | - Apply a warm pack to the arm for several minutes. - Rub or stroke the patient's arm. |
| At what angle should an IV catheter puncture the skin and vein during insertion in a middle-aged adult? | 10-30 degree angle |
| When should the tourniquet be released a second time during the procedure for insertion of a peripheral intravenous device? | After a "flashback" of blood is observed and the catheter has been advanced off the stylet. |
| The nurse is preparing an IV infusion before initiating an IV. Which of the following is a correct action performed by the nurse? | After spiking the bag of IV fluids, the nurse fills the drip chamber 1/3 to 1/2 full and primes the tubing, making sure there are no bubbles. |
| The nurse is preparing an IV infusion before initiating an IV. The nurse removes the protective sheath covering the tubing insertion spike and accidentally touches the spike. What is the nurse’s best action at this time? | Discard IV tubing and obtain a new one. |
| The nurse is assessing the patient for signs and symptoms of fluid volume excess. Which of the following would indicate the patient is experiencing this complication and should be reported? (Select all that apply.) | - Shortness of breath and crackles in lungs. - Elevated blood pressure and edema. |
| Which of the following would be consistent with infiltration? (Select all that apply.) | - Cool to touch. - Swelling around insertion site. - Pain with increasing infiltration. |
| Which of the following would be consistent with phlebitis? (Select all that apply.) | - Pain - Redness |
| An elderly patient is receiving 0.9% normal saline at 125 mL per hour. The nursing assistive personnel (NAP) reports the patient is complaining of feeling short of breath. The nurse determines the patient is experiencing fluid volume excess. What other sy | - Crackles in lungs. - Peripheral edema. - Dyspnea |
| The nurse notices failure of flow in the drip chamber with the roller clamp open and an absence of swelling at the insertion site. What should the nurse do? (Select all that apply.) | - Determine patency by aspirating for a blood return. -Check for kinking of IV tubing |
| Which of the following situations indicates discontinuation of peripheral intravenous (IV) access? (Select all that apply.) | - The patient is being discharged to home on oral (PO) medications. - The electronic infusion pump keeps alarming, indicating “occlusion” on its screen, and the nurse is unable to flush the IV. - The patient's arm is swollen and cool to the touch; the p |
| The student nurse is watching the staff nurse discontinue a peripheral IV. The staff nurse removes the catheter and then looks at it. The student asks the nurse what she is looking for. What would be a correct response? | “I am inspecting the catheter for intactness." |
| What is the primary danger related to a broken catheter tip? | Embolus |
| The nurse is discontinuing peripheral IV access. Which of the following steps, if performed by the nurse, requires correction? | With dry gauze or an alcohol swab held over the site, apply light pressure and withdraw the catheter by using a slow, steady movement with the hub at a 10- to 30-degree angle. Apply pressure to the site for 1 to 2 seconds by using a dry, sterile gauze pad |
| Which of the following demonstrates the best documentation of discontinuation of an IV? | 1030 20 Gauge 1 inch (2.5 cm) catheter removed from left forearm. Catheter tip intact. Site without redness, swelling, or bleeding. T. Rodriguez, RN. |
Created by:
Brandi Sizemore
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