NSG107 -Nursing Care of Patients Receiving Intravenous Therapy

NSG107 -Nursing Care of Patients Receiving Intravenous Therapy

NSG107 -Nursing Care of Patients Receiving Intravenous Therapy

Pre quiz Nursing Care of Patients Receiving Intravenous Therapy 7 VOCABULARY

Match the term with the appropriate definition or statement.

1. Intravenous (IV)                     1. Inside a vein
2. Cannula                                    2. Seepage of IV fluid into tissues
3. Distal                                         3. Nearest the point of attachment
4. Infiltration                               4. Inflammation of a vein
5. Peripherally inserted central catheter (PICC) 5. Access device inserted into a superficial peripheral

vein and advanced into the central system to the

superior vena cava.

 

6. Hematoma                             6. An IV needle or catheter with a stylet.
7. Phlebitis                                  7. Farthest from the center or from the trunk
8. Proximal                                 8. A localized collection of extravasated blood in the

subcutaneous tissue, from a break in a blood vessel

COMPLICATIONS OF IV THERAPY Fill in the blank with the correct complication.

1. Pain and inflammation at the IV insertion site is called ______________________________________ .
2. Redness and exudate at the IV insertion site indicate the presence of __________________________.
3. Infiltration into tissue by an IV fluid or drug is called _______________________________________ .
4. Dyspnea and crackles can be a sign of ___________________________________________________.
5. A cool, puffy insertion site indicates ____________________________________________________ .
6. Fever, chills, and tachycardia indicate a systemic infection called _____________________________ .
7. Sharp pain at the IV site during infusion of a cold fluid indicates a _____________________________ .
8. If the patient develops cyanosis, hypotension, and loss of consciousness, the nurse should suspect ________________________________________________________________.

Read the following case study and answer the questions.

Mr. Livesay is admitted with cellulitis and is receiving IV fluids by gravity drip. When you check his IV, you find it is not dripping.

What data can you collect to determine the cause of the problem?

What is the role of the licensed practical nurse (LPN)?

When must the registered nurse (RN) be consulted?

CALCULATION PRACTICE Calculate the answers to the following problems. Round each answer to the nearest whole number.

1. June has an IV of 5% dextrose in water ordered to infuse at 83 mL/hr. How many drops per minute should be set if the tubing delivers 15 drops per milliliter?
2. Frank has a piggyback antibiotic of 500 mg in 50 mL of 5% dextrose in water. The medication must infuse over 20 minutes. The tubing drip factor is 10. How many drops per minute?
3. Dave has an IV of normal saline ordered at 1 L over 12 hours. How many milliliters per hour should he receive?
4. Lucy has an order to administer 800 units of heparin per hour. The registered nurse hangs heparin 50,000 units in 500 mL of 5% dextrose in water. It will run on an electronic infusion device. How many milliliters should be administered per hour?
5. Jack has an order for 1000 mL of normal saline over 24 hours. How many drops should be administered per minute, using microdrop tubing?

 

Choose the best answer unless directed otherwise.

1. Which vein should be used first when initiating IV therapy?

Jugular

Basilic

Brachiocephalic

Axillary

 

2. When preparing a site for venipuncture with chlorhexidine gluconate, how long must the area be cleaned?

5 seconds

10 seconds

30 seconds

60 seconds

 

3. Which of the following complications can occur if a clotted cannula is aggressively flushed?

A clot can enter the circulation.

An air embolism can enter the circulation.

A painful arterial spasm can occur.

The patient can experience speed shock.

 

4. Which of the following symptoms most likely indicates that an infusion is infiltrated?

Redness at the site

Pain at the site

Puffiness at the site

Exudate at the site

 

5. An 87-year-old patient recovering from abdominal surgery has a continuous IV infusion to supply nutrients and antibiotics. What complication should the LPN suspect when signs and symptoms of redness, warmth, and pain at the infusion site are reported?

Phlebitis

Thrombosis

Hematoma

Infiltration

 

6. Which patient would benefit most from a capped IV access that is used intermittently rather than continuously?

The patient with pneumonia who needs fluids and antibiotics

The patient who has had major blood loss after a motor vehicle accident

The young child who is dehydrated

The older patient who is receiving a diuretic for fluid overload

6. The physician orders furosemide (Lasix) 40 mg IV push (IVP) STAT for a patient in acute fluid overload. Why was the IV route likely chosen?

Furosemide can be administered only by the IV route.

IVP is the route of choice for rapid action.

IVP dosing is more accurate.

IVP furosemide has fewer side effects than oral.

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8. A patient has orders to receive 1 L (1000 mL) of 5% dextrose and lactated Ringer’s solution to be infused over 8 hours. How many milliliters will be infused per hour?

80

100

125

150

 

9. A patient is receiving an IV piggyback antibiotic in 50 mL of 5% dextrose in water to run over 1 hour. The tubing has a drop factor of 60. How many drops per minute should be delivered?

6

17

50

100

 

10. The nurse is caring for a patient who is to receive IV fluids at 100 mL per hour with IV antibiotic therapy scheduled every 4 hours. Which of the following sites for the IV placement is best?

Large vein on the dorsal side of the patient’s nondominant arm

Small vein on the surface of the patient’s dominant hand

Small vein on the surface of the patient’s nondominant hand

Large vein in the nondominant antecubital space