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N114 Infusion > Infusion > Flashcards

Flashcards in Infusion Deck (43)
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1

The nurse is preparing to insert an intravenous device into a patient's left arm. To best ensure
proper assessment of the intended vein, the nurse should:
1. Remove any clothing that is covering the left arm.
2. Apply a warm washcloth to the left arm at the proposed site.
3. Place the left arm in a dependent position for 3 to 5 minutes before assessment.
4. Apply a tourniquet to the left antecubital fossa 4 to 6 inches above the proposed site.

4. Apply a tourniquet to the left antecubital fossa 4 to 6 inches above the proposed site
This is the correct option because application of a tourniquet will encourage venous distention, making the intended insertion point more visible.

2

When preparing to insert an intravenous device, the nurse best ensures patient compliance
with the procedure by:
1. Explaining the need for the procedure thoroughly.
2. Inserting the access device as quickly as possible.
3. Asking the patient to select the arm preferred for access.
4. Applying a topical anesthetic to the area before inserting the device.

1. Explaining the need for the procedure thoroughly.
This is the correct option because educating the patient to the need and possible benefits of the intervention will most likely result in patient compliance.

3

To best minimize the patient's risk for injury when inserting an intravenous access device
into a patient's arm, the nurse should:
1. Wear clean treatment gloves during the insertion process.
2. Insert the device in the patient's nondominant upper extremity.
3. Avoid leaving the tourniquet on for an extended period of time.
4. Determine the patient's tolerance of the antiseptic cleaning agent used

1. Wear clean treatment gloves during the insertion process.
This is the correct option because it best ensures that the procedure will not introduce pathogens resulting in an infection.

4

The nurse is preparing to insert an intravenous access device into a newly admitted 30-yearold patient. To best follow vein selection guidelines, the nurse should first assess which of
the following veins on the patient's nondominant upper extremity?
1. Basilic
2. Cephalic
3. Metacarpal
4. Median cubital

3. Metacarpal
This is the correct option because guidelines encourage the use of the most distal site on the nondominant arm whenever possible.

5

The nurse is preparing an intravenous access device insertion site into the median cubital
vein of a 60-year-old patient. To best minimize the patient's risk for infection, the nurse
should:
1. Initially wash the site with soap and water.
2. Allow the site to thoroughly dry after it has been prepped.
3. Avoid touching the site after it has been prepped.
4. Swab the insertion site horizontally, vertically, and then spirally

4. Swab the insertion site horizontally, vertically, and then spirally
This is the correct option because prepping the site in this fashion will markedly minimize the patient’s risk of infection.

6

The nurse is preparing to insert an intravenous device in a patient's left arm. To best ensure
effective access to the patient's vein at the intended insertion point, initially the nurse should:
1. Anchor the vein by placing a thumb 1½ to 2 inches below the site.
2. Insert the device tip at a 10- to 30-degree angle distal to the proposed site.
3. Place the left arm in a dependent position for 3 to 5 minutes before assessment.
4. Apply a tourniquet to the left antecubital fossa 4 to 6 inches above the proposed site.

1. Anchor the vein by placing a thumb 1½ to 2 inches below the site.
This is the correct option because doing so stabilizes the vein, increasing the possibility of a successful insertion.

7

While inserting an intravenous device, the nurse best prepares the patient for discomfort by:
1. Preparing the patient to expect a sharp, quick stick.
2. Inserting the access device as quickly as possible.
3. Applying a topical anesthetic to the area before inserting the device.
4. Promising that the procedure will not hurt once the device is inserted.

1. Preparing the patient to expect a sharp, quick stick.
This is the correct option because educating the patient to the reasonable expectations of the possible discomfort will best prepare the patient.

8

To best minimize the patient's risk for injury to the involved vein when inserting an
intravenous access device into a patient's arm, the nurse should:
1. Insert the needle with the bevel up.
2. Place the arm in a dependent position.
3. Instruct the patient to avoid moving the arm.
4. Hold the skin directly below the site taut.

1. Insert the needle with the bevel up.
This is the correct option because this action minimizes vein trauma by the needle itself.

9

The nurse is inserting an over-the-needle catheter (ONC) into a newly admitted patient. After
confirming blood return, the nurse should next:
1. Loosen or remove the tourniquet.
2. Advance the ONC ¼ inch into the vein.
3. Lower the catheter until it is flush with the skin.
4. Thread the catheter into the vein up to the hub.

3. Lower the catheter until it is flush with the skin.
This is the correct option because doing so minimizes the risk of passing the needle through the opposite vessel wall.

10


The nurse is withdrawing air bubbles from a patient’s IV line using a needle vented to the
distal port. To minimize the patient’s risk for injury, the nurse should:
1. Assess the intravenous tubing every 2 hours for the presence of air bubbles.
2. Educate the patient regarding the need to self-assess the IV tubing.
3. Remove large air bubbles from the IV tubing immediately.
4. Maintain the sterility of the patient’s IV fluid tubing

4. Maintain the sterility of the patient’s IV fluid tubing
This is the correct option because it minimizes the patient's risk for injury related to infection.

11

The patient is prescribed 1000 ml of IV normal saline to run over 8 hours. The initial fluid was hung at 0800. Which of the following assessment data noted at 1400 could best be an indication of overhydration?
1. Edema noted at the insertion site
2. Crackles in the lower lobes bilaterally
3. The need to hang a new liter of fluids
4. Patient reports clear, pale, yellow urine

2. Crackles in the lower lobes bilaterally
This is the correct option because it may indicate an accumulation of fluid in the patient's lungs resulting from fluid overload (overhydration).

12

The nurse calculates that the patient should receive 125 ml of IV normal saline per hour.
After programming the infusion pump to reflect that rate, the nurse best ensures proper administration of the fluid initially by:
1. Verifying the drops/min with a watch.
2. Asking another nurse to assess the programming of the pump.
3. Setting the pump alarm to sound when 50% of the fluid has been infused.
4. Checking the level of fluid remaining in the container every hour.

4. Checking the level of fluid remaining in the container every hour.
By comparing the amount of fluid infused over the hour to the prescribed infusion rate the nurse can verify the proper administration of the fluid.

13

The nurse caring for a patient receiving IV fluids should include which of the following information in the shift change report to best ensure proper programming of the infusion pump?
1. Condition of the patient’s insertion site
2. Time when new fluidsshould be hung
3. Patient’s latest pulse and respiratory rate
4. Amount of fluid remaining in the infusion bag

4. Amount of fluid remaining in the infusion bag
This is the correct option because it provides the staff with the volume of fluid that remains and should reflect a properly programmed flow rate.

14

When applying a dressing to a patient's infusion site, the nurse best minimizes the patient's risk for injury by:
1. Using aseptic technique throughout the process.
2. Applying a skin protectant to the skin before the intervention.
3. Applying a transparent dressing that allows for visualization of the site.
4. Thoroughly explaining the process to the patient before implementation

1. Using aseptic technique throughout the process.
This is the correct option because the patient's risk of injury related to infection will be minimized by following aseptic technique throughout the dressing application.

15

The nurse consistently observes that the positioning of a patient's arm has a direct effect on the flow rate of the IV solution. To best ensure the effectiveness of the patient's IV therapy, the nurse should:
1. Consider restarting the IV access device in another appropriate location.
2. Include this information in the shift report to inform the oncoming staff.
3. Assess the flow rate every hour to ensure the proper flow rate of the prescribed solution.
4. Instruct the patient to avoid positioning the arm in ways that alter the flow rate of the
solution.

1. Consider restarting the IV access device in another appropriate location.
This is the correct option because it provides the best assurance that the correct flow rate will be maintained, thus improving the effectiveness of the therapy.

16

The nurse is applying a dressing to an infusion site on a patient's left forearm. To allow for the proper maintenance of the tubing, the nurse should be most careful to:
1. Apply a transparent dressing to the insertion site.
2. Use a catheter stabilizing device when applying the dressing.
3. Apply the dressing distal to the tubing and catheter hub connector.
4. Secure the tubing with 1-inch tape securely to the patient's dressing.

3. Apply the dressing distal to the tubing and catheter hub connector.
This is the correct option because it will prevent the dressing from being applied over the connector, thus hindering the scheduled changing of the tubing.

17

What gauge does a yellow butterfly needle have?

24 gauge

This is the smallest one.

18

What is the gauge for a blue butterfly IV needle?

22 gauge

This is what we will use on each other in class

19

What is the gauge of a pink butterfly IV needle?

20 gauge

This is commonly used for surgery and blood products

20

What is the gauge for a green butterfly IV needle?

18 gauge

This is the biggest needle nurses use

21

What is the gauge for a gray butterfly IV needle?

Do we use these?

16 gauge

No, we don't.

22

LPNs who have had the appropriate practice and documented education may administer the following under the supervision of a registered nurse EXCEPT:
A) Antineoplastic agents
B) Medications
C) TPN
D) Blood
E) Blood products

A) Antineoplastic agents

23

Which of the following statements are true regarding infusing Potassium? (select all that apply)
A) NOT to be given by IV push
B) Should be administered at 20 mEq/hr
C) Mixed by pharmacy
D) Must be controlled with an infusion pump

A) NOT to be given by IV push
C) Mixed by pharmacy
D) Must be controlled with an infusion pump

24

All of the following statements regarding infusing Calcium are true EXCEPT:
A) Patient should remain recumbent
B) Cannot be given by IV Push
C) Solution must be room temperature
D) Infusion may cause dizziness, fall precautions should be taken.

B) Cannot be given by IV Push
**Calcium is given by IV push over 10 minutes

25

Which statements are true about infusing magnesium? (select all that apply)
A) Solution must be room temperature
B) Patient should be placed on fall precautions
C) Is ordered in grams
D) Infuse at no more than 2 g/hr

B) Patient should be placed on fall precautions
C) Is ordered in grams
D) Infuse at no more than 2 g/hr

26

All of the following statements are true about Ammonium Chloride EXCEPT:
A) Used to treat Metabolic acidosis
B) Administered through a central line
C) May cause loss of potassium
D) Used to treat severe Metabolic Alkalosis

A) Used to treat Metabolic acidosis

27

The following statements regarding crystalloids are true EXCEPT:
A) They are IV fluids that contain water and electrolytes normally found in the body.
B) Some may contain proteins (colloids)
C) They are inexpensive
D) Examples include: Normal Saline, Lactated Ringer's & D5W
E) May be isotonic, hypertonic or hypotonic

B) Some may contain proteins (colloids)

28

Which of the following is a blood product that is the most abundant protein in the blood plasma?
A) Crystalloids
B) Colloids
C) Glucose
D) Albumin

D) Albumin

29

Which of the following IV fluids include 50g Glucose and should be used with precautions for diabetic patients? (select all that apply)
A) D5W
B) D5LR
C) NS 0.9
D) LR
E) D5 0.25NS

A) D5W
B) D5LR
E) D5 0.25NS

30

What color top tube is used when drawing a blood sample for a CBC, Hgb A1c, Hct and ESR (Sed Rate)?
A) Green
B) Yellow
C) Gray
D) Lavender
E) Red

D) Lavender

31

What color top tube is used when drawing a blood sample for the following lab tests: Comprehensive Metabolic Thyroid (T3, T4, & TSH), Electrolytes, ALT, AST, & Basic Metabolic?
A) Red/gray or gold
B) Light blue
C) Black
D) Lavender
E) Yellow

A) Red/gray or gold

32

What are typical lab tests done with blood samples from a test tube with a light blue top?
A) Glucose analysis & ETOH analysis
B) Blood cultures
C) Protime, PTT, Thrombin time & Fibrinogen
D) Electrolytes, Serology & Immunohematology
E) Albuminm, Ammonia, Amalase, Bilirubin, & Cholesterol

C) Protime, PTT, Thrombin time & Fibrinogen

33

What is the general order of steps to obtain a blood specimen through PICCs, Port-a-caths or Central Lines?
A) Scrub hub, Flush, Draw waste, Flush, Draw sample(s)
B) Scrub hub, Flush, Draw waste, Draw sample(s), Flush
C) Flush, Draw waste, Scrub hub, Draw sample(s), Flush
D) Flush, Draw waste, Draw sample, Flush, scrub hub

B) Scrub hub, Flush, Draw waste, Draw sample(s), Flush

34

Which IV complication is characterized by pain, redness and stopped IV flow?
A) Extravasation
B) Phlebitis
C) Thrombophlebitis
D) Infiltration

C) Thrombophlebitis

35

Which IV complication is characterized by pain, stinging, burning, redness, swelling and blistering?
A) Extravasation
B) Phlebitis
C) Thrombophlebitis
D) Infiltration

A) Extravasation

36

Which IV complication is characterized by Erythema: pain, streak formation, and a palpable venous cord?
A) Extravasation
B) Phlebitis
C) Thrombophlebitis
D) Infiltration

B) Phlebitis

37

A nurse checks on her patient who is receiving IV therapy and notices her skin is cool to touch, with edema and tight skin. What IV complication does she suspect?
A) Extravasation
B) Phlebitis
C) Thrombophlebitis
D) Infiltration

D) Infiltration

38

What actions should the nurse take when she finds her patient's IV has infiltrated? (select all that apply)
A) Apply ice
B) Apply warm compress
C) Remove IV
D) Elevate
E) Apply antidote (PRN)

C) Remove IV
D) Elevate

39

Which statements are true regarding administering piggy back medications? (Select all that apply)
A) Piggy back meds are hung higher than maintenance fluids
B) Piggy back meds include antibiotics, antiemetics, and electrolytes
C) Connect to main tubing port BEFORE the pump.
D) Connect to main tubing AFTER the pump

A) Piggy back meds are hung higher than maintenance fluids
C) Connect to main tubing port BEFORE the pump.

40

List the advantages to administering medications via IV Therapy.

1. Rapid therapeutic effect
2. Alternative for patients who are NPO
3. Ability to administer to unconscious patients
4. Decreases the need for multiple needle sticks

41

Signs of physical incompatibility between IV medications include:
A) Changes in color
B) Solutions may appear carbonated (bubbly)
C) Visible particles floating in solution (precipates)
D) All of the above

D) All of the above

42

When giving IV push medications, after checking the prescription, checking drug compatibility, preparing medication and properly identifying your patient, in what order should the procedure steps for administration go?
A) Clamp the main line, Scrub the hub, Flush (10 mL syringe), IV Push (SLOW), Flush (10 mL syringe. Document
B) Scrub the hub, Flush (10 mL syringe), Clamp the main line, IV Push (SLOW), Flush (10 mL syringe), Document.
C) Scrub the hub, Clamp the main line, Flush (10 mL syringe), IV Push (SLOW), Flush (10 mL syringe) Document.
D) Clamp the main line, Flush (10mL syringe), Scrub the hub, IV Push (SLOW), Flush (10mL syringe), Document

C) Scrub the hub, Clamp the main line, Flush (10 mL syringe), IV Push (SLOW), Flush (10 mL syringe) Document.

43

Administering chemically incompatible medications may result in which of the following:
A) Toxicity
B) Therapeutic inactivity
C) complexation, oxidation, photolysis
D) All of the above

D) All of the above