IV exam

Question 1

hypotonic fluids

Answer 1

fluid into the cell
SWELLS
less than 0.9 so hypo
0.45 NaCl
0.33 NaCl

Question 2

isotonic fluids

Answer 2

expands ECF
0.9 NS
lactated ringers
D5W outside of body

Question 3

fluid compatible with blood products

Answer 3

ONLY 0.9 NORMAL SALINE

Question 4

hypertonic fluids

Answer 4

takes fluid out of cell
SHRINKS
“i’m hyper, i like to go out”
more than 0.9 so hyper
D5.45 NaCl
D5.9 NaCl
D5LR

Question 5

hypertonic glucose solution precautions

Answer 5

dextrose solutions
assess for hyperglycemia and sepsis

Question 6

primary tubing

Answer 6

longer tubing
continous flow
tubing ports

Question 7

macrodrop

Answer 7

10 gtts/mL
15 gtts/mL
20 gtts/mL

Question 8

microdrip

Answer 8

60 gtts/mL

Question 9

secondary tubing

Answer 9

hung higher - administered first/faster
no injection port, due to shorter tubing
given thru IV pump or gravity

Question 10

KCl infusions

Answer 10

ALWAYS thru pump
NEVER give as IV push or bolus
rate should not exceed 10 mEq/hr
assess for phlebitis/ infiltration

Question 11

nursing assessment for IV start

Answer 11

assess site for infiltration and inflammation
verify solution and rate
assess when tubing and IV is to be changed

Question 12

dwell time

Answer 12

how long an IV can be in for before being changed

usually 48-72hrs max

Question 13

labels

Answer 13

bag, tubing, pt site

Question 14

IV start documentation

Answer 14

method of infusion
number of attempts
size
pt response
IV info : amount, solution, additive, rate, site

Question 15

how long can a bag hang

Answer 15

should not exceed 24 hrs

Question 16

what is phlebitis

Answer 16

inflammation of vein
redness

Question 17

signs and symptoms of phlebitis

Answer 17

redness, warmth, swelling/ puffy
possible fever
tenderness
palpable venous cord

Question 18

treatment of phlebitis

Answer 18

stop infusion
warm packs
slow rate or dilute solution

Question 19

infiltration

Answer 19

fluid leaks to surrounding tissues

Question 20

signs and symptoms of infiltration

Answer 20

cold sensation @ site
swelling @ and around site
translucent blanching
slowed IV rate
burning/pain

Question 21

treatment of infiltration

Answer 21

stop infusion
elevate extremity
start infusion @ different site
assess pulse, cap refill, paresthesia

Question 22

signs and symptoms of fluid overload

Answer 22

crackles
moist cough
JVD
edema
elevated BP
confusion

Question 23

patients at risk for overload

Answer 23

heart failure
kidney failure

Question 24

discontinue an IV steps

Answer 24

confirm order
gather supplies and gloves
stop infusion
prevent skin tears - remove slowly
apply gauze over site
pull cannula straight back
apply pressure to site
examine catheter and document
dispose into sharps

Question 25

how often do you flush the IV site?

Answer 25

aspirate to see blood return then flush before and after meds every 8 hrs

Question 26

how many mL do you use to flush an IV site?

Answer 26

2-3 mL

Question 27

when do you flush?

Answer 27

before and after meds

Question 28

IV monitoring

Answer 28

monitor site hourly document baseline vitals

Question 29

when do you administer IV push meds?

Answer 29

NPO pt as a loading dose IV site closest to pt

Question 30

how to calculate IV push rate

Answer 30

push at a rate of 15-30 seconds per 1 mL

Question 31

how to give an IV push

Answer 31

SLOWLY 1-5 minutes

Question 32

starting an IV steps

Answer 32

2 pt identifiers correct IV size IV start kit tourniquet find IV site clean insert at 15-30* bevel up "flash" of blood, advance the catheter, and remove needle apply pressure to site and apply tegaderm

Question 33

areas to avoid for IV insertion

Answer 33

areas below infiltrated vein area below phlebitis arm with shunt/ fistula inflammation, disease, or bruised site arm with edema, infection, blood clot or lymph node dissection sclerosed/thrombosed vein (hard vein)

Question 34

IV dressing

Answer 34

transparent tegaderm over cath site tape tubing to patient label with date and initials attach ordered fluids

Question 35

tourniquet use

Answer 35

blue rubber band 2-4 inches above insertion site used to help buldge and puncture vein, removed after blood flashes