PRETEST IV THERAPY 1. After having an IV. in place for 72 hours, a patient complains of tenderness, burning, and swelling.

Assessment of the IV. site reveals that it is warm, and erythematous. This usually indicates: a. Infection c. Phlebitis c. Infiltration d. Bleeding During the nurse's initial assessment of a patient's IV. therapy, the least important consideration is: a. calculating how many hours the solution will infuse b. observing the type and amount of IV. solution c. checking that the flow rate is correct d. inspecting the infusion insertion site The IV. line has been inserted in a vein in Mr. N's right antecubital space. Factors that can impede the free flow of infusion includes all of the following except: a. patient movement and positioning b. height of the IV. bag in relation to the patient c. amount of fluid present in the IV. container d. length of the tubing used The nurse should take special care to preserve a healthy IV. site in an elderly patient because elderly patients: a. often become upset when a new IV. site must be found b. tend to have fragile veins, leaving fewer sites available for IV. therapy c. often become confused at night, which could result in accidental dislodgment of the catheter d. tends to forget about the IV. line and may roll over on it in their sleep Which of the following can help prevent a systemic infection during central venous catheter IV. therapy? a. changing the dressing over the IV. site every 8 hours b. calculating the flow rate for accuracy c. using a 0.22 micron in-line filter on the IV. tubing d. assessing the patient's vital signs every 4 hours.

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Indications for TPN include all of the following except: a. hypertensive crisis b. obstruction of the GI tract c. malnutrition d. hypermetabolism or catabolism How should the patient be positioned for a percutaneous central venous catheter (subclavian) insertion? a. reverse Trendelenburg b. prone c. supine d. Trendelenburg The nurse notes that the patient IV TPN is infusing at 10 ml per hour and the ordered rate is 100 ml per hour. What action should the nurse take? a. increase the flow rate to 100 ml per hour. b. increase the flow rate over time to 100ml per hour c. continue the present flow rate d. stop the infusion and alert the physician Your patient is being started on TPN. Which of the following tests should be performed on a patient receiving TPN more than once per day? a. blood glucose levels b. urine glucose levels c. BUN and creatinine levels d. albumin levels The TPN infusion line can be used for administering a. blood products b. secondary infusions of other IV's c. IV medication such as diuretics d. TPN solutions only When a pediatric client is receiving IV therapy, both the client and the IV site should be monitored a. every hour or more frequently if condition warrants it b. every shift or every 8 to 12 hours c. every 24 hours

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The cannula size for an infusion should be as large as will fit into a vein. When using a plastic IV container, the nurse should label it by writing directly on the bag using an indelible marker To prevent dislocation and the possibility of air embolism or contamination, Luer-Lok connectors and adapters should be used. The CVC needs to be positioned so that the tip terminates in the SVC or the right atrium. The major preventable complications that can occur any time during therapy with a CVC is infection With pneumothorax there is perforation of the interpleural space with air accumulation in the mediastinum. A client complains of burning sensation or discomfort during infusion as well as a gurgling sound in the ear, is indicative of CVC dislodgment or migration. Performing the Valsalva maneuver prevents air from entering the circulation and embolizing what a large vessel is cannulated or there is a breach in the IV line. The CDC recommends that the CVC dressing is changed every 72 hours with antimicrobial ointment applied to the insertions site. Prior to CVC insertion, the nurse should assist the client to a Trendelenburg position with a rolled towel between the shoulder blades. When CVC tubing is changed, the catheter should be clamped with a hemostat prior to disconnecting.

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