IV Therapy Equipment and Supplies; IV Therapy Unit 2; Skills IV Insertion; Infusion Therapy Questions; Med Surg Infusion Therapy: FINAL EXAM LATEST 2022
... [Show More] 100% Verified and Grade A+
Question:List the equipment and supplies needed for initiation of IV therapy.
Question: Using ________ gauge and ________ length catheter in the _______ vein possible will reduce the mechanical and chemical irritation to the vein wall.
Question: Cannulas range from __ to __ gauge?
Question: Over the cannula needles range from __ inch to __ inches in length.
Question: Butterfly style cannulas range from __ inch to -- inch in length.
Question: What are the advantages of using extension tubing and an over the needle cannula?
Question: Cannulas for children and elderly __ to __.
Question: Cannulas for medical patients and post op surgical patients __ to __.
Question: Cannulas for surgical patients and rapid blood administration __.
Question: Cannulas for trauma patients and requiring large volumes of fluid rapidly.
Question: What is the purpose of the protective caps at each end of the administration set and when should they be removed?
Question: IV equipment that must remain sterile.
Question: A bag of IV solution should hang no longer than __ hours.
Question: IV tubing must be changed every __ to __hours.
Question: IV sites must be changed ever __ hours.
Question: a gauge dressing must be changed every __ hours.
Question: transparent IV dressing must be changed every __ hours.
Question: what is macro tubing?
Question: what is micro drip?
Question: A physician's order for IV therapy must contain what components?
Question: If medication is ordered, identify what additional components to the order must be present.
Question: What is IV push (IVP)
Question: What is IV bolus?
IV Therapy Unit 2
Question:The number of drops needed to deliver 1 mL of fluid and is based on the size of the hollow, internal diameter (bore) of the administration tubing.
Question: This type of drip system has a distinctive metal tip where the drop is formed. May also be called minidrip or pediatric infusion set. Forms very small drops.
Question: What type of drip system would you use to deliver a very small amount of a solution over a long period of time?
Question: This type of drip system is also called an infusion set and can deliver different drip rates/mL due to different sized drop factors. Requires use of a formula to calculate flow rate/minute.
Question: What type of drip system would you use to deliver a very large volume of fluid in a short time?
Question: This type of IV tubing consists of straight IV tubing with either type of drip system. May contain multiple secondary ports. Closed system with no openings.
Question: This type of IV tubing may be used with a bag, plastic bottle, or vented glass bottle.
Question: This type of IV tubing consists of straight IV tubing with either type of drip system. May contain multiple secondary ports. Has filtered opening to allow air to enter the system (usually lies at side of the uppermost of drip chamber).
Question: This type of IV tubing can be used with non-vented glass bottle.
Question: The ________ allows air to enter this type of container to replace the volume of fluid as the fluid runs out. Without this, a __________ will form and fluid cannot leave the container.
Question: What is added to the distal tip of the IV administration set and allows for greater patient mobility (can connect to IV needle or cath)?
Question: Most common fluid containers today.
Question: These fluid containers are vacuum systems that require a vent.
Question: These fluid containers are semi-rigid or flexible and no vent is needed.
Question: These are primarily used for pediatric patients. May include an in-line filter.
Question: How often are peripheral IV sites changed?
Question: How often must the nurse assess and document the condition of an IV site?
Question: What is the procedure for cleansing an IV port to be accessed?
Question: How often should tubing be changed for TPN?
Question: How often should tubing be changed for IV fluids?
Question: How often should tubing be changed for blood products?
Question: How often should tubing be changed for intermittent infusions?
Question: What is INS's recommendation minimum flush for peripheral IV and type of solution?
Question: This type of tubing does not go through the pump.
Question: What is the drop rate for microdrips?
Question: What is the drop rate for macrodrips?
Question: What is the most commonly used venous access device of IV's?
Question: This IV needle would be used for infants and children.
Question: This IV needle would be used for short-term therapy (<24 hours).
Question: This IV needle would be used to deliver viscous liquids.
Question: This IV needle can be used in arterial monitoring.
Question: This IV needle would be used for long-term therapy (>24 hours).
Question: What does SASH stand for?
Question: When selecting needle size and type for prescribed IV therapy, select the ____________ catheter gauge and the __________ length needle. Insert the needle into the ___________ vein possible.
Question: This gauge needle is appropriate for most adults.
Question: This gauge needle is used in trauma/surgery.
Question: This gauge needles should not be routinely inserted into stable med/surg patients. (increases risk of mechanical phlebitis)
Question: What is the drop factor for piggyback sets?
Question: _______________ will be used when a patient does not need large amounts of IV fluids but does need IV medications.
Question: List vein sites to avoid.
Question: What should be listed on the label placed at the IV insertion site? IV tubing label?
Question: How often is the IV site changed for pediatrics?
Question: List information that should be documented about venous procedures.
Question: List methods used to distend vein for easier cannulation.
Question: List factors that affect flow rates of parenteral IV infusions.
Question: Use of a(n) _____________ over areas that have positional changes may help maintain patency of the IV site.
Question: List nursing observations/assessments/interventions in regard to monitoring IV systems.
Question: When discontinuing an IV site, what type of dressing should be applied over the site?
Skills IV Insertion
N:B in this section I have started with Answer then Question
what must be done before IV fluids are started?
what must be done to tubing or saline lock before administering meds
most common size gauge for adult
common size gauge for blood products
if an emergency, what size gauge would be used?
common gauge size for ped's, gero, and neo
what size gauge is used for major surgery with high flow rates?
if an IV is started by a paramedic it must be removed within ___
Macro drip
Micro drip
what must be checked before placing IV?
what angle is the IV inserted at?
after the IV is inserted, what do you look for?
how often do you check an IV site?
how often do you flush an IV site?
how often do you change the IV site?
how often do you change IV tubing?
how often do you change IV solution bag?
what is thrombophlebitis?
how do you treat infiltration?
how do you treat extravasation?
what are signs of infiltartion?
what is phlebitis?
what is the first indicator?
how do you treat hematoma formation?
what is sensible loss?
what is insensible loss?
osotonic number range
hypotonic solutions
hypertonic solutions
isotonic solutions
what area do isotonic solutions effect?
what area do hypertonic solutions effect?
what area do hypotonic solutions effect?
what are the main isotonic solutions?
What is the only fluid compatible with blood transfusions?
These solutions are commonly used to treat fluid loss, dehydration, and hypernatremia
Monitor which patients for fluid overload?
this solution is used b/c of need of multiple electrolyets and isotonic expansion of plasma. no calories, used for GI losses and intraoperatively
Do not give LR to patients with
Do not take this solution for more than 48 hours because of risk of calorie depletion
What are the most common hypotonic solutions?
What are hypertonic solutions used to treat?
who are hypotonic solutions contraindicated for?
what are common hypertonic solutions?
What is D50 used to treat?
Hypertonic solutions are used to treat people with
hypertonic solutions should be given at what kind of rate?
hypertonic solutions are contraindicated for
what is the #1 indicator of fluid and electrolyte status in a person?
what is the KO rate?
How do you calculate maintenance?
Which CVCs are placed bedside? Which are sugically placed?
what are the sites for CVC placement?
how are CVC placement verified?
Multilumen Suclavian catheter (Non-tunneled)
short term catheters need to be changed every ___ days b/c infection rates are high (Burn, ICU patients ___)
PICC Line (Peripherally Inserted Central Catheter)
where are PICC lines placed?
what cannot be done through PICC line?
Tunneled Central catheters
Port-a-cath
You can draw blood samples and infuse blood products into a port-a-cath but you cannot get a
port-a-caths must be accessed every
the needle of a port-a-cath must be changed how often?
dressing changes for CVCs are done
dressing change procedure for CVC
what must be done after performing dressing change on CVC?
when should multi lumen CVCs be flushed?
what must be done before performing flush?
what size syringe and how much flush are used for flushing CVCs?
when drawing blood from a CVC...
how often do injection caps need to be changed?
How often should IV tubing on CVC be changed?
How often should IV fluids be changed on CVC?
Infusion Therapy Questions
An order for infusion therapy must contain the following to be complete: specific type of fluid, rate of administration, and drugs added to the solution. Osmolarity of the solution is not necessary because it is incorporated into the specific type of fluid. It is the nurse's independent decision about the most appropriate
vein to cannulate and the catheter size to use. - 1. Before the administration of intravenous fluid, it is most important for the nurse to obtain which information from the health care provider's orders?
a. Intravenous catheter size
b. Osmolarity of the solution
c. Vein to be used for therapy
d. Specific type of IV fluid
To be complete, IV orders for infusion fluids should specify the rate of infusion. This order does not specify the rate of infusion and is not considered complete. - 2. Which IV order does the nurse question?
a. Flush Groshong catheter with 10 mL normal
saline every 8 hours.
b. Infuse 20 mEq potassium chloride in 1000
mL D5W at 50 mL/hr.
c. Infuse 500 mL normal saline over 1 hour.
d. Infuse 0.9% normal saline at keep vein open
(KVO) rate.
An older adult client who has dehydration will require a large fluid volume that is accurately measured by using a cassette pump during the infusion. Volumetric controllers count drops for administered volume and are inherently inaccurate because of variation in drop size. A syringe pump is accurate but not appropriate for a large volume. Elastomeric balloons are used to deliver intermittent medications. - 3. Which infusion device does the nurse select for the older adult client with a medical diagnosis of "dehydration"?
a. Cassette pump
b. Elastomeric balloons
c. Volumetric controller
d. Syringe pump
The Centers for Disease Control and Prevention (CDC) recommends having a dedicated IV team to reduce complications, save money, and improve client satisfaction and outcomes. In-service education would always be helpful, but it would not have the same outcomes as an IV team. Limiting IV starts to the most experienced nurses does not allow newer nurses to gain this expertise. The quality of skin preparation products is only one aspect of IV insertion that could contribute to infection. - 4. A nursing administrator is concerned about the incidence of complications related to IV therapy, including bloodstream infection. Which action by the administrator would have the biggest impact on decreasing complications?
a. Investigate initiating a dedicated IV team.
b. Require inservice education for all RNs.
c. Limit IV starts to the most experienced
nurses.
d. Perform quality control testing on skin
preparation products.
The Infusion Nurses Society publishes guidelines and standards related to IV therapy and offers a national certification examination. The State Board of Nursing publishes legal information related to nursing practice, and the solutions vendor would have written information pertaining only to specific products. The IV Therapy Nursing Society does not exist, and the other organizations listed do not provide standards and guidelines related to IV therapy. - 5. The nurse wants to find written standards for IV therapy. The nursing manager suggests that the nurse investigate publications from which resource?
a. IV Therapy Nursing Society
b. Infusion Nurses Society
c. Nurse's State Board of Nursing
d. Hospital's IV solutions vendor
Huber needles are used to access implanted ports placed under the skin. Because the dense septum holds tightly to the needle, a rebound can occur when it is pulled from the septum, often resulting in needle stick injury to the nurse. Topical anesthetic cream can be used when accessing the system. Flushing is carried out when the system is accessed and once monthly. Because the implanted port is not being removed, there is no need for a pressure dressing. - 6. The RN assigned a new nurse to a client who was receiving chemotherapy through an intravenous extension set attached to a Huber needle. Which information about disconnecting the Huber needle is most important for the RN to provide to the new nurse?
a. "Apply topical anesthetic cream to the area
after discontinuing the system."
b. "Be aware of a rebound effect when
discontinuing the system."
c. "Be sure to flush the system with saline after
removing the Huber needle."
d. "Place pressure over the site to prevent
bleeding."
After removal of a catheter, measure the catheter length and compare it with the length documented on insertion. If the entire length has not been removed, the nurse should contact the physician immediately because some of the catheter may still be in the client's vein. - 7. After discontinuing a nontunneled, percutaneous central catheter, it is most important for the nurse to record which information?
a. Application of a sterile dressing
b. Length of the catheter
c. Occurrence of venospasms
d. Type of ointment used to seal the tract
The presence of a red streak and palpable cord indicates grade 3 phlebitis. No information in the description indicates that infection, infiltration, or thrombosis is present. - 8. When assessing the client's peripheral IV site, the nurse observes a streak of red along the vein path and palpates a 4-cm venous cord. What is the most accurate documentation of this finding?
a. Grade 3 phlebitis at IV site
b. Infection at IV site
c. Thrombosed area at IV site
d. Infiltration at IV site
A properly placed PICC (in the antecubital fossa or the basilic vein) allows the client considerable freedom of movement. Clients can participate in most activities of daily living; however, heavy lifting can dislodge the catheter or occlude the lumen. Although it is important to keep the insertion site and tubing dry, the client can shower. The device is flushed with heparin. - 9. What information is most important to teach the client going home with a peripherally inserted central catheter (PICC) line?
a. "Avoid carrying your grandchild with the arm that has the IV."
b. "Be sure to place the arm with the IV in a sling during the day."
c. "Flush the IV line with normal saline daily."
d. "You can use the arm with the IV for most of the activities of daily living."
Midline catheters are used for therapies lasting from 1 to 4 weeks. Short peripheral catheters can be inserted by the nurse for use with antibiotic therapy, but they can stay in only for up to 96 hours. If the length of IV therapy is longer than 6 days, a midline catheter should be chosen. Nontunneled central catheters and Hickman catheters are inserted by a physician. - 10. A client is to receive 10 days of antibiotic therapy for urosepsis. The nurse plans to insert which type of intravenous catheter?
a. Hickman
b. Midline
c. Nontunneled central
d. Short peripheral
The nurse selects the access device most appropriate for the designated purpose. In this case, because a large amount of fluid will be needed as a result of excessive fluid loss, the appropriate needle is the 20-gauge catheter IV, because this is the most commonly used size in adults and it can be used for all fluids. The 22- and 24-gauge catheters will have a slower rate of flow, which may not be desirable with excessive fluid losses and low blood pressure. The 18-gauge catheter allows rapid flow of IV fluids. However, it requires a large vein and is more prone to irritation to the vein wall. - 11. A client is admitted to the hospital for excessive nausea and vomiting, and a blood pressure of 90/50 mm Hg. A catheter of which gauge is most appropriate for the nurse to choose for this client's peripheral IV?
a. 24
b. 22
c. 20
d. 18
The backpriming method allows multiple drugs to be infused through the same secondary set. This method allows the primary and secondary sets to remain connected together as an infusion system and allows the nurse to adhere to the Infusion Nurses Society (INS) standards of practice. The client is at increased risk for infection whenever the catheter is disconnected from the tubing. Sterile gloves are not necessary for IV administration of medication. - 12. To prevent infection when infusing an intermittent "piggyback" line, which intervention does the nurse implement?
a. Backpriming the secondary container from the primary line
b. Detaching and capping the secondary line after use
c. Using a new secondary container with each drug infused
d. Using sterile gloves when administering medication
The Groshong catheter is a type of midline catheter. After intermittent use, the catheter is to be flushed with saline. The manufacturer's instructions state that the catheter should not be clamped to maintain the integrity of the catheter valve. If a heparin flush is ordered, it is given after the catheter has been flushed with saline. The access needle is used for implanted ports. - 13. The nurse finishes administering an intermittent medication through a Groshong catheter. What is the nurse's next action?
a. Clamping the catheter
b. Flushing the line with saline
c. Flushing with heparin
d. Removing the access needle
A Groshong catheter is a peripherally inserted catheter that needs to be flushed with saline after intermittent use. Peripheral IV catheters should be discontinued after 4 days, so this one should be changed; however, this is not the priority. An order to discontinue the peripheral catheter requires intervention, but flushing of the Groshong catheter is more of an immediate intervention to prevent clotting of the catheter. A nonaccessed implanted port site needs to be assessed, but this is not an immediate intervention. - 14. The nurse is assessing several clients receiving intravenous therapy. Which client situation requires immediate intervention?
a. Completion of an intermittent medication into a Groshong catheter
b. Physician's order to discontinue a peripheral intravenous catheter
c. Nonaccessed implanted port placed 1 month ago without problem
d. Peripheral IV catheter dated 5 days ago used for once-daily antibiotics
The clinical manifestations described are those associated with phlebitis. Phlebitis is an inflammation of the vein. Its presence in a vein being used for IV therapy may be caused by mechanical forces associated with the IV device, or by chemical factors related to the composition and osmolarity of the drug solution. The key manifestation is that symptoms are directly associated with the vein, and the catheter must be removed. Warm compresses can be applied for 20 minutes four times daily after the catheter is removed. The site needs to be monitored after the catheter is removed. The arm is not swollen. Therefore, elevation of the extremity is not a correct option. - 15. In examining a peripheral IV site, the nurse observes a red streak along the length of the vein, and the vein feels hard and cordlike. What action by the nurse takes priority?
a. Applying continuous heat
b. Continuing to monitor site
c. Elevating the extremity
d. Removing the catheter
Fluid flow through the infusion system requires that pressure on the external side be greater than pressure at the catheter tip. Fluid flow can be slowed for many reasons. A common reason, and one that is easy to correct, is a kinked catheter. If this is not the cause of the pressure alarm, the nurse may have to ascertain whether a clot has formed inside the catheter lumen, or if the pump is no longer functional. - 16. When an IV pump alarms because of pressure, what action does the nurse take first?
a. Check for kinking of the catheter.
b. Flush the catheter with a thrombolytic
enzyme.
c. Get a new infusion pump.
d. Remove the IV catheter.
Older adults are more prone to fluid overload and resulting congestive heart failure. Because this client is receiving continuous IV fluid, he or she is at risk for fluid overload and needs to be assessed. All other clients would need to be assessed for complications of IV catheters. However, they do not need immediate assessment. - 17. The nurse is caring for four clients receiving IV therapy. Which client does the nurse assess first?
a. Client with a newly inserted peripherally
inserted central catheter (PICC) line waiting
for x-ray
b. Client with a peripheral catheter for
intermittent infusions
c. Older adult client with a nonaccessed
implanted port
d. Older adult client with normal saline
infusion
An insertion-related complication of central venous catheters is a pneumothorax. Signs and symptoms of a pneumothorax include chest pain and dyspnea. Treatment includes removing the catheter, administering oxygen, and placing a chest tube. Pain is caused by the pneumothorax, which must be taken care of with a chest tube insertion. Use of a sterile dressing and placement of the client in a Trendelenburg position are not indicated for the primary problem of a pneumothorax. - 18. A client who is having a tunneled central venous catheter inserted begins to report chest pain and difficulty breathing. What action does the nurse take first?
a. Administer the PRN pain medication.
b. Prepare to assist with chest tube insertion.
c. Place a sterile dressing over the IV site.
d. Place the client in the Trendelenburg
position. [Show Less]