IV Insertion and Medication Administration
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Questions and Answers

What clinical problem is most appropriately targeted by administering hypotonic fluids?

  • Severe nausea
  • Dehydrated cells (correct)
  • Cerebral edema
  • Fluid overload
  • Which of the following statements regarding isotonic fluids is false?

  • Examples of isotonic fluids include normal saline.
  • Isotonic fluids without risks can be rapidly infused. (correct)
  • Isotonic fluids prevent net water movement into or out of cells.
  • Isotonic fluids have the same concentration of solutes as blood.
  • Which condition contraindicates the use of hypotonic fluids?

  • Fluid volume excess
  • Dehydrated cell condition
  • Increased intracranial pressure (correct)
  • Hyperglycemic conditions such as DKA
  • What is the primary action of hypertonic fluids on body cells?

    <p>Shrink the cells (B)</p> Signup and view all the answers

    What issue arises from the rapid infusion of isotonic fluids?

    <p>Fluid overload (B)</p> Signup and view all the answers

    Which condition would NOT be appropriate for IV insertion?

    <p>Arm with a mastectomy on the opposite side (C)</p> Signup and view all the answers

    What is the correct order for preparing for IV insertion?

    <p>Prepare equipment, apply tourniquet, scrub the site (B)</p> Signup and view all the answers

    What is the most common reason for cellulitis around an IV site?

    <p>Poor aseptic technique during insertion (C)</p> Signup and view all the answers

    How should a nurse react to an adverse reaction during IV medication administration?

    <p>Support airway, give oxygen, and administer antidote if available (B)</p> Signup and view all the answers

    Which of the following is NOT among the nine rights of medication administration?

    <p>Right observation (B)</p> Signup and view all the answers

    Which type of IV fluid is typically used to treat hypovolemia?

    <p>Isotonic fluids (C)</p> Signup and view all the answers

    What is the primary purpose of extension tubing in IV therapy?

    <p>To connect to the patient's saline flush (B)</p> Signup and view all the answers

    Which IV fluid category has the same concentration of solutes inside and outside of the cells?

    <p>Isotonic fluids (C)</p> Signup and view all the answers

    Which medication is used to treat 'Red Man Syndrome' during IV administration?

    <p>Vancomycin (B)</p> Signup and view all the answers

    Which method is NOT recommended for enhancing vein prominence prior to IV insertion?

    <p>Injecting saline into the vein (C)</p> Signup and view all the answers

    What is the primary cause of cellulitis related to IV therapy?

    <p>Poor aseptic insertion technique (C)</p> Signup and view all the answers

    Which electrolyte imbalance is most likely corrected by administering IV fluids?

    <p>Hypokalemia (B)</p> Signup and view all the answers

    What is the primary effect of hypotonic IV fluids on red blood cells?

    <p>They lead to hemolysis of the cells. (D)</p> Signup and view all the answers

    Which of the following drugs requires Vitamin K as an antidote?

    <p>Warfarin (C)</p> Signup and view all the answers

    What is a critical risk factor associated with administering hypotonic IV fluids?

    <p>Increased intracranial pressure (D)</p> Signup and view all the answers

    In what situation would IV medications most likely be indicated?

    <p>To compensate for ongoing vomiting and diarrhea (C)</p> Signup and view all the answers

    Which of the following is a common hypotonic IV fluid?

    <p>0.45% NaCl (A)</p> Signup and view all the answers

    What is the primary objective of establishing an IV line?

    <p>To provide a route for medication and nutrients (C)</p> Signup and view all the answers

    What is the role of acetylcysteine in clinical practice?

    <p>To act as an antidote for acetaminophen overdose (C)</p> Signup and view all the answers

    What is the effect of hypotonic solutions on cells in hyperglycemic conditions?

    <p>Water flows into the cells, potentially causing them to burst. (A)</p> Signup and view all the answers

    What is the primary mechanism of action of valacyclovir in treating herpesviruses?

    <p>It inserts into replicating viral DNA to halt synthesis. (A)</p> Signup and view all the answers

    Which of the following is NOT a common side effect of valacyclovir?

    <p>Muscle hypertrophy (C)</p> Signup and view all the answers

    When performing a baseline assessment for a client with a genital herpes simplex virus infection, which symptom is least relevant to note?

    <p>Color of urine (B)</p> Signup and view all the answers

    In monitoring for the side effects of antiviral treatments, which neurological side effect should be considered an emergency?

    <p>Seizures (A)</p> Signup and view all the answers

    Which of the following best describes a nursing consideration when educating a client about valacyclovir?

    <p>It is important to monitor for signs of thrombocytopenia. (A)</p> Signup and view all the answers

    Which complication is most associated with severe side effects of acyclovir and valacyclovir?

    <p>Thrombotic thrombocytopenic purpura (A)</p> Signup and view all the answers

    What is a crucial piece of client education when starting antiviral therapy for herpes management?

    <p>It is essential to avoid dehydration during treatment. (A)</p> Signup and view all the answers

    What differentiates hypotonic fluids from hypertonic fluids in relation to cell dynamics?

    <p>Hypotonic fluids lead to water influx into cells. (A)</p> Signup and view all the answers

    Which herpesvirus is most commonly treated with valacyclovir?

    <p>Herpes simplex virus (C)</p> Signup and view all the answers

    What is the risk of not identifying the main intravenous fluid being infused during treatment?

    <p>Inability to detect allergic reactions. (A)</p> Signup and view all the answers

    What is the primary goal of the antiviral medication prescribed for herpes simplex virus?

    <p>To alleviate symptoms related to the herpes simplex virus (D)</p> Signup and view all the answers

    Which of the following side effects is NOT commonly associated with antiviral treatment for herpes simplex virus?

    <p>Vision loss (A)</p> Signup and view all the answers

    What should clients be instructed to do if experiencing persistent side effects from herpes treatment?

    <p>Contact their healthcare provider (C)</p> Signup and view all the answers

    During the administration of antiviral medications for herpes, clients should be educated on the importance of which of the following?

    <p>Maintaining hydration and taking the medication regularly (B)</p> Signup and view all the answers

    Which of the following is a key component in performing a baseline assessment before starting treatment for herpes simplex virus?

    <p>Evaluating the presence of herpes lesions (A)</p> Signup and view all the answers

    What potential serious side effect should be monitored for during antiviral treatment?

    <p>Thrombotic thrombocytopenic purpura (D)</p> Signup and view all the answers

    What is an important practice regarding sexual activity for clients with herpes simplex virus?

    <p>Using condoms even when sores are not present (D)</p> Signup and view all the answers

    What class of medications is primarily used to treat herpesviruses?

    <p>Guanosine analogs (C)</p> Signup and view all the answers

    Flashcards

    Herpes Medication Function

    Reduces herpes symptoms but does not eliminate the infection or stop virus spread.

    Sexual Activity & Herpes

    Avoid sexual activity with sores or symptoms; always use barrier protection (latex/polyurethane condoms), even without sores.

    Medication Administration

    Take medication with plenty of water, with or without food, on a regular schedule, and stay hydrated.

    Side Effects of Antivirals

    Possible side effects include headaches, fatigue, nausea, and vomiting. Contact provider if persistent or worsening.

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    Guanosine Analogs

    A group of antiviral medications that inhibit viral DNA replication, used in herpes treatment.

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    Common Antiviral Medications

    Acyclovir, ganciclovir, valacyclovir, valganciclovir, and famciclovir are examples of these types of medications.

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    IV Insertion Site Considerations

    Avoid veins with dialysis shunts, AV fistulas, infections, scarring, burns, surgeries, paralysis, recent infiltrations, extravasation, or phlebitis; and sites distal to previous punctures

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    Monitoring Herpes Treatment

    Monitor for side effects (headache, nausea) and therapeutic response (absence of lesions, symptoms) during antiviral therapy.

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    IV Insertion Site Avoidance

    Avoid veins in arms with dialysis shunts, AV fistulas, infections, scarring, burns, surgeries, CVA paralysis side, recent infiltrations, extravasations, phlebitis, or distal to previous punctures.

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    IV Insertion Technique - Equipment

    Prepare the needed tools and supplies for IV insertion.

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    IV Insertion Technique - Aseptic Technique

    Use the necessary precautions (alcohol or chlorhexidine) to prevent infections during IV insertion.

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    IV Insertion Technique - Tourniquet

    Apply a tourniquet 6-8 inches above the intended insertion site, use it for short duration and maintain pressure.

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    IV Insertion Technique - Veins

    Massage veins and/or clench patient's fist as needed for better visibility/access of vein.

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    IV fluids categorized

    Intravenous fluids are classified as isotonic, hypotonic, or hypertonic based on their concentration compared to bodily fluids.

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    Isotonic IV Fluids

    Isotonic IV fluids have the same concentration as blood plasma, therefore they do not significantly shift fluid between cells and blood vessels.

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    Cellulitis

    Infection of the soft connective tissue around IV insertion site caused by poor aseptic practice

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    Right Patient/Drug/Dose/Route/Time

    Key aspect of medication administration—ensuring correct patient, medication, dosage, route, and time.

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    IV Push - Adverse Reactions

    Monitor patients during and after administering IV medications; be prepared for possible adverse reactions and appropriate treatment.

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    Hypotonic Fluid

    A fluid with a lower solute concentration than the cells. Water moves into cells, causing them to swell.

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    Hypertonic Fluid

    A fluid with a higher solute concentration than the cells. Water moves out of cells, causing them to shrink.

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    Valacyclovir MOA

    Valacyclovir, a guanosine analog, interferes with viral DNA replication by inserting into replicating viral DNA, halting viral DNA synthesis and replication.

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    Valacyclovir Side Effects (mild)

    Headache, nausea, skin rash, itching (pruritus).

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    Valacyclovir Side Effects (severe)

    Kidney damage (nephrotoxicity), severe allergic reactions (Stevens-Johnson syndrome, angioedema), neurological issues (agitation, tremors), or even seizures or coma.

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    Herpesviruses

    A group of DNA viruses, including herpes simplex virus, varicella-zoster virus, cytomegalovirus.

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    Valacyclovir

    An antiviral medication used to treat herpesvirus infections.

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    Baseline Assessment (valacyclovir)

    Initial assessment of a patient's symptoms to compare with future assessment of infection: lesion location, pain, itching, drainage.

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    Nursing Consideration - Valacyclovir

    Perform a baseline assessment before administering valacyclovir and compare future assessment results with original report; note current symptoms and their severity to monitor treatment success or alert to side effects.

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    IV Meds: Purpose

    Intravenous medications are used to expand blood volume, correct fluid and electrolyte imbalances, provide nourishment and calories, administer medications, transfuse blood products, and facilitate diagnostic testing.

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    Flumazenil

    Antidote for benzodiazepine overdose.

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    Naloxone (Narcan)

    Antidote for opioid overdose.

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    Protamine Sulfate

    Antidote for heparin overdose.

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    Acetylcysteine (Mucomist)

    Antidote for acetaminophen (Tylenol) overdose.

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    Vitamin K

    Antidote for warfarin (Coumadin) overdose.

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    Hypotonic IV Fluid Examples

    Commonly ordered hypotonic IV fluids include 0.45%NS (half-normal saline), 0.33%NS, and 0.2%NS.

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    Hypotonic IV Contraindications

    Hypotonic fluids are contraindicated in patients with increased intracranial pressure, dehydration, or trauma.

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    Clinical Problems Targeted by Hypotonic Fluids

    Dehydration, hyperglycemic conditions like DKA/HHNS that draw fluid out of cells and into the intravascular space.

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    Clinical Problems Targeted by Hypertonic Fluids

    Cerebral edema, hyponatremia (low sodium in the blood)

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    Study Notes

    IV Insertion Procedure

    • Never choose a vein in an arm with a mastectomy, dialysis shunt, AV fistula, infection, extensive scarring, burns, or surgeries.
    • Prepare equipment using strict aseptic technique (alcohol or chlorhexidine).
    • Use a tourniquet 6-8 inches above the intended site.
    • Massage the vein as needed.

    Setting Up an IV

    • Apply a tourniquet and palpate the vein.
    • Do not leave the tourniquet on for longer than 2 minutes at a time.
    • Practice scrubbing the hub.
    • Use a saline flush to connect the extension tubing.
    • Connect the extension tubing to the correct equipment.

    IV Complications

    • Cellulitis: Inflammation of loose connective tissue around the insertion site.
    • Caused by poor aseptic technique
    • Treated with antibiotics.
    • Red swollen area spreads outward in a circular pattern from the insertion site.

    Medication Administration- 9 Rights

    • Right patient
    • Right drug
    • Right dose
    • Right route
    • Right time
    • Right documentation
    • Right to refuse
    • Right assessment
    • Right education

    Types of IV Fluids

    • Isotonic: Remains within the intravascular compartment (same concentration inside & outside of the cell)
    • Common problems targeted by isotonic fluids: Hypovolemia & hypotension
    • Examples: 0.9% sodium chloride (Normal Saline), Lactated Ringers (LR), D5W(can be isotonic or hypotonic)
    • Hypotonic: Pulls body water into the cells (net inflow – cell expands)
    • Common problems targeted by hypotonic fluids: Dehydrated cells (e.g., DKA/HHNS)
    • Examples: 0.45% NS, 0.33% NS, 0.2% NS
    • Hypertonic: Pulls body water out of the cells (net outflow – cell shrinks)
    • Common problems targeted by hypertonic fluids: Cerebral edema, hyponatremia
    • Examples: D5 0.45% NS, D5 LR, 3% NS, D10W

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    Description

    This quiz covers the essential procedures for intravenous (IV) insertion and the key principles of medication administration, including the 9 Rights of medication. It emphasizes the importance of proper aseptic techniques and awareness of potential complications such as cellulitis. Test your knowledge on best practices and safety measures in IV therapy.

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