IV Therapy and Fluid Replacement Quiz
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Questions and Answers

What solution is typically used for blood transfusions?

  • Dextran
  • Lactated Ringer's
  • Normal Saline Solution (correct)
  • Five Percent Dextrose and Water

Which of the following is NOT a common indication for administering an intravenous (IV) infusion?

  • Administering antibiotics
  • Diluting poisons in the blood
  • Replacing electrolytes
  • Providing a source of oxygen (correct)

Which IV solution is considered isotonic and contains 5 grams of dextrose per 100 ml of water?

  • Lactated Ringer's
  • Plasma Protein Fraction
  • Normal Saline Solution
  • Five Percent Dextrose and Water (correct)

What is the primary function of a CVAD?

<p>To administer therapies and medications directly into the bloodstream (D)</p> Signup and view all the answers

Which of the following is an example of a colloid solution used in fluid replacement therapy?

<p>Plasma Protein Fraction (D)</p> Signup and view all the answers

What is the primary indication for using Lactated Ringer's solution?

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

Which of the following is NOT a type of fluid used in fluid replacement therapy?

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

What is the primary purpose of venipuncture?

<p>To obtain blood samples for diagnostic purposes (B)</p> Signup and view all the answers

Which of the following is a factor that can contribute to inadequate catheter length and insertion depth for a central venous access device (CVAD)?

<p>Patient's body habitus (A)</p> Signup and view all the answers

Which of the following conditions can lead to secondary intravascular malposition of a CVAD, also known as tip migration?

<p>Congestive heart failure (B)</p> Signup and view all the answers

What is the primary purpose of documentation related to intravenous therapy?

<p>All of the above (D)</p> Signup and view all the answers

Which of the following details should be documented when initiating IV therapy?

<p>All of the above (D)</p> Signup and view all the answers

What is a possible consequence of undiagnosed congenital venous abnormalities in relation to CVAD placement?

<p>Increased risk of air or thrombotic emboli (D)</p> Signup and view all the answers

Which of the following factors can contribute to secondary intravascular malposition of a CVAD, specifically tip migration?

<p>Positive pressure ventilation (B)</p> Signup and view all the answers

Why is proper documentation of IV therapy crucial?

<p>All of the above (D)</p> Signup and view all the answers

What is the role of cardiac imaging studies in the context of CVAD placement?

<p>All of the above (D)</p> Signup and view all the answers

What is the recommended frequency for changing a transparent semi-permeable (TSM) dressing on a CVAD site?

<p>Every 7 days (C)</p> Signup and view all the answers

A white, shiny appearance at or above an IV insertion site could indicate which of the following?

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

Which of the following conditions is characterized by edema, redness, pain, and irritation at an IV site?

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

When is a gauze dressing preferred over a TSM dressing?

<p>When the patient is diaphoretic (B)</p> Signup and view all the answers

What is the primary purpose of the Chlorhexidine Gluconate (CHG) in the Tegaderm Transparent Dressing?

<p>To prevent bacterial growth (B)</p> Signup and view all the answers

A blood return can be obtained from an IV site even if the fluid is leaking into the tissues. What is the reason for this?

<p>The IV catheter may have punctured the posterior wall of the vein (A)</p> Signup and view all the answers

When is a gauze dressing not considered a gauze dressing, according to the provided text?

<p>When it's used to secure a non-coring needle in an implanted port (B)</p> Signup and view all the answers

According to the provided text, what are the possible causes of cellulitis at an IV site?

<p>Irritation from the catheter, extravasation of irritating medications, and lack of aseptic technique (A)</p> Signup and view all the answers

What is the maximum infusion pressure recommended for intravenous therapy to avoid damage to blood vessels?

<p>25 psi (D)</p> Signup and view all the answers

Which technique is recommended for maintaining the patency of a catheter?

<p>Pulsatile Flush Technique (C)</p> Signup and view all the answers

When should a needless connector be changed in intravenous therapy?

<p>If there is blood or debris within it (C)</p> Signup and view all the answers

What type of device is a stopcock in intravenous therapy?

<p>A valve that controls fluid flow (D)</p> Signup and view all the answers

What is the primary purpose of in-line filters in intravenous therapy?

<p>To ensure the purity of the solution (C)</p> Signup and view all the answers

What is a crucial action to take when performing a positive pressure technique during flushing?

<p>Clamp the line while flushing the last 0.5 mL (D)</p> Signup and view all the answers

How often should a needless connector be changed at a minimum?

<p>No more frequently than every 96 hours (B)</p> Signup and view all the answers

What role does a port protector serve in intravenous therapy?

<p>As a disinfectant prior to access (D)</p> Signup and view all the answers

Which of the following details should NOT be included when labeling a sample?

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

Why is it important to invert blood collection tubes immediately after filling?

<p>To mix the blood with preservatives (B)</p> Signup and view all the answers

What is a recommended action to encourage hemostasis after drawing blood?

<p>Keep the arm straight (A)</p> Signup and view all the answers

What should be done immediately after disposing of sharps?

<p>Wash hands (D)</p> Signup and view all the answers

What is the consequence of not following the order of draw during blood collection?

<p>Contamination of samples leading to false results (B)</p> Signup and view all the answers

What should be done with the tray after completing a blood draw?

<p>Wipe it with a disinfectant wipe (A)</p> Signup and view all the answers

Which of these options describes a factor that represents a pre-analytical variable?

<p>Incorrect labeling of the sample (A)</p> Signup and view all the answers

What is the purpose of placing a specimen in a leak-proof receptacle after collection?

<p>To reduce contamination risks (A)</p> Signup and view all the answers

What does the term Catheter-Associated Bloodstream Infection (CABSI) encompass?

<p>Bloodstream infections from both peripheral and central vascular access devices. (A)</p> Signup and view all the answers

Which criterion accurately confirms a catheter-related bloodstream infection (CR-BSI)?

<p>Isolation of the same organism from a peripheral vein and catheter blood culture. (B)</p> Signup and view all the answers

Which of these could NOT be a source of a catheter-associated bloodstream infection (CABSI)?

<p>Infection from a skin lesion not related to catheter use. (B)</p> Signup and view all the answers

What is the primary focus of CLABSI surveillance definitions?

<p>Monitoring primary bloodstream infections related to a central line. (D)</p> Signup and view all the answers

What potentially affects the accuracy of CLABSI incidence reporting?

<p>Identification of infections unrelated to the central line. (D)</p> Signup and view all the answers

What is the minimum requirement for an organism to confirm a positive catheter tip culture?

<p>A growth of at least 15 colony forming units (CFUs). (C)</p> Signup and view all the answers

What preventative strategy is essential for maintaining catheter integrity?

<p>Routine monitoring of catheter insertion sites. (A)</p> Signup and view all the answers

What differentiates a central line-associated bloodstream infection (CLABSI) from other bloodstream infections?

<p>It must develop in conjunction with a central line within the past 48 hours. (C)</p> Signup and view all the answers

Flashcards

Central Venous Access Device (CVAD)

A thin, flexible tube inserted into a vein to provide therapy directly into the bloodstream.

Venipuncture

A procedure to draw blood for testing.

Intravenous (IV) Infusion

Administering fluids, medications, or other substances into the bloodstream via a vein.

Normal Saline (NSS 0.9% NaCl)

A type of IV fluid that is isotonic, meaning it has the same concentration of electrolytes as blood plasma.

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Ringer's Solution or Lactated Ringer's (LR)

A type of IV fluid that is also isotonic, like normal saline, but contains electrolytes similar to those found in plasma.

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Five Percent Dextrose and Water (D5W)

An isotonic IV solution containing dextrose (glucose).

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Infusion Flow Rate

The rate at which an IV fluid is administered.

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Vascular Access Device (VAD)

A device used to access the bloodstream.

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What is infiltration?

A condition where fluid leaks from the IV into surrounding tissues, causing swelling and blanching.

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What is cellulitis?

An inflammation of the subcutaneous tissue, often caused by irritation, extravasation, poor technique, or contaminated equipment.

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How often should a TSM dressing be changed?

The transparent dressing should be changed every 7 days.

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How often should a gauze dressing be changed?

The gauze dressing should be changed every 48 hours (2 days) or if it becomes loose or soiled.

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What is the dressing change frequency for a gauze dressing covered by a transparent dressing?

A transparent dressing applied over a gauze dressing should be changed every 48 hours.

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What is the purpose of IV Tegaderm Transparent Dressing?

Used to cover and protect catheter sites and secure devices to the skin.

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What is the purpose of IV Tegaderm with Chlorhexidine Gluconate?

Contains Chlorhexidine Gluconate (CHG), an anti-microbial and anti-fungal antiseptic that prevents bacterial growth on the skin.

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What should be assessed at an IV site?

The insertion site should be assessed for pain, tenderness, discomfort, swelling, blanching, and signs of cellulitis.

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Prefilled Normal Saline Syringe

A 10 mL syringe filled with normal saline. It helps to avoid excessive pressure that can cause catheter rupture, especially when using syringes smaller than 10 mL.

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Infusion Pressure Limit

Maximum pressure that should be applied during flushing to avoid damaging the catheter or blood vessels.

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Pulsatile Flush Technique

A technique used to maintain catheter patency by creating turbulence in the lumen using a syringe filled with saline.

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Positive Pressure Technique

A procedure that involves clamping the IV line while flushing with saline to prevent blood from flowing back into the catheter when disconnected.

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Needleless Connector

A connector on a central venous catheter that allows for needleless access.

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Stopcock

A valve that controls the flow of fluids through IV tubing, allowing you to switch between solutions.

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In-line Filter

A filter inserted into IV tubing that removes contaminants from solutions, ensuring purity for the patient.

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Port Protector

A protective cap used to disinfect IV connectors, ensuring hygiene and preventing contamination.

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Catheter-Associated Bloodstream Infection (CABSI)

A blood infection associated with any type of catheter, including peripheral intravenous catheters (PIVCs) and central vascular access devices (CVADs).

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Catheter-Related Bloodstream Infection (CR-BSI)

A blood infection definitively linked to a catheter, where the same organism is found in both a blood culture and the catheter tip culture, with a higher quantity in the tip culture.

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Central Line-Associated Bloodstream Infection (CLABSI)

A blood infection occurring in a patient who had a central line within the 48 hours before the infection.

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Catheter Insertion/Dwell Time

A possible source of CABSI that occurs when microorganisms migrate down the catheter tract during insertion or dwell time.

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Catheter Hub/Lumen Contamination

A possible source of CABSI that occurs during routine administration or manipulation at the catheter hub/lumen.

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Endogenous Microorganisms

A possible source of CABSI that occurs when endogenous microorganisms within the blood multiply and cause an infection.

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Infusate Contamination

A possible source of CABSI that occurs when contaminated infusates introduce microbes into the bloodstream.

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Catheter Damage Prevention

Strategies to prevent damage to catheters, thus reducing the risk of complications and infections.

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Factors Affecting CVAD Placement

Conditions that can affect catheter placement or function, including patient position changes, respiratory movement, body habitus, and congenital or acquired venous abnormalities.

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Secondary Intravascular Malposition (Tip Migration)

Movement of the tip of a CVAD after insertion, often caused by changes in intrathoracic pressure, original tip placement, or DVT.

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Importance of IV Therapy Documentation

Accurate documentation of IV therapy provides a legal record and ensures continuity of care. It includes information about insertion, initiation, maintenance, solution changes, and discontinuation.

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IV Cannula Gauge

The gauge of the cannula refers to its diameter: smaller gauge means larger diameter.

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IV Cannula Site and Location

Recording the specific location of the IV cannula, including the vein and anatomical landmark.

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Documenting IV Therapy Initiation

Documenting the date and time of IV therapy initiation, including the type of solution and prescribed flow rate or medication.

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IV Site Condition Assessment

Regular assessment of the IV site for signs of complications, such as redness, swelling, or infiltration.

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IV Tubing Set Change Documentation

Documenting the procedures for changing the IV tubing set, including date and time.

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Order of Draw for Blood Tubes

The order in which blood tubes should be filled to prevent additives from contaminating each other.

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Mixing of Blood Tubes

Properly mixing blood in tubes after collection helps ensure accuracy in tests.

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Pre-Analytical Variables

These are factors that can impact the quality of a blood sample before testing.

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Proper Blood Sample Labeling

Labeling includes patient name, hospital number, date of birth, and phlebotomist's initials.

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Safe Disposal of Sharps

Sharps, like needles, should be disposed of in puncture-resistant containers to prevent injuries.

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Inverting Blood Tubes

Immediately after drawing blood, tubes are inverted gently several times to mix blood with additives.

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Specimen Placement

Specimens should be placed in leak-proof containers to prevent contamination and spills.

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Post-Venipuncture Care

The arm should be elevated to help stop bleeding, but bending the arm should be avoided as it can cause bruising.

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Study Notes

IV Therapy and Phlebotomy

  • This document covers intravenous therapy and phlebotomy procedures.
  • It details the anatomy and physiology of vascular vessels, including veins, arteries and the layers of the vessel wall.
  • It outlines different types of intravenous fluids, including indications for their use.
  • It details different vascular access devices (VADs), including peripheral intravenous catheters (PIVs), midline catheters, central venous catheters (CVADs), non-tunneled and tunneled CVADs and implanted ports, and their uses and maintenance.
  • It covers the process of intravenous cannulation, including site selection, site preparation, cannula selection, and flushing procedures and indications.
  • It discusses intravenous therapy maintenance procedures including monitoring and assessment, dressing changes, and flushing techniques.
  • It details complications of vascular access devices, including phlebitis, infiltration, and extravasation.
  • It discusses the importance of proper documentation in intravenous therapy and includes examples of documentation required.
  • It also discusses guidelines for phlebotomy technique, including patient identification, and site selection.
  • It details procedures for blood collection, including handling and transport, and the types of add-on devices used in IV therapy.
  • It includes guidelines for infection prevention procedures and discusses the complications of blood collection, such as hematoma, nerve damage and pain, and infection.
  • It gives information about how to classify different types of central line related bloodstream infections.
  • It details the different types of vascular access devices (VADs) and the situations in which each might be used, along with their maintenance.
  • The document includes flow rate calculations for intravenous infusions.
  • There is a table of commonly used intravenous solutions, including normal saline (0.9% NaCl), Ringer's solution (Lactated Ringer's), and 5% dextrose in water (D5W), and descriptions of each.
  • The document provides details regarding the collection of blood culture specimens, including appropriate materials and devices.
  • A table describes types of catheters, their gauge, colour and indications.
  • Specific guidelines for patient preparation, including patient identification and site selection for venipuncture, are also included.
  • The document provides a detailed procedure for venipuncture.
  • It discusses pre-analytical variables, including the correct sequence for filling blood tubes.
  • It covers the importance of using the proper devices and materials, including a correct order of draw (for filling tubes), minimum fill levels, and recognizing hemolysis and possible causes.
  • It includes guidance for flushing and locking vascular access devices, including heparin lock solutions for vascular access devices (for example, peripherally inserted central catheters)

Additional Information

  • The document is reviewed periodically and updated as needed.
  • The document references multiple sources and organizations related to the care of IV patients.

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IV Therapy Manual - Final 2023 PDF

Description

Test your knowledge on intravenous (IV) therapy and fluid replacement solutions. This quiz covers common IV solutions, indications for use, and procedures involved in blood transfusions and catheter placement. Perfect for nursing students and healthcare professionals.

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