Nursing Central Line Care Quiz

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Questions and Answers

What is a critical action a nurse should take for a patient with hypovolemic shock who has a heart rate of 160 BPM and is receiving oxygen?

Apply warm, moist compresses to the affected area

Administer prescribed IV fluids (correct)

Increase the flow rate of the nasal cannula

Assess for signs of right-sided heart failure

Which symptom is NOT associated with left-sided heart failure?

Shortness of breath

Low cardiac output

Jugular venous distention (JVD) (correct)

Pulmonary edema

What is a common side effect of nitroglycerin that patients should expect?

Nausea

Dizziness

Increased heart rate

Headache (correct)

Which statement made by a patient taking nitroglycerin for chronic angina requires further teaching?

I will call my PCP to request a new prescription 3 months after opening the bottle Signup and view all the answers

What underlying condition can cause premature ventricular contractions (PVCs)?

Hypokalemia Signup and view all the answers

What is the primary reason for not administering digoxin if the heart rate is below 60?

It increases the risk of digoxin toxicity. Signup and view all the answers

What is the recommended action for changing the dressing of a central line?

Change every 7 days unless dirty. Signup and view all the answers

Which of the following signs indicates digoxin toxicity?

Yellow/green halos around objects. Signup and view all the answers

What is a common complication associated with coarctation of the aorta?

Poor perfusion in the lower body. Signup and view all the answers

What should be monitored in a patient taking digoxin with concerns for hypokalemia?

Potassium levels. Signup and view all the answers

What is an appropriate nursing intervention for a patient with deep vein thrombosis (DVT)?

Elevate the affected extremity. Signup and view all the answers

What is a contraindication of administering digoxin?

Use of loop diuretics. Signup and view all the answers

What symptom often accompanies a cerebrovascular accident (CVA)?

Slurred speech. Signup and view all the answers

What is the first action to take for a patient with a 10-inch gushing laceration to the head?

Apply pressure to stop the bleeding Signup and view all the answers

Which symptom is NOT associated with acute adrenal insufficiency (Addison's disease)?

Elevated blood pressure Signup and view all the answers

In managing a patient with Addison's disease, which dietary recommendation is advised?

High-protein and carbohydrate diet Signup and view all the answers

What critical electrolyte imbalances might a patient with Addison's disease exhibit?

Hyperkalemia and hyponatremia Signup and view all the answers

If a patient is experiencing signs of corticosteroid under-replacement, which symptoms might they report?

Severe fatigue and weight loss Signup and view all the answers

Which of the following interventions is NOT part of the care for someone undergoing glucocorticoid replacement therapy?

Encourage strenuous exercise Signup and view all the answers

What should a patient with Addison's disease wear to alert medical personnel of their condition?

A MedicAlert bracelet Signup and view all the answers

Which of the following describes a strategy that patients with Addison's disease should follow during times of stress?

Increase glucocorticoid dosage as needed Signup and view all the answers

What is a common cause of an Addisonian crisis?

Stress and trauma Signup and view all the answers

Which of the following is NOT a symptom of an Addisonian crisis?

Elevated heart rate Signup and view all the answers

Which food should be avoided to prevent calcium oxalate kidney stones?

Dark leafy vegetables Signup and view all the answers

What crucial monitoring is necessary for a patient with an Addisonian crisis?

Vital signs and I&O’s Signup and view all the answers

What is the primary function of desmopressin?

Raise blood pressure Signup and view all the answers

What defines nephrolithiasis?

Formation of kidney stones Signup and view all the answers

Which of the following is a risk factor for urolithiasis?

UTIs and prolonged urinary catheterization Signup and view all the answers

In a patient with an AV fistula for dialysis, what should be avoided?

Taking blood pressure on the affected arm Signup and view all the answers

What are the common signs and symptoms of hypokalemia and hyperglycemia?

Polyuria and increased urinary output Signup and view all the answers

What should be done if no stool passes in 6-12 hours in a patient with constipation?

Call the medical doctor Signup and view all the answers

What triggers the symptoms of ulcerative colitis?

Viral or bacterial illness Signup and view all the answers

What distinguishes duodenal ulcer pain from gastric ulcer pain?

Pain that is relieved by eating Signup and view all the answers

When should a patient with hepatic encephalopathy call the provider?

When urine output is less than 450 mL in 24 hours Signup and view all the answers

What is a potential complication of ulcerative colitis?

Pouch formation in colon Signup and view all the answers

Which medication is not commonly used for treating peptic ulcer disease?

Aminosalicylates Signup and view all the answers

At what age is it recommended for patients to start getting colonoscopies?

50 years old Signup and view all the answers

Study Notes

Central Line Care

Change dressing every 7 days unless dirty; use sterile procedure.
Ensure dressing remains dry; avoid submerging in water.
For a triple lumen central venous catheter, flush with normal saline (NS) using a 10 mL syringe after each use.

Coarctation of the Aorta (COA)

Characterized by narrowing of the descending aorta, potentially causing murmurs.
Treatment involves balloon angioplasty.
Assess femoral pulses for lower body perfusion.

Cerebrovascular Accident (CVA)

Often caused by atherosclerosis, hypertension, a-fib, hyperlipidemia, and diabetes mellitus.
Symptoms include one-sided weakness, slurred speech, and arm drift.
High risk of aspiration due to dysphagia.

Digoxin Administration

Toxicity occurs with levels >2, presenting confusion, anorexia, nausea, visual disturbances (yellow/green halos).
Vital signs must be assessed; place patient on cardiac monitor and report findings to PCP.
Low potassium and magnesium levels increase toxicity risk; encourage potassium-rich foods.
Do not administer if heart rate is below 60 in adults or 90 in children.
Educate patients to take apical pulse for one full minute before administration.

Deep Vein Thrombosis (DVT)

Symptoms include redness, swelling, warmth, and pain in legs; avoid pressing on the affected area.
High risk for pulmonary embolism; management includes heparin or Lovenox/Enoxaparin therapy.
Elevate affected extremity, avoid pillows under knees, and apply warm, moist compresses.

Hypovolemic Shock

Caused by blood loss/hemorrhage; management includes bolus fluids.
Be cautious of pulmonary edema; observe for crackles in lung sounds.
Prioritize administration of IV fluids if patient is not on oxygen therapy.

Infective Endocarditis

Inflammatory condition of the endocardium, can stem from streptococcal infections or rheumatic fever.
Symptoms include murmurs, emboli, fever, and decreased cardiac output.

Heart Failure Signs

Jugular Venous Distension (JVD) indicates right-sided heart failure; associated with hypervolemia.
Left-sided heart failure is characterized by pulmonary edema, no JVD present.

Nitroglycerin Use

A vasodilator to improve blood flow; administer sublingually.
Take first dose, and if pain persists after five minutes, call for help and take a second dose (up to three).
Common side effect includes headaches; ensure prescription is within five months of opening.

Premature Ventricular Contractions (PVCs)

Three or more PVCs indicate potential Ventricular Tachycardia (V-tach).
Causes include hypokalemia and hypoxemia; assess peripheral pulses.

Emergency Procedures

For a severe head laceration, first apply pressure to control bleeding, then establish IV access.

Acute Adrenal Insufficiency (Addison's Disease)

Results from high ACTH and low cortisol production; symptoms include bronzed skin, fatigue, and low blood pressure.
Interventions include monitoring vital signs, weights, and electrolyte levels. Long-term glucocorticoid therapy is essential.
Addisonian crisis can occur due to stress, presenting with hyponatremia and severe hypotension.

Kidney Stones

Calcium oxalate stones are most common; avoid certain foods high in calcium and oxalate.
Nephrolithiasis symptoms and management include dietary restrictions and hydration.

Desmopressin for Diabetes Insipidus

Synthetic ADH used to manage symptoms, helping reduce excessive urine output.
Monitor hydration status and electrolyte levels, especially potassium and glucose.

Gastrointestinal Conditions

Inflammatory bowel diseases like ulcerative colitis present with chronic abdominal pain and frequent bowel movements.
Symptoms of peptic ulcer disease include pain that worsens with eating; treated with proton pump inhibitors and lifestyle adjustments.

Patient Education

Recommend colonoscopy starting at age 50, every 10 years.
Monitor for changes like difficulty swallowing post-ERCP to provide appropriate follow-up care.

Hepatic Encephalopathy

Urine output should be at least 720 mL in 24 hours; report output of 450 mL urgently to the provider.

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Description

Test your knowledge on central line care procedures, including dressing changes and flushing techniques for triple lumen central venous catheters. This quiz will cover key assessment points and important nursing interventions related to central line management.