Nursing Management IV Therapy Quiz
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Questions and Answers

What is an appropriate intervention if signs of phlebitis are noted at the IV site?

  • Increase the flow rate to improve circulation at the site
  • Continue IV therapy and monitor the site closely
  • Remove the IV line and notify the healthcare provider (correct)
  • Apply a warm compress and leave the IV in place

How often should the IV site be changed to minimize the risk of infection and phlebitis?

  • Every 72-96 hours (correct)
  • Every 24 hours
  • Every week
  • Every 48-72 hours

When preparing to administer IV therapy, which step is crucial before starting?

  • Obtain a routine blood glucose level
  • Ensure the patient is lying flat
  • Check the expiration date of the IV bag
  • Compare the IV bag with the physician's order (correct)

What should a nurse monitor for if a patient is receiving intravenous therapy for an extended period?

<p>Signs of fluid overload (C)</p> Signup and view all the answers

If an IV bag runs out, what should the nurse do until a new bag is available?

<p>Use 10% dextrose to prevent hypoglycemia (C)</p> Signup and view all the answers

Which test is used to assess the depth of tumor penetration in colorectal cancer?

<p>CT, PET, or MRI (D)</p> Signup and view all the answers

In patients with inflammatory bowel disease, which electrolyte imbalance is likely due to diarrhea?

<p>Decreased sodium (D)</p> Signup and view all the answers

At what age should colorectal cancer screening typically begin?

<p>45 years (A)</p> Signup and view all the answers

Which test can be used to identify obstructions in the bile ducts for cholelithiasis?

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

What type of testing is performed to assess chronic hepatitis infections?

<p>RNA testing (D)</p> Signup and view all the answers

Which laboratory marker could potentially provide false positives for certain types of cancers?

<p>Carcinoembryonic antigen (CEA) (C)</p> Signup and view all the answers

What is the primary nursing intervention for phlebitis?

<p>Stop the infusion and relocate the IV site (B)</p> Signup and view all the answers

Which imaging technique is NOT typically used for diagnosing acute pancreatitis?

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

What is a common laboratory finding in patients with cholecystitis?

<p>Increased AST and ALT (A)</p> Signup and view all the answers

Which symptom is NOT associated with fluid overload?

<p>Severe dehydration (D)</p> Signup and view all the answers

What complication is characterized by the leakage of vesicant fluids into subcutaneous tissue?

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

What condition is indicated by jugular venous distention (JVD)?

<p>Right-sided heart failure (B)</p> Signup and view all the answers

How can you assess for pitting edema in the lower extremities?

<p>Depress the skin over the tibia or medial malleolus (D)</p> Signup and view all the answers

What assessment finding is most indicative of an air embolism?

<p>Sudden onset hypotension (D)</p> Signup and view all the answers

Which nursing intervention is crucial to prevent local infection at an IV site?

<p>Rotate the IV site regularly (D)</p> Signup and view all the answers

What scale is used to evaluate the strength of a pulse during palpation?

<p>0 to 4 scale (D)</p> Signup and view all the answers

What is a common sign of refeeding syndrome in patients receiving TPN?

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

What term describes a vibration felt over an artery due to turbulent blood flow?

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

Which nursing action should be taken immediately if infiltration is suspected at an IV site?

<p>Elevate the affected limb (B)</p> Signup and view all the answers

How should the capillary refill test be performed?

<p>Squeeze a nail bed and release it (B)</p> Signup and view all the answers

What does a bruit indicate when auscultating an artery?

<p>Narrowing or bulging of the artery (C)</p> Signup and view all the answers

What symptom would most likely indicate a severe allergic response to TPN?

<p>Development of a rash (C)</p> Signup and view all the answers

What is the primary purpose of comparing the characteristics of arteries in both extremities?

<p>To assess for symmetry in blood flow (D)</p> Signup and view all the answers

What clinical finding is most often associated with hyperglycemia?

<p>Increased thirst and urination (C)</p> Signup and view all the answers

What is a significant risk factor for fluid overload during IV therapy?

<p>Rapid infusion of large volumes (D)</p> Signup and view all the answers

What is the normal expected return time for color in the nail bed during the capillary refill test?

<p>Less than 2 seconds (C)</p> Signup and view all the answers

What type of information should be gathered about a patient's medication history?

<p>Current and past use of medications (D)</p> Signup and view all the answers

Which of the following is NOT considered a major cardiovascular risk factor?

<p>Regular aerobic exercise (A)</p> Signup and view all the answers

What should patients with heart problems avoid during bowel movements?

<p>Straining (Valsalva maneuver) (D)</p> Signup and view all the answers

What is a common symptom that may indicate a cardiovascular problem during exercise?

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

Which pattern involves assessing a patient's nutritional status related to cardiovascular health?

<p>Nutritional-metabolic pattern (C)</p> Signup and view all the answers

Which assessment is crucial when evaluating a patient's elimination pattern?

<p>Presence of swelling in lower extremities (C)</p> Signup and view all the answers

What is a recommended treatment approach for bursitis?

<p>Rest with immobilization and apply ice (A)</p> Signup and view all the answers

How might acute cardiovascular events affect a patient emotionally?

<p>They may lead to concerns about body image (A)</p> Signup and view all the answers

What type of exercise is considered most beneficial for cardiovascular health?

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

Which statement is true concerning fractures?

<p>Keep the cast dry and report increasing pain (A)</p> Signup and view all the answers

What is a sign of compartment syndrome?

<p>Loss of sensation and pulselessness in late stages (D)</p> Signup and view all the answers

Which dietary recommendation is necessary for managing gout?

<p>Reduce alcohol consumption and limit purine intake (B)</p> Signup and view all the answers

What is the advised daily calcium intake for women aged 51 or older?

<p>1200 mg (A)</p> Signup and view all the answers

Which therapy is NOT considered complementary for osteoarthritis?

<p>Standard pharmaceutical treatments (D)</p> Signup and view all the answers

In the management of Systemic Lupus Erythematosus (SLE), which symptom is monitored?

<p>Signs of bleeding (B)</p> Signup and view all the answers

What is true regarding the use of calcium carbonate?

<p>It is best taken with meals to enhance absorption (C)</p> Signup and view all the answers

Flashcards

IV site care

Assess IV site for signs of phlebitis (redness, warmth, tenderness, swelling) and localized infection (warmth, tenderness, palpable venous cord).

IV fluid bag check

Compare the IV bag label with the doctor's order before administration to ensure accuracy.

IV Tubing Changes

Replace IV tubing every 96 hours to prevent infections.

IV solution monitoring

Observe IV solution for color changes, particulate matter, clarity, or fat emulsion separation; return to pharmacy if abnormal.

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Glucose monitoring

Check blood glucose levels every 4-6 hours for patients receiving intravenous fluids, especially if there are complications.

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Subjective Data

Information gathered directly from the patient through their verbal reports, descriptions, and feelings; includes personal health history, symptoms, and concerns.

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History of Present Illness

A detailed account of the patient's current health problem, including its onset, progression, characteristics, and any associated symptoms.

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Health History

A summary of the patient's past health conditions, including surgeries, hospitalizations, medications, and significant family medical history.

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Cardiovascular Risk Factors

Conditions or habits that increase the chances of developing heart disease or stroke, such as high cholesterol, hypertension, smoking, and diabetes.

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Nutrition Assessment

Evaluating the patient's dietary intake and weight history to identify potential nutritional deficiencies or excesses that could affect cardiovascular health.

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Elimination Patterns

Assessing the patient's bowel movements and urination patterns for signs of fluid retention, diuretic effects, or complications related to cardiovascular medications.

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Activity-Exercise Pattern

Assessing the patient's regular exercise habits and any limitations or symptoms experienced during activity, which can reveal potential cardiovascular issues.

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Sleep-Rest Pattern

Assessing the patient's sleep quality and duration, as poor sleep can contribute to cardiovascular problems.

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Jugular Venous Distention (JVD)

Distention and prominent pulsations of the neck veins, often seen in right-sided heart failure.

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Pitting Edema

Indentation of the skin that remains after pressure is applied, indicating fluid buildup in the tissues.

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Pulse Grading Scale

A scale used to rate the force of a pulse, ranging from 0 (absent) to 4+ (bounding).

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Thrill

A palpable vibration felt over an artery, indicating turbulent blood flow.

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Capillary Refill

A test of peripheral blood flow, where a blanched nail bed should return to its usual color within 2 seconds.

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Bruit

A buzzing or humming sound heard over an artery, indicating turbulent blood flow.

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Right-Sided Heart Failure (RSHF)

A condition where the right ventricle can't pump blood effectively, leading to fluid buildup in the body.

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Apply Knowledge of Cardiovascular Medications

Understand how cardiovascular medications work and their impact on patients with heart conditions.

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Phlebitis

Inflammation of the inner layer of a vein, often caused by irritation from an IV catheter, antibiotics, or bacteria. It can be identified by redness, pain, swelling, warmth, and a hardened vein.

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IV Infiltration

Leakage of IV fluids into the surrounding tissue outside of the vein. Non-vesicant fluids generally don't cause tissue damage.

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IV Extravasation

Leakage of vesicant fluids (harmful to tissue) outside the vein into the surrounding tissue. It can cause tissue damage, blistering, pain, swelling, necrosis, and even compartment syndrome.

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Fluid Overload

An excessive amount of fluid in the body, often caused by rapid IV infusions or excess fluid intake. Signs include edema, confusion, distended neck veins (JVD), lung congestion, increased blood pressure, and shortness of breath.

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Air Embolism

Air entering a vein, usually due to improper IV tubing priming. It can cause sudden onset of hypotension, tachycardia, dyspnea, and loss of consciousness.

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Refeeding Syndrome

Metabolic complications that can occur in severely malnourished individuals when they are reintroduced to food or nutrients too rapidly.

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Hyperglycemia

High blood sugar levels

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Hypoglycemia

Low blood sugar levels

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Infection/Sepsis

A serious infection that can occur in the bloodstream, often associated with IV catheters or central lines.

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Feeding Syndrome

Metabolic and electrolyte disturbances that can occur in severely malnourished individuals who are rapidly re-fed.

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Bursitis

Inflammation of a bursa, a fluid-filled sac that cushions joints and tendons.

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Fracture care: DO

After getting wet, dry the cast thoroughly. Report increasing pain despite elevation, ice, and analgesia. Report swelling with pain and discoloration or movement. Report burning or tingling under the cast. Report sores or foul odor under the cast.

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Fracture care: DO NOT

Do not elevate if compartment syndrome is suspected. Do not get the plaster cast wet. Do not remove padding. Do not insert objects inside the cast. Do not bear weight for 48 hours. Do not cover the cast with plastic for a prolonged period.

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Compartment Syndrome

A serious condition that occurs when pressure builds up in a muscle compartment, restricting blood flow and damaging nerves and tissues.

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Osteoporosis

A condition characterized by weak and brittle bones due to decreased bone density.

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Calcium intake for Osteoporosis

Women 19-50 and men 19-70 need 1000mg/day, women 51+ and men 71+ need 1200mg/day.

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Gout Prevention

Monitor serum uric acid levels, limit alcohol and purine-rich foods, maintain adequate urine volume, and manage weight.

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CBC and iron studies

Blood tests used to assess overall health, including red blood cell count, white blood cell count, platelet count, and iron levels. These tests help diagnose infections, anemia, and other blood-related conditions.

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Electrolyte levels

Measures the concentration of essential minerals in the blood, including sodium, potassium, chloride, and magnesium. These electrolytes play vital roles in maintaining fluid balance, nerve function, and muscle contraction.

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Stool examination and culture

Examining a stool sample under a microscope to identify blood, parasites, bacteria, or other abnormalities that may indicate infection, digestive problems, or cancer.

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Small bowel follow-through

A diagnostic procedure that uses X-rays to visualize the small intestine. The patient drinks a contrast drink, which helps the intestines show up on the images.

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Colonoscopy

A procedure using a flexible, lighted scope to examine the entire colon and rectum. It allows for tissue biopsies and removal of polyps.

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Sigmoidoscopy

A procedure using a flexible, lighted scope to examine the sigmoid colon and rectum. It allows for tissue biopsies and removal of polyps.

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Carcinoembryonic antigen (CEA)

A protein found in the blood that can be elevated in some types of cancer, particularly colorectal cancer. However, it can also be elevated in other conditions, leading to false positives.

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Liver function tests

Blood tests that measure the activity of enzymes and proteins produced by the liver. They can indicate liver damage, inflammation, or disease.

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Study Notes

Nursing Management for Patients Receiving IV Therapies

  • Assess the IV site each time it's accessed, checking for signs of phlebitis (inflammation). Remove the IV if warmth, tenderness, or a palpable cord is present.
  • Flush saline locks every shift or as needed.
  • Perform hand hygiene before and after each procedure.
  • Verify that the IV bag matches the order.
  • Change IV sites every 72-96 hours to reduce infection risk.
  • Change IV tubing every 96 hours.
  • Use appropriate needle connectors and tubing.
  • If the IV bag runs out prematurely, use 10% dextrose to prevent a drop in blood sugar.
  • Educate patients about proper IV care and the importance of recognizing signs of complications.

Patient Teaching for IV Therapy

  • Refrigerate IV solutions for 30 minutes before use, and they are good for 24 hours at room temperature.
  • Follow proper aseptic procedures to reduce infection risk.
  • Teach the patient to check for any tubing obstructions.
  • Teach the patient to report any perceived kinks or obstructions in the IV tubing.
  • Inspect frequently the IV solution for color changes, leaks, and particulate matter.
  • Clarify any issues about clarity of infused solutions, or clumps of fat emulsions that need to be reported to the pharmacy.
  • Increase the flow rate slowly to avoid refeeding syndrome.
  • Monitor blood glucose every 4-6 hours.

IV Complications

  • Phlebitis: Inflammation of the inner vein. Signs include redness, pain, swelling, warmth.
  • Infiltration: Leakage of IV fluids into the surrounding tissue. Signs include swelling, coolness, and leaking near the IV site.
  • Extravasation: Leakage of vesicant fluids (e.g., chemo drugs) into the tissue. Signs may include blistering.
  • Fluid overload: Too much IV fluid infused. Signs can involve swelling, confusion, shortness of breath (dyspnea) and increased blood pressure.

Local Infections

  • Local Infection: Caused by poor aseptic techniques or prolonged use of the same IV site. Signs include redness, swelling, fever, and warmth.
  • Nursing Interventions: Change the IV catheter site and immediately report if signs of infection appear.
  • Fluid Overload: Excessive fluid infused. Signs involve puffiness (edema), confusion, shortness of breath, and elevated blood pressure.

Air Embolism

  • Air in the vein: Caused by improper priming, or air introduced into the tubing. Signs include sudden onset, hypotension, tachycardia, and shortness of breath.
  • Nursing Interventions: Position the patient on their left side, immediately notify the medical team, assess the patient frequently, and monitor vital signs to spot any complications.

Other Complications (PN, TPN)

  • Infection/sepsis: Signs include fever, chills, and reduced blood pressure; requires prompt medical intervention or hospitalization.
  • Hyperglycemia: High blood glucose. Signs involve frequent urination, excessive thirst, and possibly other symptoms depending on the cause.
  • Hypoglycemia: Low blood glucose. Signs involve clammy skin, dizziness, confusion, fatigue, weakness, shakiness, and possibly other symptoms depending on the underlying cause.
  • Refeeding syndrome: Serious complications in undernourished patients, who start receiving fluids or nutrition too quickly,.

Additional Information in the Text

  • Subjective data collection during patient assessment
  • History of present illness
  • Focus on cardiovascular and vascular disorders, including patient's descriptions of their symptoms, and past medical history from patient interview.
  • Assessment of various body systems: health history, medications, surgeries, health management lifestyle, nutritional-metabolic status, elimination (bowel/bladder) patterns, activity-exercise, sleep-rest, cognitive-perceptual, self-perception–self-image, role-relationship, sexuality-reproductive, and coping-stress tolerance.
  • Review of pertinent health history to identify risk factors and current health status.

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Description

Test your knowledge on nursing management practices for patients receiving IV therapies. This quiz covers essential protocols such as assessing IV sites, maintaining aseptic technique, and patient education for IV care. Ensure you understand how to minimize complications and effectively manage IV therapy.

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