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Questions and Answers
What potential adverse outcome is commonly linked to phlebitis?
What potential adverse outcome is commonly linked to phlebitis?
According to the Infusion Nurses Society Visual Infusion Phlebitis Scale, what clinical criteria defines a Grade 2 phlebitis?
According to the Infusion Nurses Society Visual Infusion Phlebitis Scale, what clinical criteria defines a Grade 2 phlebitis?
What is the primary difference between infiltration and extravasation?
What is the primary difference between infiltration and extravasation?
Which clinical manifestation is indicative of infiltration at an IV site?
Which clinical manifestation is indicative of infiltration at an IV site?
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What immediate action should a nurse take upon suspecting an extravasation during an infusion?
What immediate action should a nurse take upon suspecting an extravasation during an infusion?
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Which of the following complications is specifically associated with central venous infusion therapy?
Which of the following complications is specifically associated with central venous infusion therapy?
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During central line insertion, which of the following vascular complications might occur?
During central line insertion, which of the following vascular complications might occur?
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What pulmonary complication is directly associated with central line placement?
What pulmonary complication is directly associated with central line placement?
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For what condition would a patient most likely require a transfusion of fresh frozen plasma?
For what condition would a patient most likely require a transfusion of fresh frozen plasma?
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A patient with neutropenia and a persistent infection despite antibiotic treatment may benefit from a transfusion of which blood component?
A patient with neutropenia and a persistent infection despite antibiotic treatment may benefit from a transfusion of which blood component?
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What is the primary reason blood components are stored according to strict guidelines?
What is the primary reason blood components are stored according to strict guidelines?
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Before obtaining a blood component from the laboratory, what critical information must be confirmed?
Before obtaining a blood component from the laboratory, what critical information must be confirmed?
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A patient with blood type A requires a platelet transfusion. According to ABO compatibilities, which donor blood types are suitable?
A patient with blood type A requires a platelet transfusion. According to ABO compatibilities, which donor blood types are suitable?
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When crystalloid solutions are not adequate for volume expansion, which blood component is most appropriate?
When crystalloid solutions are not adequate for volume expansion, which blood component is most appropriate?
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A physician orders a blood transfusion for a patient experiencing symptomatic anemia. Which blood component is most appropriate for this condition?
A physician orders a blood transfusion for a patient experiencing symptomatic anemia. Which blood component is most appropriate for this condition?
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A patient with disseminated intravascular coagulation (DIC) is most likely to require which blood component?
A patient with disseminated intravascular coagulation (DIC) is most likely to require which blood component?
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What is a primary disadvantage associated with centrally-inserted venous access devices that requires vigilant monitoring?
What is a primary disadvantage associated with centrally-inserted venous access devices that requires vigilant monitoring?
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What is the main purpose of specifying lumens as proximal, medial, or distal in multiple-lumen central venous catheters?
What is the main purpose of specifying lumens as proximal, medial, or distal in multiple-lumen central venous catheters?
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What is a key characteristic of tunneled catheters that contributes to their stability and infection resistance?
What is a key characteristic of tunneled catheters that contributes to their stability and infection resistance?
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What is the primary benefit of implanted ports (Mediports) compared to other types of central venous access devices?
What is the primary benefit of implanted ports (Mediports) compared to other types of central venous access devices?
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Why is the upper chest wall considered the preferred site for implanted port reservoir placement?
Why is the upper chest wall considered the preferred site for implanted port reservoir placement?
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What is the key feature of noncoring needles used to access implanted ports, and why is it important?
What is the key feature of noncoring needles used to access implanted ports, and why is it important?
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After accessing an implanted port with a noncoring needle, what are the essential maintenance requirements to ensure its functionality?
After accessing an implanted port with a noncoring needle, what are the essential maintenance requirements to ensure its functionality?
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In what type of setting are tunneled catheters typically inserted, and why?
In what type of setting are tunneled catheters typically inserted, and why?
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Why is the transfusion of whole blood considered rare in modern medical practices?
Why is the transfusion of whole blood considered rare in modern medical practices?
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What is the primary reason for performing ABO blood typing before a blood transfusion?
What is the primary reason for performing ABO blood typing before a blood transfusion?
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What is the significance of the Rh factor in blood transfusions?
What is the significance of the Rh factor in blood transfusions?
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Why is it crucial for healthcare providers to perform independent identification and specimen labeling during blood sample collection?
Why is it crucial for healthcare providers to perform independent identification and specimen labeling during blood sample collection?
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Which of the following is a potential consequence of HLA incompatibility in blood transfusions and organ transplants?
Which of the following is a potential consequence of HLA incompatibility in blood transfusions and organ transplants?
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Which blood component is LEAST likely to be administered as a whole blood transfusion, but rather as a separated component?
Which blood component is LEAST likely to be administered as a whole blood transfusion, but rather as a separated component?
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What is the rationale behind administering specific blood 'component' rather than whole blood?
What is the rationale behind administering specific blood 'component' rather than whole blood?
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Why are volunteer donors and multiple screening tests considered 'modern practices' that contribute to the current blood's safety?
Why are volunteer donors and multiple screening tests considered 'modern practices' that contribute to the current blood's safety?
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Why is it necessary for the nurse to verify adequate IV access and availability of transfusion supplies before blood component retrieval from the lab?
Why is it necessary for the nurse to verify adequate IV access and availability of transfusion supplies before blood component retrieval from the lab?
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What information must be verified by two licensed staff members before initiating a blood product transfusion?
What information must be verified by two licensed staff members before initiating a blood product transfusion?
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According to the National Quality Forum, what type of event is a mismatched blood transfusion considered?
According to the National Quality Forum, what type of event is a mismatched blood transfusion considered?
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Immediately prior to starting a blood transfusion, what patient assessment is most crucial?
Immediately prior to starting a blood transfusion, what patient assessment is most crucial?
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What should the nurse do immediately following observation of a suspected acute hemolytic reaction?
What should the nurse do immediately following observation of a suspected acute hemolytic reaction?
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Why is patient identification considered the most important process in the safe administration of blood components?
Why is patient identification considered the most important process in the safe administration of blood components?
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What is the recommended frequency of patient assessments during a blood transfusion, after the initial 15 minutes?
What is the recommended frequency of patient assessments during a blood transfusion, after the initial 15 minutes?
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Which action best demonstrates the nurse's role in addressing the anxiety a patient may experience prior to a blood transfusion?
Which action best demonstrates the nurse's role in addressing the anxiety a patient may experience prior to a blood transfusion?
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What is the primary reason blood products not fully infused within a 4-hour period should be returned to the laboratory?
What is the primary reason blood products not fully infused within a 4-hour period should be returned to the laboratory?
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What is the purpose of the 170- to 260-micron filter in the administration set used for packed RBCs?
What is the purpose of the 170- to 260-micron filter in the administration set used for packed RBCs?
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What is the purpose of priming the administration set tubing with 0.9% sodium chloride before a blood transfusion?
What is the purpose of priming the administration set tubing with 0.9% sodium chloride before a blood transfusion?
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Why is the intravenous route for providing nutrition only indicated when oral or enteral routes are not possible?
Why is the intravenous route for providing nutrition only indicated when oral or enteral routes are not possible?
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What is the primary carbohydrate source used in TPN solutions to provide energy for the body?
What is the primary carbohydrate source used in TPN solutions to provide energy for the body?
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Why might lipid emulsions be included in a TPN solution or infused separately?
Why might lipid emulsions be included in a TPN solution or infused separately?
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Which healthcare professional is LEAST likely to be involved in the interprofessional approach to TPN program design?
Which healthcare professional is LEAST likely to be involved in the interprofessional approach to TPN program design?
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Why are total parenteral nutrition solutions prepared in the pharmacy under special conditions?
Why are total parenteral nutrition solutions prepared in the pharmacy under special conditions?
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Flashcards
Phlebitis
Phlebitis
Inflammation of a vein that can lead to complications.
Infusion Nurses Society Scale
Infusion Nurses Society Scale
A scale used to grade the severity of phlebitis.
Grade 0
Grade 0
No clinical symptoms of phlebitis.
Grade 1
Grade 1
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Extravasation
Extravasation
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Vesicants
Vesicants
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Complications of Central Lines
Complications of Central Lines
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Assessment Intervals
Assessment Intervals
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Dislodgement of CVAD
Dislodgement of CVAD
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Multiple-lumen catheter
Multiple-lumen catheter
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Lumens in catheters
Lumens in catheters
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Tunneled catheters
Tunneled catheters
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Dacron cuff
Dacron cuff
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Implanted ports
Implanted ports
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Noncoring needle
Noncoring needle
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Central vasculature
Central vasculature
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Blood donor screening
Blood donor screening
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Component therapy
Component therapy
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ABO blood type
ABO blood type
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Hemolytic transfusion reaction
Hemolytic transfusion reaction
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Rh factor
Rh factor
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HLA system
HLA system
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Patient identification
Patient identification
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Blood component benefits
Blood component benefits
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Packed Red Blood Cells
Packed Red Blood Cells
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Fresh Frozen Plasma
Fresh Frozen Plasma
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Indications for Platelet Transfusion
Indications for Platelet Transfusion
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Granulocyte Transfusion
Granulocyte Transfusion
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Albumin Indication
Albumin Indication
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Blood Component Storage
Blood Component Storage
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ABO Compatibility for RBCs
ABO Compatibility for RBCs
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Informed Consent for Transfusion
Informed Consent for Transfusion
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IV access confirmation
IV access confirmation
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Two-person verification
Two-person verification
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ABO and Rh compatibility
ABO and Rh compatibility
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Transfusion reaction observation
Transfusion reaction observation
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Acute hemolytic reaction
Acute hemolytic reaction
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Baseline patient assessment
Baseline patient assessment
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Post-transfusion assessment
Post-transfusion assessment
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Blood Product Infusion Time
Blood Product Infusion Time
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Blood Filter Type
Blood Filter Type
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IV Catheter Gauge for Blood
IV Catheter Gauge for Blood
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Total Parenteral Nutrition (TPN)
Total Parenteral Nutrition (TPN)
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Macronutrients in TPN
Macronutrients in TPN
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Proteins in TPN
Proteins in TPN
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Lipid Emulsions in TPN
Lipid Emulsions in TPN
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Interprofessional TPN Approach
Interprofessional TPN Approach
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Study Notes
Introduction to Infusion Therapy
- Infusion therapy is delivered across various healthcare settings, including hospitals, extended care facilities, clinics, and patient homes.
- Advancements in techniques, equipment, and technologies are constantly improving patient outcomes and reducing costs.
- Specialized "IV resource teams" are showing better outcomes and lower costs.
- Generalist nurses need current knowledge and competency in infusion therapy.
Infusion Nurses Society (INS)
- The INS has established evidence-based practice standards for infusion therapy (revised 2021).
- Standards are based on ranked evidence.
- The INS provides a national certification program called Certified Registered Nurse Infusion (CRNI©).
Patient Needs for Infusion Therapy
- Patients require IV therapy for various reasons, such as fluid/electrolyte replacement, medication administration, blood products, and nutritional support.
- Duration can range from hours to a lifetime.
- IV fluids are given to maintain/restore fluid and electrolyte balance, especially when oral intake is insufficient.
- Sensible and insensible fluid losses must be accounted for.
- IV medication administration is used when oral or other routes are not suitable. Some medications are only given intravenously to get to target blood levels quicker.
- Nutritional support can be given intravenously if the gastrointestinal tract cannot absorb sufficient nutrients.
Types of IV Solutions
- Two major types are crystalloids and colloids.
- Crystalloids are electrolytes dissolved in water, and include dextrose solutions, sodium chloride, and balanced electrolyte solutions
- Colloids contain larger molecules (usually proteins or starch) suspended in fluid, also called plasma volume expanders.
- Colloids are used to maintain intravascular volume and prevent shock.
Osmolarity
- Osmolarity (mOsm/L) and Osmolality (mOsm/kg) measure solution concentration.
- Isotonic solutions (250-375 mOsm/L) have similar osmolarity to plasma and cause no fluid movement into or out of cells.
- Hypotonic solutions (less than 250 mOsm/L) cause fluid to move into cells, hydrating cells but depleting intravascular fluid volume.
- Hypertonic solutions (greater than 375 mOsm/L) cause fluid to move out of cells and into the intravascular space.
Blood Products
- Blood products are administered intravenously.
- They can include packed red blood cells, platelets, plasma, albumin, and clotting factors.
Veins for Infusion Therapy
- Veins return deoxygenated blood to the heart.
- Vein walls are composed of tunica intima, tunica media, and tunica adventitia.
- Valves in veins prevent backflow.
- Larger veins closer to the heart are appropriate for higher volumes.
- Choosing the correct vein size and gauge is critical to avoid complications.
Types of IV Access Devices
- Peripheral venous access (short over-the-needle catheters, steel-winged devices/butterfly).
- Central venous access (CVA: Nontunneled percutaneous, tunneled catheters, implanted ports, PICCs).
Infusion Systems
- Infusion systems deliver solutions and medications to the IV access device.
- OSHA mandates needleless access to reduce needle-stick injuries.
- Different tubing (macro/micro-drop) are used to control rate delivery and measure drops per minute.
Infusion Complications
- Phlebitis (inflammation of the vein) and infiltration (fluid leaking into surrounding tissue) are common.
- Chemical, mechanical, and bacterial factors all contribute to complications.
- Monitoring for signs/symptoms of infiltration and phlebitis is essential.
- Correct flushing of equipment and catheters is required for avoiding complications.
- Incompatibility of medications during administration can negatively impact infusion therapy.
Nursing Management
- Nurses should monitor fluid balance, vital signs, and administer medications safely.
- Nurses should monitor patients for complications, such as phlebitis, infiltration, and air embolism.
- Nurses must correctly flush and use compatible solutions when administering intermittent infusions or using other medical equipment.
Blood Component Transfusions
- Blood products (RBCs, plasma, platelets) are used in treatment for anemia and other critical situations.
- Blood component transfusion requires meticulous adherence to procedures and close patient monitoring due to risks and complications.
- Proper patient identification and matching (ABO and Rh) are essential.
Total Parenteral Nutrition (TPN)
- TPN is used when the gastrointestinal tract cannot deliver sufficient nutrition.
- TPN solutions contain amino acids, dextrose, lipids, and electrolytes.
- TPN therapy necessitates gradual initiation to address patient's glucose and fluid tolerance.
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Description
Test your knowledge on the nursing management of intravenous (IV) complications including phlebitis, infiltration, and extravasation. This quiz covers critical concepts relevant to infusion therapy and central venous access. Enhance your understanding of the complications that may arise during IV therapy and the appropriate nursing interventions.