CRNI CRNI Home Infusion Therapy and Patient Education 2 — Questions and Answers
Question 1: When teaching PICC line care at home, which instruction is the highest priority?
- Flush the catheter with saline on the prescribed schedule to maintain patency (Correct answer)
- Change the dressing every day without exception
- Clamp the catheter with metal hemostats after each use
- Avoid showering for the duration of PICC therapy
Correct answer: Flush the catheter with saline on the prescribed schedule to maintain patency
Scheduled saline flushing per protocol is essential to maintain catheter patency and prevent occlusion in home infusion patients.
Question 2: A home infusion patient reports the infusion is running much slower than prescribed. What should the nurse recommend assessing first?
- Tubing for kinks and catheter for positional obstruction (Correct answer)
- Immediately increasing the drip rate
- Replacing the IV bag with a fresh one
- Calling emergency services
Correct answer: Tubing for kinks and catheter for positional obstruction
Kinks in tubing or positional changes affecting catheter flow are the most common and easily corrected causes of slow infusion in the home setting.
Question 3: Which symptom in a home infusion patient warrants an immediate emergency call?
- Sudden shortness of breath, chest pain, or fever above 38.5°C (101.3°F) (Correct answer)
- Mild soreness at the IV insertion site
- Slight redness at the dressing edge
- Infusion completing earlier than scheduled
Correct answer: Sudden shortness of breath, chest pain, or fever above 38.5°C (101.3°F)
Sudden dyspnea, chest pain, or high fever can signal pulmonary embolism, air embolism, or catheter-related bloodstream infection requiring emergency evaluation.
Question 4: How should a home infusion patient properly dispose of used sharps?
- In an FDA-cleared sharps disposal container following local regulations (Correct answer)
- In a sealed household trash bag
- In a zip-lock bag placed in recycling
- Flushed down the toilet
Correct answer: In an FDA-cleared sharps disposal container following local regulations
Used sharps must go into an FDA-cleared sharps container and be disposed of per state and local regulations to prevent community needlestick injuries.
Question 5: What is the purpose of the beyond-use date (BUD) on a home infusion IV bag?
- It indicates the latest time the preparation remains sterile and chemically stable (Correct answer)
- It is the drug manufacturer's expiration date
- It tells the patient when to reorder medication
- It indicates when IV tubing must be replaced
Correct answer: It indicates the latest time the preparation remains sterile and chemically stable
The BUD set by the compounding pharmacist based on USP <797> specifies the maximum safe-use window for the sterile preparation.
Question 6: A patient receiving home IV vancomycin asks why they need regular blood draws. What is the best explanation?
- Vancomycin levels must be monitored to ensure therapeutic dosing and prevent nephrotoxicity and ototoxicity (Correct answer)
- The blood draws detect whether the IV site is infected
- Blood tests verify that the IV catheter is functioning
- It is a routine requirement for all patients on home IV therapy
Correct answer: Vancomycin levels must be monitored to ensure therapeutic dosing and prevent nephrotoxicity and ototoxicity
Vancomycin has a narrow therapeutic index, requiring serum level or AUC monitoring to achieve efficacy while avoiding nephrotoxicity and ototoxicity.
CRNI CRNI Home Infusion Therapy and Patient Education 2
When teaching PICC line care at home, which instruction is the highest priority?