Infusion-Related Pharmacology Flashcards
6 cards from real CRNI practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Infusion-Related Pharmacology flashcards as text
What is the significance of osmolality when selecting a peripheral versus central infusion route?
Answer: Solutions with osmolality greater than 900 mOsm/L should be infused via central venous access to prevent phlebitis
Solutions exceeding 900 mOsm/L cause significant endothelial damage to peripheral veins, necessitating central venous administration where rapid blood flow dilutes the solution.
Which mechanism describes how IV iron dextran can cause anaphylaxis?
Answer: IgE-mediated hypersensitivity to the dextran moiety
Anaphylaxis to IV iron dextran is primarily an IgE-mediated hypersensitivity reaction to the dextran component, which is why a test dose is required.
What is the CRNI's responsibility regarding medication compatibility when multiple IV infusions run simultaneously?
Answer: Verify Y-site and additive compatibility before co-administration using current references
The CRNI must verify both Y-site and additive compatibility using current, drug-specific references before any co-administration to prevent precipitation, degradation, or toxicity.
Why must IV potassium chloride never be administered by IV push?
Answer: It can cause fatal cardiac arrhythmias from sudden hyperkalemia
IV push potassium causes an immediate, lethal surge of potassium to the heart, triggering fatal arrhythmias including ventricular fibrillation and cardiac arrest.
What pharmacokinetic advantage does continuous IV infusion provide over intermittent bolus dosing for time-dependent antibiotics?
Answer: Sustained drug levels above the MIC for a greater percentage of the dosing interval
Time-dependent antibiotics (beta-lactams, carbapenems) achieve optimal bactericidal activity when drug concentrations remain above the MIC for extended periods, which continuous infusion achieves.
A patient's IV medication order reads dopamine 5 mcg/kg/min, titrate to MAP greater than 65. What does this titration order require from the CRNI?
Answer: Continuously monitor MAP and adjust the infusion rate within the prescribed parameters
Titration orders require continuous hemodynamic monitoring and independent nursing adjustment of infusion rates to maintain the specified physiological parameter within prescribed limits.