Infusion-Related Pharmacology Flashcards
7 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 7 Infusion-Related Pharmacology flashcards as text
A patient receiving IV acyclovir complains of burning pain at the infusion site. The nurse observes swelling and pallor around the IV site. What is the priority action?
Answer: Stop the infusion and assess for extravasation
Acyclovir is highly alkaline and vesicant; signs of swelling and pallor indicate possible extravasation, requiring immediate cessation of the infusion and site assessment.
Which statement about IV nitroglycerin administration is correct?
Answer: Glass bottles and non-PVC tubing must be used to prevent adsorption
Nitroglycerin adsorbs to PVC plastic, significantly reducing drug delivery; glass containers and non-PVC tubing must be used to ensure accurate dosing.
A nurse is preparing to administer IV potassium chloride. Which concentration is safe for peripheral IV administration without requiring central line access?
Answer: 20 mEq/100 mL
Concentrations of 10 mEq/100 mL or less (equivalent to 20 mEq/200 mL) are generally safe peripherally; 20 mEq/100 mL is the maximum recommended concentration for peripheral infusion per most guidelines.
When administering IV amiodarone for acute atrial fibrillation, which adverse effect requires IMMEDIATE intervention?
Answer: QTc interval prolongation greater than 500 ms
A QTc greater than 500 ms significantly increases the risk of torsades de pointes, a life-threatening arrhythmia requiring immediate prescriber notification and possible drug discontinuation.
A patient on total parenteral nutrition (TPN) develops sudden onset of chest pain and dyspnea 30 minutes after the infusion begins. The nurse notes a new cardiac murmur. What complication should be suspected?
Answer: Air embolism from TPN administration
Air embolism can occur with TPN through central lines; presenting with chest pain, dyspnea, and a new 'mill wheel' murmur requires immediate left lateral Trendelenburg positioning and emergency intervention.
Which pharmacokinetic principle explains why loading doses are used when initiating continuous IV infusions of drugs like lidocaine?
Answer: To rapidly achieve therapeutic plasma concentrations before steady state
Steady state takes approximately 4-5 half-lives to achieve; a loading dose rapidly fills the volume of distribution to produce therapeutic levels while the maintenance infusion sustains them.
A nurse is administering IV metronidazole and notices the patient is also receiving IV phenytoin. Which drug interaction should the nurse anticipate?
Answer: Metronidazole increases phenytoin serum levels
Metronidazole inhibits CYP2C9, the primary enzyme responsible for phenytoin metabolism, causing accumulation of phenytoin and increasing the risk of toxicity.