CRNI CRNI Home Infusion Therapy and Patient Education 5 — Questions and Answers
Question 1: A patient receiving home enteral nutrition via a gastrostomy tube reports tube displacement. The tube has only been in place for 2 weeks. What should the nurse instruct the patient to do?
- Reinsert the tube at home and resume feedings
- Go to the emergency department immediately without reinserting the tube (Correct answer)
- Cover the stoma with gauze, do not reinsert, and call the home health nurse
- Clamp the tube, tape it to the abdomen, and wait for the next scheduled visit
Correct answer: Go to the emergency department immediately without reinserting the tube
A gastrostomy tube displaced within the first 4–6 weeks has not yet formed a mature tract and requires emergency reinsertion under medical supervision to prevent stoma closure.
Question 2: Which type of flush solution and frequency is recommended for maintaining patency of an implanted venous port that is not in active use?
- Normal saline every 24 hours
- Heparinized saline (100 units/mL) monthly (Correct answer)
- 10 units/mL heparin solution every 2 weeks
- Normal saline weekly with a positive-pressure technique
Correct answer: Heparinized saline (100 units/mL) monthly
Implanted ports not in active use are typically flushed every 4 weeks (monthly) with heparinized saline per institutional protocol to maintain patency.
Question 3: A home infusion nurse is assessing a patient's understanding of safe medication storage for a home parenteral nutrition solution. Which statement by the patient indicates correct understanding?
- I will store my TPN bags in a cool, dry cabinet away from sunlight.
- I will refrigerate my TPN at 36–46°F and remove it 1 to 2 hours before infusion. (Correct answer)
- I will freeze extra TPN bags to extend their shelf life.
- I can leave the TPN at room temperature for up to 24 hours before use.
Correct answer: I will refrigerate my TPN at 36–46°F and remove it 1 to 2 hours before infusion.
TPN must be refrigerated at 36–46°F (2–8°C) and brought to room temperature 1–2 hours before infusion to prevent discomfort and adverse reactions.
Question 4: A patient on long-term home IV antibiotics for osteomyelitis asks how to recognize a sign of thrombophlebitis at their peripheral IV site. Which response is most accurate?
- Swelling and redness along the vein track above the insertion site (Correct answer)
- Mild coolness at the insertion site after medication is infused
- A small hematoma that forms at the end of each infusion
- Slight resistance when flushing the IV line
Correct answer: Swelling and redness along the vein track above the insertion site
Thrombophlebitis presents as redness, warmth, swelling, and tenderness along the vein above the catheter tip, indicating vein inflammation.
Question 5: During a home visit, a nurse finds that a patient's infusion pump has alarmed with an 'air-in-line' alert. What is the correct first action?
- Restart the pump and monitor the patient closely
- Clamp the tubing, stop the infusion, and locate and remove the air before restarting (Correct answer)
- Reposition the tubing and override the alarm
- Replace the entire IV tubing set immediately
Correct answer: Clamp the tubing, stop the infusion, and locate and remove the air before restarting
Clamping the line and removing the air bubble before restarting prevents air embolism, which can be life-threatening.
Question 6: A CRNI is developing a discharge teaching plan for a patient who will self-administer home IV therapy. Which learning barrier should be assessed first?
- The patient's insurance coverage for home infusion supplies
- The patient's health literacy, vision, dexterity, and ability to perform aseptic technique (Correct answer)
- Whether the patient has a family member who can take over if needed
- The availability of a 24-hour pharmacy in the patient's area
Correct answer: The patient's health literacy, vision, dexterity, and ability to perform aseptic technique
Assessing cognitive, physical, and literacy abilities ensures the teaching plan is realistic and that the patient can safely perform the required procedures.
Question 7: A patient receiving home infusion therapy for Crohn's disease asks about the correct way to dispose of used infusion supplies and sharps at home. What is the most appropriate guidance?
- Place all supplies in a regular trash bag and seal it tightly
- Use an FDA-cleared sharps disposal container; check local regulations for full container disposal (Correct answer)
- Recap needles and place them in a zip-lock bag before disposal
- Return all used supplies to the infusion pharmacy for disposal
Correct answer: Use an FDA-cleared sharps disposal container; check local regulations for full container disposal
FDA-cleared sharps containers prevent needle-stick injuries; local regulations (mail-back, drop-off sites, or household hazardous waste) govern safe container disposal.
CRNI CRNI Home Infusion Therapy and Patient Education 5
A patient receiving home enteral nutrition via a gastrostomy tube reports tube displacement.
The tube has only been in place for 2 weeks.
What should the nurse instruct the patient to do?