CRNI Managing Infusion Complications 4

Question 1

A patient receiving a vesicant chemotherapy agent through a peripheral IV reports burning and the nurse observes no blood return and swelling at the site. What is the priority nursing action?

Accepted Answer

Stop the infusion immediately and aspirate residual drug if possible

Answer

When vesicant extravasation is suspected, the infusion must be stopped immediately and residual drug aspirated before removing the catheter to minimize tissue damage.

Question 2

A patient develops chills, rigors, and a temperature of 39.8°C within 30 minutes of starting an infusion. Which complication is most consistent with these findings?

Accepted Answer

Catheter-related bloodstream infection (CRBSI)

Answer

Sudden onset of fever, chills, and rigors during infusion are classic signs of catheter-related bloodstream infection or infusion-related sepsis.

Question 3

When grading phlebitis using a standard scale, which finding corresponds to Grade 3 phlebitis?

Accepted Answer

Pain with erythema, streak formation, and palpable venous cord

Answer

Grade 3 phlebitis is characterized by pain with erythema, streak formation, and a palpable venous cord greater than 1 inch in length.

Question 4

A central venous catheter patient suddenly develops dyspnea, hypotension, and a mill-wheel murmur. Which complication does this presentation indicate?

Accepted Answer

Air embolism

Answer

A mill-wheel murmur combined with dyspnea and hypotension is pathognomonic for venous air embolism, caused by air entering the central venous system.

Question 5

Which intervention is correct when a nurse suspects air embolism in a patient with a central venous catheter?

Accepted Answer

Place the patient in left lateral Trendelenburg position and clamp the catheter

Answer

Left lateral Trendelenburg (Durant's maneuver) traps air in the right ventricle apex, preventing it from entering the pulmonary vasculature, while clamping prevents further air entry.

CRNI Exam Practice Test

CRNI Exam Practice Test

CRNI Managing Infusion Complications 4