CRNI Managing Infusion Complications 5

Question 1

A nurse notices that a patient's IV infusion has been running into the subcutaneous tissue for an unknown period. The infiltrated solution was D10W. Which local complication is the primary concern?

Accepted Answer

Tissue necrosis from hyperosmolar solution

Answer

Hyperosmolar solutions such as D10W can cause tissue necrosis when infiltrated into subcutaneous tissue due to osmotic damage to local cells.

Question 2

During a lipid infusion via a peripheral IV, a patient develops a fever, chest and back pain, and dyspnea. Which rare but serious complication should the nurse suspect?

Accepted Answer

Fat overload syndrome

Answer

Fat overload syndrome is a rare complication of lipid emulsions presenting with fever, hepatosplenomegaly, coagulopathy, and pulmonary symptoms caused by impaired lipid clearance.

Question 3

A patient with a tunneled central catheter develops pain, erythema, and warmth along the subcutaneous tunnel tract. What complication does this indicate?

Accepted Answer

Tunnel infection

Answer

Erythema, warmth, and tenderness extending more than 2 cm along the subcutaneous tunnel tract beyond the exit site is diagnostic of a tunnel infection.

Question 4

What is the recommended nursing action when a patient receiving IV potassium chloride reports severe burning and pain at the peripheral IV site with no other abnormal findings?

Accepted Answer

Dilute the solution further and reduce the infusion rate

Answer

Potassium chloride is a chemical irritant; reducing the concentration and slowing the rate often relieves burning while maintaining the same access site when no extravasation is present.

Question 5

A postoperative patient receiving a continuous peripheral nerve block infusion suddenly develops confusion, metallic taste, tinnitus, and perioral numbness. What is the most likely cause?

Accepted Answer

Local anesthetic systemic toxicity (LAST)

Answer

Metallic taste, tinnitus, perioral numbness, and CNS symptoms are classic early signs of local anesthetic systemic toxicity (LAST) due to intravascular absorption.

CRNI Exam Practice Test

CRNI Exam Practice Test

CRNI Managing Infusion Complications 5