IV Therapy in Special Populations Flashcards

Which IV access device is most commonly recommended for pediatric oncology patients requiring long-term IV therapy?

Answer: Implanted port (Port-a-Cath)

Implanted ports are preferred for pediatric oncology patients requiring long-term, repeated IV access because they minimize infection risk and preserve vein integrity between treatment cycles.

Why is it important to monitor blood glucose levels closely in neonates receiving total parenteral nutrition (TPN) via IV?

Answer: Neonates have limited glycogen stores and immature glucose regulation, making both hypo- and hyperglycemia risks

Neonates have immature hepatic glucose regulation and limited glycogen reserves, making them vulnerable to both hypoglycemia and hyperglycemia during TPN infusion.

When caring for an immunocompromised oncology patient with a central venous catheter, which intervention is most critical?

Answer: Strict adherence to ANTT for every access and dressing change

Immunocompromised patients have no immune reserve to combat CRBSI; strict ANTT for every catheter access and dressing change is the most critical protective measure.

An elderly patient with difficult venous access has a midline catheter inserted. Which medication class is contraindicated for midline administration?

Answer: Continuous vesicant infusions or parenteral nutrition

Midline catheters terminate in the basilic or cephalic vein, not a central vein, so continuous vesicants, TPN, and hyperosmolar solutions are contraindicated due to phlebitis risk.

Which consideration is most important when selecting an IV insertion site in a patient undergoing hemodialysis?

Answer: Avoid the arm with an AV fistula or graft to prevent thrombosis and preserve access

The arm with an AV fistula or graft must never be used for IV insertion, venipuncture, or blood pressure measurement to protect the patient's dialysis access.

When calculating IV fluid requirements using the Holliday-Segar method for a 25 kg pediatric patient, what is the correct daily fluid maintenance rate?

Answer: 1600 mL/day

Holliday-Segar: 100 mL/kg for first 10 kg (1000 mL) + 50 mL/kg for next 10 kg (500 mL) + 20 mL/kg for remaining 5 kg (100 mL) = 1600 mL/day for a 25 kg child.