Mixed Deck — All IV Topics Flashcards

What is the best practice for monitoring a patient receiving an IV medication infusion?

Answer: Monitor the IV site for any signs of infiltration or infection.

The best practice for monitoring a patient receiving an IV medication infusion involves regularly assessing the IV insertion site for signs of complications. This includes checking for infiltration (fluid leaking into surrounding tissue), phlebitis (vein inflammation), or infection (redness, warmth, pus), which can compromise therapy and cause patient harm.

An elastomeric infusion device (balloon pump) is used primarily for which type of IV therapy?

Answer: Ambulatory antibiotic infusions where a portable, non-electronic delivery device is preferred

Elastomeric pumps use balloon pressure to deliver medication at a preset rate, making them ideal for home or ambulatory antibiotic infusions that do not require rate adjustment.

In elderly patients, which factor most significantly increases the risk of IV therapy complications such as fluid overload?

Answer: Decreased cardiac and renal reserve

Decreased cardiac and renal reserve in elderly patients impairs their ability to handle IV fluid loads, significantly increasing the risk of fluid overload.

Why is it critical to use microbore (low-volume) IV tubing when infusing medications to neonates?

Answer: To minimize dead-space volume and prevent large unintended drug boluses during flushes

Microbore tubing minimizes dead-space volume in pediatric IV lines, preventing inadvertent drug boluses when lines are flushed in neonates.

Speed shock is best prevented by which of the following nursing actions?

Answer: Programming infusion pumps with appropriate rate limits and using bolus checks

Speed shock — a systemic reaction to rapid IV drug delivery — is best prevented by programming infusion pumps with correct rate settings and utilizing secondary line checks.

Why should IV medications be administered cautiously in patients with chronic kidney disease (CKD)?

Answer: Impaired renal clearance leads to drug accumulation and increased risk of toxicity

CKD impairs renal drug clearance, causing renally-cleared medications to accumulate to toxic levels if doses are not adjusted.

What is the maximum recommended dwell time for a peripheral IV catheter in adults per current INS guidelines?

Answer: No set time limit — replace only on clinical indication

Current INS standards recommend removing peripheral IV catheters based on clinical indication rather than a routine scheduled replacement interval.

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.

Thrombophlebitis differs from simple phlebitis in that it also involves which additional finding?

Answer: Palpable cord along the vein

Thrombophlebitis involves both inflammation and thrombus formation, making the vein palpable as a hard, cord-like structure along its course.

What is the first step in preparing a medication for intravenous administration?

Answer: Reading the medication order.

The very first and most critical step in preparing any medication, especially for IV administration, is to accurately read and interpret the medication order. This ensures the correct drug, dose, route, time, and patient are identified, preventing potential errors before any physical preparation begins and adhering to the 'five rights' of medication administration.

What is the primary purpose of venous access devices?

Answer: To allow for the infusion of intravenous fluids and medications

The primary purpose of venous access devices is to provide a reliable and continuous route for the infusion of intravenous fluids and medications directly into a patient's bloodstream. These devices, such as peripheral IVs or central lines, allow healthcare professionals to administer necessary therapies, draw blood samples, and maintain hydration without repeated needle sticks. This ensures efficient and effective delivery of treatment.

Which of the following is the correct method for priming IV tubing to remove air before connecting to a patient?

Answer: Open the clamp and allow fluid to slowly fill the tubing from top to bottom until all air is expelled, then close the clamp

Proper IV tubing priming requires opening the clamp and slowly filling the tubing from the drip chamber downward, expelling all air before clamping and connecting to the patient.

When should a nurse check the patency of a venous access device?

Answer: Before every medication or fluid infusion

Checking the patency of a venous access device before every medication or fluid infusion is crucial for patient safety. This ensures the catheter is correctly positioned within the vein and functional, preventing complications like infiltration or extravasation that can occur if the device is occluded or dislodged. Proactive patency checks confirm safe and effective delivery of therapy.

What is the recommended minimum internal diameter (bore) of IV tubing for blood product administration?

Answer: Blood administration tubing with minimum 2.5–3 mm ID to prevent RBC trauma

Blood products require administration sets with an adequate internal diameter to prevent mechanical hemolysis; standard blood tubing with a minimum 2.5–3 mm ID is required.

Which of the following best describes a central venous catheter (CVC)?

Answer: A catheter placed in a central vein, typically for long-term therapy

A central venous catheter (CVC) is accurately described as a catheter placed in a large central vein, such as the subclavian, jugular, or femoral vein, with its tip typically resting in the superior vena cava. CVCs are primarily used for long-term therapy, administration of irritating medications, rapid fluid resuscitation, and central venous pressure monitoring, differentiating them from peripheral access devices.

What is the primary purpose of lipid emulsions in total parenteral nutrition?

Answer: To supply essential fatty acids and a concentrated caloric source for energy

Lipid emulsions in TPN provide essential fatty acids (linoleic and linolenic acid) and a calorie-dense energy source that reduces dextrose load and prevents essential fatty acid deficiency.

How should you monitor fluid balance during IV therapy?

Answer: By tracking fluid intake and urinary output

Monitoring fluid balance during IV therapy is best achieved by tracking fluid intake and urinary output. This comprehensive approach allows healthcare providers to assess if the patient is retaining fluid, becoming dehydrated, or maintaining an appropriate balance. Accurate intake and output measurements are essential for preventing complications like fluid overload or hypovolemia.

A patient receiving TPN through a central line suddenly develops hypoglycemia. The TPN has been running continuously. What is the most likely cause?

Answer: Insulin was added to the TPN bag in excessive amounts or a separate insulin infusion was not adjusted

TPN-related hypoglycemia is most often caused by excessive insulin in the TPN admixture or failure to adjust a concurrent insulin infusion, causing blood glucose to drop despite ongoing dextrose infusion.

What is 'refeeding syndrome' and when is it most likely to occur with TPN?

Answer: Dangerous electrolyte shifts (especially hypophosphatemia) when nutrition is reintroduced to severely malnourished patients

Refeeding syndrome occurs when malnourished patients receive TPN, causing rapid intracellular phosphate shifts that result in life-threatening hypophosphatemia, hypokalemia, and hypomagnesemia.

What is an appropriate response if a patient experiences discomfort during IV insertion?

Answer: Stop the procedure and reassess the insertion site

If a patient experiences discomfort during IV insertion, the appropriate response is to stop the procedure and reassess the insertion site. Patient discomfort signals a potential issue, such as nerve irritation, vein puncture, or improper technique. Halting the procedure allows the nurse to evaluate the situation, adjust the approach, and ensure patient safety and comfort before attempting re-insertion.