VA-BC Infusion Therapy & Solutions 2 — Questions and Answers
Question 1: Which filter size is recommended when administering 3-in-1 total nutrient admixtures (TNA) that contain lipid emulsions?
- 0.2 micron filter
- 1.2 micron filter (Correct answer)
- 5 micron filter
- No filter is required
Correct answer: 1.2 micron filter
A 1.2-micron filter is required for lipid-containing admixtures because a 0.2-micron filter would trap fat particles and prevent proper infusion.
Question 2: Why is Lactated Ringer's solution contraindicated for co-administration with blood products?
- It is hypertonic and causes hemolysis
- Its calcium content can promote clot formation in the tubing (Correct answer)
- It has an osmolarity too low for blood compatibility
- It raises blood glucose and affects coagulation
Correct answer: Its calcium content can promote clot formation in the tubing
Lactated Ringer's contains 3 mEq/L of calcium, which can bind to the citrate anticoagulant in blood products and promote clot formation in the IV tubing.
Question 3: What is the maximum recommended peripheral infusion rate for potassium chloride (KCl) to prevent cardiac toxicity?
- 5 mEq/hr
- 10 mEq/hr (Correct answer)
- 20 mEq/hr
- 40 mEq/hr
Correct answer: 10 mEq/hr
The maximum safe peripheral infusion rate for KCl is 10 mEq/hr; rates above this via peripheral access risk serious cardiac dysrhythmias and vein damage.
Question 4: Which IV solution is contraindicated in patients with increased intracranial pressure (ICP) because it can worsen cerebral edema?
- 0.9% Normal Saline
- 3% Hypertonic Saline
- D5W (Correct answer)
- Lactated Ringer's
Correct answer: D5W
D5W is effectively a hypotonic solution once dextrose is metabolized, and free water can cross the blood-brain barrier and increase cerebral edema.
Question 5: What is the primary purpose of using a 0.2-micron filter when infusing TPN without lipids (2-in-1 formulation)?
- To slow the infusion rate to prevent hyperglycemia
- To remove bacteria, fungi, and particulate matter (Correct answer)
- To prevent air from entering the bloodstream
- To filter out excess electrolytes
Correct answer: To remove bacteria, fungi, and particulate matter
A 0.2-micron filter removes bacteria, fungi, and particulate contaminants from non-lipid TPN, reducing the risk of catheter-related bloodstream infections.
Question 6: Per INS standards, how frequently should IV administration sets used for lipid-containing solutions be changed?
- Every 12 hours
- Every 24 hours (Correct answer)
- Every 48 hours
- Every 72 hours
Correct answer: Every 24 hours
Administration sets used for lipid-containing solutions must be changed every 24 hours due to the increased risk of microbial growth in lipid emulsions.
Question 7: A patient receiving IV vancomycin develops sudden flushing, erythema of the face and upper torso, and pruritus. What is the most likely cause?
- Anaphylactic allergic reaction to vancomycin
- Red Man Syndrome from too-rapid infusion (Correct answer)
- Extravasation of vancomycin into tissue
- Catheter-related bloodstream infection
Correct answer: Red Man Syndrome from too-rapid infusion
Red Man Syndrome is a non-immune-mediated reaction caused by rapid vancomycin infusion that triggers mast cell degranulation, causing the characteristic flushing and erythema.
VA-BC Infusion Therapy & Solutions 2
Which filter size is recommended when administering 3-in-1 total nutrient admixtures (TNA) that contain lipid emulsions?