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NURS 366 Exam 2 Questions And Answers
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NURS 366 Exam 2 Questions And AnswersWhat is phlebitis?
Inflammation of a vein due to blood clotting inside it or damage to vein walls
What are the signs and symptoms of phlebitis?
Redness, swelling and warmth at IV site. Vein feels hard upon palpation
What are the nursing interventions to treat phlebitis?
Stop the IV, elevate extremity, and apply warm compress
What is infiltration?
Non-irritating fluid is leaked into the surrounding soft tissue from the vein
Symptoms and Signs of Infiltration
Pain, coolness, and swelling to the site. IV dressing has leakage in it and pump beeping
occlusion on patient side
Nursing Interventions for Infiltration
Stop the IV, elevate the extremity, and apply warm or cool compress depending on pH of
solution-warm for normal-high pH solutions and cool for low pH solutions
What is extravasation?
Irritating fluid leaks out of the vein and into the surrounding soft tissue
What are the signs and symptoms of extravasation?
,Redness, swelling, or a stinging sensation at the IV site. Tissue may become necrotic
What are the nursing implications for extravasation?
Discontinue the IV, aspirate any residual medicine you can from line, administer
antidote to medication, then elevate extremity, and apply warm or cool compress
What is an isotonic solution?
Solution of IV fluid concentrations that contain the same concentration of dissolved
particles as blood. The creation of constant pressure inside and outside of the cells
causes the cells to remain the same. Ex: DW5; 0.9% NS
What is a hypotonic solution?
Solution of IV fluid concentrations that have a lower concentration of dissolved particles
than blood. It will cause the cells to swell. Ex: 0.45% NS, 2.5% Dextrose
What is a hypertonic solution?
IV fluid concentrations that have more dissolved particles than blood. Causes cells to
shrink. D5W and 0.45% sodium chloride, D10W
What would the nurse monitor during the administration of IV fluids?
During an assessment of an IV, the nurse should be looking for blood in the IV tubing,
making sure that the dressing is clean and intact, and assure that there is no swelling or
infection at the IV site
What action should be taken with an IV site that is not WNL?
Discontinue the IV. Remove all the dressings, pull back the catheter, and secure their
site with some cotton balls and tape. Check the catheter, just to make sure it is indeed
all in one piece
What would you need to insert an IV?
Gloves, tape, dressing (Tegaderm), alcohol prep pad, tourniquet, gauze, IV catheter,
,connector tubing, saline flush, drip set, IV fluid
What would a 25g IV needle be indicated for?
Newborn
For what would a 24g IV needle be used?
Pediatric; fragile older adult
With what could an IV fluid, antibiotics, low flow fluids be administered?
22g IV needle
What can be administered through a 20g IV needle?
Blood products, concentrated solutions
What can be administered via an 18g IV needle?
Operation room, labor and delivery, blood products, high flow fluids
For what would a 16g IV needle be used?
Operation room, trauma
What are appropriate IV sites for an adult patient?
Forearm, antecubital fossa, hand veins, last resort foot
What are appropriate IV sites for a pediatric patient?
Forearm, antecubital fossa, hand veins, last resort foot
, What are appropriate IV sites for a newborn patient?
Foot, if not ambulatory; cephalic, only less than 9 months, larger than veins in hands and
feet without valves, and cannot roll; or others. They have a lot of subcutaneous fat in the
extremities, which makes the insertion of the IV difficult. A larger vein in the leg is better
than the hand, great saphenous.
How would you prepare to insert an IV in an infant?
Having someone there to hold the child-holder makes the site more visible and ensures
the child doesn't move. Hold a transilluminator over the extremity so you can insert the
IV etc. Have all of the supplies ready by you so you do not have to go running for
something before the IV is secured. Cool extremities have small, flat veins so you may
need to use heel warmers to encourage vasodilation for infants, or for older children
you can use warm blankets or tape the heel warmer directly to the site for 5-7 minutes
What are the veins in the hand used for an IV?
Digital veins, metacarpal veins, dorsal vein, cephalic vein, basilic vein
What are the veins in the foot used for an IV?
Great saphenous vein, lesser saphenous vein, dorsal venous arch
When do you use foot veins for IV access?
In the adult population we do NOT start IV's in the foot, unless we have a MD order
because getting fluid back up is hard, especially when the patient is lying down, can be
used in a patient that cannot walk or will not be walking during hospital stay
What are characteristics of a good vein for IV insertion?
Superficial, smooth, bouncy, no pulsation, avoid the vein bifurcations, not close to a
joint, skin is normal (no contraindications)
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