SKILLS LAB: IV Therapy (ATI Testing – Skills Modules 2.0) – Flashcards
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A nurse is discontinuing an IV infusion. For which of the following reasons is it important to verify and document the integrity and condition of the IV catheter?
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A broken-off catheter tip indicates the risk for an embolus *The tip of the catheter can break off, thus creating an embolus. To limit the movement of the embolus, the nurse should apply a tourniquet high on the extremity where the IV line was located and notify the provider immediately.
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A nurse is removing an IV catheter from a patient whose IV infusion has been discontinued. Which of the following actions is appropriate?
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Pull the catheter straight back from the insertion site *With the catheter stabilized and using a slow, steady movement, the nurse should withdraw the catheter straight back and away from the insertion site, making sure to keep the hub parallel to the skin.
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A patient in early stage renal failure is prescribed an infusion of 0.45% sodium chloride. This type of solution is appropriate because it
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Dilutes extracellular fluid and rehydrates the cell *Infusing a hypotonic solution such as 0.45% sodium chloride moves fluid into the cells, thus enlarging and rehydrating them.
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A nurse initiating a peripheral IV infusion punctures the skin and selected vein and observes blood return in the flashback chamber of the IV catheter. Which of the following actions should the nurse perform next?
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Lower the catheter until it is almost flush with the skin *Lowering the angel and then advancing the catheter slightly facilitates full penetration of wall of the vein, thus placing the catheter within the vein's lumen and making it easy to advance the catheter off the stylet.
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A patient is to receive 1,000 mL of 5% dextrose in lactated Ringer's over 8 hours. Using tubing with a drop factor of 15 gtt/mL, the nurse should regulate the fluid to infuse at how many drops per minute? (Round the answer to the nearest whole number.)
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31 gtt/min *A formula for determining an IV flow rate in drops per minute is: volume (mL) x drop factor (gtt/mL) = IV flow rate (gtt/min) time (min)
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Which of the following is an important nursing action when converting an IV infusion to a saline lock?
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Flush the IV catheter to confirm patency *It is essential to attach the primed saline lock adapter to the extension tubing and to flush the tubing with normal saline to confirm patency.
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A nurse finds a patient's IV insertion site red, warm, and slightly edematous. Which of the following actions should the nurse perform first?
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Discontinue the IV line *The patient has classic signs of phlebitis, an inflammation of the vein. The IV line must be discontinued immediately to reduce the risk of thrombophlebitis and embolism.
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A nurse has just inserted a peripheral IV catheter for a continuous infusion. To secure the catheter, the nurse should
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Leave the connection between the hub and the tubing uncovered *This makes it possible to replace to tubing without removing the dressing.
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A nurse has just initiated a new peripheral IV infusion with 5% dextrose in water for continuous infusion. How often should the nurse plan to replace the primary infusion tubing?
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Every 96 hours *The Centers for Disease Control and Prevention and the Infusion Nurses' Society recommend changing the IV tubing no more than than every 92 hours unless the tubing has been contaminated, punctured, or obstructed.
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A nurse who has just initiated an IV infusion explains to the patient that complications are possible and that she will monitor the infusion regularly. The nurse should teach the patient that which of the following findings is an indication of early infiltration?
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Coolness *Coolness is a classic sign of infiltration, along with swelling, pallor, and possibility tenderness. Infiltration is a leakage of IV solution out of the intravascular compartment into the surrounding tissue.
