question

What are the four primary sources of law in the US?

answer

- Constititional - Statutory - Administrative - Common

question

Powers of government and rights of people can be defined as...

answer

Constitutional Law

question

The right to self determination and independence can be defined as...

answer

Autonomy

question

Privacy to health information can be defined as...

answer

Confidentiality

question

"Value and worth" can be described as...

answer

Respect of a Person

question

"Truthfulness" can be described as...

answer

Veracity

question

"Doing good" is another term for...

answer

Beneficence

question

"Doing no harm" is another term for...

answer

Nonmalfience

question

An obligation to be faithful can be defined as...

answer

Fidelity

question

An obligation to be fair to all persons can be defined as...

answer

Justice

question

Laws written and enacted by federal, state and local government can be described as...

answer

Statutory Laws

question

Laws set forth by administrative agencies can be described as...

answer

Administrative Laws

question

Defamation, breech of confidentiality, false imprisonment, assualt and/or battery can all be described as intentional (or) unintentional torts?

answer

Intentional Torts

question

Failure to perform according to standards of practice can best be described as...

answer

Breech of Duty

question

What does ANA stand for?

answer

American Nurses Association

question

What does JCAHO stand for?

answer

Joint Comission on Accreditation of Healthcare Organizations

question

What agency created the Nursing Standards of Practice?

answer

National Boards and/or State Boards of Nursing

question

What CDC stand for?

answer

Centers for Disease Control & Prevention

question

What does INS stand for?

answer

Intravenous Nurse Society

question

Who developed the specific guidelines for IV therapy?

answer

Ohio Board of Nursing / Intravenous Nurse Society

question

In what five ways can a nurse breech his/her duties regarding IV therapy?

answer

- Delay in administration of a medication - Unfamiliarity with a drug - Altered and unverified route of administration - Failure to clarify orders - Failure to teach the patient

question

The law regarding nursing practice is referred to as the...

answer

Nurse Practice Act

question

In Ohio, what agency carries out the laws of nursing?

answer

Ohio Board of Nursing

question

What laws regulate the role of the LPN in IV Therapy?

answer

House Bill 303, Senate Bill 178

question

What clinicians are permitted to direct the LPN to administer IV therapy to an adult patient?

answer

- Physician - Dentist - Optometrist - Podiatrist - Registered Nurse

question

What location(s) may a Registered Nurse be absent while an LPN is initiating and conducting IV therapy?

answer

- At a patient's home or residence - In an MRDD care facility

question

True or False: The Registered Nurse is not required to remain within telecommunication to the LPN while the LPN is initiating and conducting IV therapy at a patient's home or at an MRDD facility.

answer

False. The Registered Nurse must remain within telecommunication to the LPN at all times.

question

True or False: An authorized LPN, who is certified in IV therapy, may not initiate and maintain blood products.

answer

True. Only a Registered Nurse may initiate and maintain blood products.

question

True or False: If a patient is having critical reactions to the blood infusion or if vital signs obtained by the authorized LPN indicate a critical issue with the blood infusion, the LPN may stop the infusion and contact the RN.

answer

True. If an LPN suspects a critical problem with a blood infusion, he/she may stop the infusion and report immediately to the RN so additional measures may be taken to assess the problem.

question

True or False: An authorized LPN may maintain TPN solutions as long as the RN has initiated the first infusion.

answer

False: An LPN may never initiate or maintain any TPN solutions of any kind.

question

True or False: An authorized LPN may not initiate or maintain chemotherapeutic agents via IV therapy.

answer

True: Only a Registered Nurse may complete chemotherapy via IV therapy.

question

True or False: Investigation or experimental medications may only be administered through the IV by a physician.

answer

False: Both a Registered Nurse or Physician may infuse experimental medications. The LPN, however, may not.

question

True or False: The authorized LPN may administer IVPB (IV Piggyback), and antibiotics through a CVAD (central venous access device) as long as the RN has completed the initial administration.

answer

True: As long as the Registered Nurse has complete the first infusion, an LPN may hang or spike proceeding intermittent solutions and antibiotics within their scope of IV therapy.

question

True or False: An authorized LPN may not discontinue a CVAD.

answer

True. Only an RN may discontinue a CVAD.

question

True or False: An authorized LPN may not aspirate any IV therapy line to maintain patency.

answer

False: The authorized LPN is permitted to aspirate.

question

True or False: An LPN may assist in the programming of a PCA pump as long as the RN is present.

answer

False: An LPN is never permitted to program a PCA pump.

question

This term is defined as the means of communication of a plan of care.

answer

Direction

question

To "start or begin" can be defined as...

answer

Initiation

question

To administer or regulate an IV infusion according to the prescribed flow rate can be defined as...

answer

Maintenance

question

An authorized LPN may initiate IV therapy in patients ages _____ and older.

answer

18

question

Solutions that an authorized LPN may infuse include...

answer

- Dextrose 5% and 10% Water (D5W, D10W) - Normal Saline (NSS) - Lactated Ringers (LR) - Sodium Chloride 0.45% - Sodium Chloried 0.20% - Sterile H2O without mixed unauthorized solutions

question

The areas that an authorized LPN may initiate an IV is...

answer

Any area in an adult patient that begins at the antecubidal space (ac) down to the hand.

question

True or False: An authorized LPN may initiate an IV in the foot.

answer

False: For reasons related to DM, authorized Practical Nurses are not permitted to insert IV catheters in the foot.

question

ICF stands for...

answer

Intracellular Fluid

question

ECF stands for...

answer

Extracellular Fluid

question

ECF can be broken down into two components. They are...

answer

Interstitial fluid (fluid between the cells and is typically comprised of 15% ISF) and intravascular fluid (fluid in the blood, also known as plasma, and is typically comprised of 5% IVF)

question

What are the six functions of fluid?

answer

- Maintain blood volume - Regulate body temperature - Transport materials - Medium for metabolism and waste - Aide in digestion - Acts as solvent for solutes

question

Passage of water from low concentration of particles toward high concentration of particles across a semi-permeable membrane can be defined as...

answer

Osmosis

question

Movement of ions from high concentration to low concentration through a semi-permeable membrane can be defined as...

answer

Passive Diffusion

question

The transfer of water / dissolved substances from high pressure areas to low pressure areas, and there is usually force involved can be defined as...

answer

Filtration

question

When ions actually move themselves from a low concentration to high concentration can be defined as...

answer

Active Transport

question

This term describes less salt in the blood than in the cell. H2O will move in and hydrate the cell.

answer

Hypotonic

question

This term describes having osmotic pressure equal to that of blood. Some sodium content is present here. This usually has no effect of fluid in the cell.

answer

Isotonic

question

This term describes more salt in the blood than in the cell. H2O moves out into intravascular space.

answer

Hypertonic

question

This term describes the property of possessing tone or tension to influence water.

answer

Tonicity

question

In what way does the renal system aide in homeostatic balance.

answer

The kidneys help control fluids and electrolytes by filtering and excreting.

question

This hormone informs the kidneys to increase NA+ re-absorption in the blood, so fluid is kept in.

answer

Aldosterone

question

This hormone informs the kidneys to conserve H2O and keeps cell pressure by controlling H2O excretion or retention.

answer

Antidiuretic Hormone (ADH)

question

In what way does the respiratory system aide in the homeostatic balance?

answer

Lungs remove 300-500 mL of water daily. They remove the acidic CO2.

question

Hypovolemia can also be referred to as...

answer

Fluid Volume Deficit

question

Hypervolemia can also be referred to as...

answer

Fluid Volume Excess

question

A decrease in which plasma shifts from intravascular to interstitial space is called...

answer

Third-Spacing

question

Cardiovascular symptoms indicative of FVD include...

answer

- Thirst - Hypotension - Weak, thready pulse

question

Skin and temperature changes related to FVD include...

answer

- Low grade fever - Tenting - Sunken Fontanels

question

Urine volume indications regarding FVD could include...

answer

Concentrated urine and low volume. It may have a specific gravity of 1.035 or less.

question

Laboratory findings regarding FVD reflect hemoconcentration. H & H and protein values are _____ and BUN levels are elevated above _____.

answer

Laboratory findings regarding FVD reflect hemoconcentration. H & H and protein values are **increased** and BUN levels are elevated above **20mg**.

question

Treatment for FVD includes...

answer

- Fluid Replacement - Isotonic solutions of 0.9% NaCl and LR infused - Hypotonic 0.45% NSS is often used

question

It is important for the nurse to watch for _____ during FVD.

answer

Fluid Overload

question

Cardiovascular symptoms indicative of FVE include...

answer

- Distended Neck Veins - Bounding Pulse - Peripheral Edema

question

Respiratory symptoms indicative of FVE include...

answer

- Tachypnea (greater than 20 per minute) - Dyspnea - Labored Breathing - Wet Lung Sounds

question

Urine volume indications regarding FVE include...

answer

Polyuria and a specific gravity greater than 1.010

question

Three lab findings indicating FVE include...

answer

- Decreased H & H - Decreased NA+ - Decreased Serum Osmolality

question

Treatment for FVE can include (three methods)...

answer

- Sodium and Fluid Restriction - Diuretics - Treat the underlying cause

question

It is important for the nurse to watch for _____ during FVE.

answer

Urinary Output

question

What is the normal pH level?

answer

7.35 - 7.45

question

True or False: A solution is basic or acidic based on the concentration of hydrogen ions in the solution.

answer

True

question

The higher amount of pH indicate a [lower or higher] amount of hydrogen and the lower amount of pH indicate a [lower or higher] amount of hydrogen.

answer

The higher amount of pH indicate a **lower** amount of hydrogen and the lower amount of pH indicate a **higher** amount of hydrogen.

question

What occurs during respiratory acidosis?

answer

The body's CO2 is combining with water and producing carbonic acid. This accumulation is reducing the blood pH, therefore making the outcome Respiratory Acidosis.

question

True or False: Drowsiness and unresponsiveness may occur isfCO2 is low.

answer

False: Drowsiness and unresponsiveness generally occurs if CO2 is high.

question

A pH level greater than 7.45 and a PaCO2 level less than 35 mmHg could indicate...

answer

Respiratory Alkalosis

question

A pH level less than 7.35 and a Bicarbonate level less than 22 mEq/L could indicate...

answer

Metabolic Acidosis

question

The measure of acidity or alkalinity based on hydrogen ions present is defined as...

answer

pH

question

The partial pressure of O2 that is dissolved in arterial blood is defined as...

answer

PaO2

question

The arterial saturation of O2 is defined as...

answer

SAO2

question

The amount of carbon dioxide dissolved in arterial blood is defined as...

answer

PaCO2

question

The calculate value of the amount of bicarbonate in the blood stream is defined as...

answer

HCO3

question

The amount of excess or insufficient level of HCO3 in the system.

answer

Base Excess (BE)

question

The normal range for PaO2 is...

answer

80 - 100 mm Hg

question

The normal range for SAO2 is

answer

95% - 100%

question

The normal range for PaCO2 is...

answer

35 - 45 mm Hg

question

The normal range for HCO3 is...

answer

22 - 26 mEq/L

question

The normal range for BE is...

answer

-2 - +2 mEq/L

question

True or False: Glucose is an electrolyte.

answer

False: Glucose is not an electrolyte.

question

The five key elements of IV therapy include...

answer

- Water - Glucose - Protein - Vitamins - Electrolytes

question

D5W, 0.9% NaCl and LR solution are considered [isotonic, hypotonic or hypertonic].

answer

D5W, 0.9% NaCl and LR solution are **isotonic**.

question

0.33% and 0.45% NaCl are considered [isotonic, hypotonic or hypertonic].

answer

0.33% and 0.45% NaCl are considered **hypotonic**.

question

D5.45% NaCl, D10W and D5.9% NaCl are considered [isotonic, hypotonic or hypertonic].

answer

D5.45% NaCl, D10W and D5.9% NaCl are considered **hyerptonic**.

question

This IV solution acts as a vehicle for medication administration, provides glucose, water. In large amounts, this may decrease sodium.

answer

D5W

question

This IV solution provides the electrolyte NaCl, but can quickly increase NaCl levels.

answer

0.9% NaCl

question

This IV solutions contains basic electrolytes and aides with hypovolemia.

answer

LR

question

This IV solution will lower blood pressure.

answer

0.33% NaCl

question

This IV solution provides NaCl and free water.

answer

0.45% NaCl

question

This IV solution is used to treat hypovolemia along with LR.

answer

D5.45% NaCl

question

This IV solution supplies calories.

answer

D10W

question

This IV solution replaces nutrients and electrolytes.

answer

D5.9% NaCl

question

For TPN solutions, the nurse will need to monitor the glucose level every _____ hours.

answer

6

question

Vital signs for TPN solutions will need to be obtained every _____ hours.

answer

4

question

Weight gain with TPN solutions should not exceed _____ pounds per week.

answer

3

question

In regards to blood transfusions, routine blood vitals should be completed in what order?

answer

(1) Before Infusing (2) Every 15 Minutes X2 (3) Every 30 Minutes (4) Every 1 Hour until Finished (5) 1 Hour after Finished

question

A temperature reading of _____ *F or greater should be alerted to the Registered Nurse.

answer

100*F

question

What are the disadvantages to a butterfly needle when initiating an IV?

answer

- Increases risk for infection - Not suitable for areas of flexion - Re-puncture by contamination of needle possible

question

A major disadvantage to over the needle catheters (regular IV catheters) is...

answer

Phlebitis

question

An increased risk of catheter embolus and infection may be caused by...

answer

PICC Lines and Central Ports or Through the Needle Catheters

question

What is the typical gauge and length of a PICC Line?

answer

- Gauge 16 - 20 - Length 20 - 24 Inches

question

The three most important items to remember when completing a patient assessment prior to the insertion of an IV include...

answer

- Privacy/Environmental Control - Explanation of Procedure - Patient and Family Instruction

question

In regards to IV site selection, it is important to remember the following items. What are they?

answer

- Patient's age - Presence of disease or prior surgery

question

True or False: When just before inserting an IV, it is permitted to allow the patient to clinch their fist.

answer

True

question

In regards to IV initiation, the authorized LPN will want to document...

answer

- Procedure - Patient Response - Instructions Provided

question

It is important for the nurse to complete what three asks prior to inserting an IV?

answer

- Check the solution for clarity. - Check the expiration date. - Assure that the catheter is intact.

question

Vein walls consist of three layers. What are they?

answer

- Tunica Adventia (Outer) - Tunica Media (Middle) - Tunica Intima (Inner)

question

What size catheter may be used at the digital and metacarpal sites?

answer

20 - 22 Gauge

question

What size catheter may be used at the cephalic, basilic and accessory cephalic sites?

answer

18 - 22 Gauge

question

What size catheter may be used at the upper cephalic site?

answer

16 - 20 Gauge

question

What size catheter may be used at the median antebrachial, median basilic and median cubital sites?

answer

18 - 20 Gauge

question

What size catheter may be used at the AC site?

answer

16 - 18 Gauge

question

How does the medical team confirm placement of the central line?

answer

X-Ray

question

How often are IV peripheral sites changed to a new site?

answer

Every 3 Days

question

How often is the long term central line dressing changed?

answer

Every 7 Days and PRN

question

Dressing changes to a central line is a [sterile or clean] technique.

answer

Sterile

question

True or False: It is required to wear sterile gloves when changing a peripheral IV dressing.

answer

False. Only clean gloves are required if it is a non-CVAD dressing.

question

Inadvertent administration of nonvesicant solution into surrounding tissues is referred to as...

answer

Infiltration

question

Five S/Sx of infiltration include...

answer

- Coolness at the site - Taut skin - Depending edema - Absence of blood return - Infusion rate continues but is slow

question

Three treatment techniques that may be used for infiltration include...

answer

- Warm or cold compresses - Assuming a comfortable position

question

Inadvertent administration of a vesicant into the surround tissue is referred to as...

answer

Extravasation

question

Five S/Sx of extravasation include...

answer

- c/o burning and pain - Swelling proximal or distal to site - Skin tightness - Blanching/coolness - Damp or wet dressing

question

The only four vesicants that an authorized LPN may infuse include...

answer

- Vancmycin - Flagyl - Piperacillin - Lower doses of K+

question

Infiltration of blood into the surrounding tissues is referred to as a...

answer

Hematoma

question

Four S/Sx of a hematoma include...

answer

- Bruising or discoloration - Sweeling and discomfort - Unable to advance catheter - Resistance during flushing

question

General treatment for a hematoma includes...

answer

- Direct light pressure with a sterile 2x2 gauze for 2-3 minutes - Elevation of Extremity - Cold application

question

Trauma to the endothelial walls and causes RBC's to adher to vein wall, which may cause a clot, is referred to as...

answer

Thrombosis

question

Slowed drip rate, difficulty in flushing and resistance may all indicate a...

answer

Thrombosis

question

True or False: An IV site will look unhealthy if a thrombosis occurs.

answer

False. In most cases, the outer site will look healthy because the clot has occurred on the inside of the vein, on a vein wall.

question

True or False: Fever and malaise may be present during a thrombosis.

answer

True.

question

It is important to assess for _____ impairment when a thrombosis has occured.

answer

Circulatory

question

Inflammation of the vein walls can be referred to as...

answer

Phlebitis

question

What are the four types of phlebitis?

answer

- Mechanical (phlebitis related to the device) - Chemical (phlebitis related to the solution) - Bacterial (phlebitis related to foreign microorganisms) - Post-Infusion (phlebitis related to removal)

question

Five S/Sx of phlebitis include...

answer

- Redness at the site - Site is warm to touch - Local Swelling - Sluggish infusion rate - Increased basal temperature

question

A sudden involuntary contraction of a vein or artery resulting in temporary cessation of blood flow.

answer

Venous Spasm

question

Two common S/Sx of a venous spasm include...

answer

- Sharp pain traveling up the arm - Slowing of the infusion

question

Treatment of a venous spasm includes...

answer

- Warm compresses - Restarting the IV

question

Identify the following IV gauge color sizes: Gray = _____ gauge Green = _____ gauge Pink = _____ gauge Blue = _____ gauge Yellow = _____ gauge

answer

Gray = 16 gauge Green = 18 gauge Pink = 20 gauge Blue = 22 gauge Yellow = 24 gauge

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