Chapter 18 Skills in Clinical Nursing 8th Edition by Audrey J. Berman- Shirlee Snyder

Chapter 18 Skills in Clinical Nursing 8th Edition by Audrey J. Berman- Shirlee Snyder

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE.  Choose the one alternative that best completes the statement or answers the question.

• The nurse is initiating IV therapy for an adult client who will require IV fluid infusion for 2-3 days 1) and might require blood Which of the following would the nurse choose as the best option for IV catheterization?

1. A) Butterfly B) Huber needle
2. C) Angiocatheter D) Implantable venous access device

Answer: C

Explanation: A)       An angiocatheter would be the best choice because the needle is removed and only the catheter remains in place, so it is more likely to last for two days without infiltrating. A butterfly can be used, if necessary, for IV catheterization, but is best when used for short-term IV infusion, as the needle remains in place within the vein, and is more likely to infiltrate sooner than is an angiocatheter. A huber needle is used to access an implantable venous access device, and would not be used for short-term use of a few days. Implantable venous access devices are used when IV fluid needs are anticipated for several months.

Cognitive Level: Application

Client Need: Physiological Integrity

Nursing Process: Planning

1. An angiocatheter would be the best choice because the needle is removed and only the catheter remains in place, so it is more likely to last for two days without A butterfly can be used, if necessary, for IV catheterization, but is best when used for short-term IV infusion, as the needle remains in place within the vein, and is more likely to infiltrate sooner than is an angiocatheter. A huber needle is used to access an implantable venous access device, and would not be used for short-term use of a few days. Implantable venous access devices are used when IV fluid needs are anticipated for several months.

Cognitive Level: Application

Client Need: Physiological Integrity

Nursing Process: Planning

1. An angiocatheter would be the best choice because the needle is removed and only the catheter remains in place, so it is more likely to last for two days without A butterfly can be used, if necessary, for IV catheterization, but is best when used for short-term IV infusion, as the needle remains in place within the vein, and is more likely to infiltrate sooner than is an angiocatheter. A huber needle is used to access an implantable venous access device, and would not be used for short-term use of a few days. Implantable venous access devices are used when IV fluid needs are anticipated for several months.

Cognitive Level: Application

Client Need: Physiological Integrity

Nursing Process: Planning

 

1. An angiocatheter would be the best choice because the needle is removed and only the catheter remains in place, so it is more likely to last for two days without A butterfly can be used, if necessary, for IV catheterization, but is best when used for short-term IV infusion, as the needle remains in place within the vein, and is more likely to infiltrate sooner than is an angiocatheter. A huber needle is used to access an implantable venous access device, and would not be used for short-term use of a few days. Implantable venous access devices are used when IV fluid needs are anticipated for several months.

Cognitive Level: Application

Client Need: Physiological Integrity

Nursing Process: Planning

Objective: Learning Outcome 18-1: Define the key terms used in the skills of intravenous therapy.

• The nurse is caring for a client with an IV line continuously infusing solution containing dextrose 2) and The client complains of a burning pain along the course of the vein, and the nurse assesses the site to find redness, warmth, and mild swelling at the site. The nurse documents the

client:

1. Has phlebitis at the IV insertion
2. Has an IV
3. Has an extravasated vesicant drug, requiring emergency
4. Has an

Answer: A

Explanation: A)      Redness, warmth, edema, and pain that runs along the course of the vein characterize phlebitis. Dextrose and water are not a vesicant, and do not require immediate intervention. An infiltrate is defined as fluid entering the tissues, resulting in swelling, coolness, pallor, and discomfort at the site. This client’s site is red and warm, not cool and pale, so it is not an infiltrate. Extravasation includes a vesicant drug (one that causes blistering when in the tissues but not in the vascular system), so this is not an extravasation.

Cognitive Level: Analysis

Client Need: Physiological Integrity

Nursing Process: Assessment

1. Redness, warmth, edema, and pain that runs along the course of the vein

characterize phlebitis. Dextrose and water are not a vesicant, and do not require immediate intervention. An infiltrate is defined as fluid entering the tissues, resulting in swelling, coolness, pallor, and discomfort at the site. This client’s site is red and warm, not cool and pale, so it is not an infiltrate. Extravasation includes a vesicant drug (one that causes blistering when in the tissues but not in the vascular system), so this is not an extravasation.

Cognitive Level: Analysis

Client Need: Physiological Integrity

Nursing Process: Assessment

1. Redness, warmth, edema, and pain that runs along the course of the vein

characterize phlebitis. Dextrose and water are not a vesicant, and do not require immediate intervention. An infiltrate is defined as fluid entering the tissues, resulting in swelling, coolness, pallor, and discomfort at the site. This client’s site is red and warm, not cool and pale, so it is not an infiltrate. Extravasation includes a vesicant drug (one that causes blistering when in the tissues but not in the vascular system), so this is not an extravasation.

Cognitive Level: Analysis

Client Need: Physiological Integrity

Nursing Process: Assessment

 

1. D) Redness, warmth, edema, and pain that runs along the course of the vein

characterize phlebitis. Dextrose and water are not a vesicant, and do not require immediate intervention. An infiltrate is defined as fluid entering the tissues, resulting in swelling, coolness, pallor, and discomfort at the site. This client’s site is red and warm, not cool and pale, so it is not an infiltrate. Extravasation includes a vesicant drug (one that causes blistering when in the tissues but not in the vascular system), so this is not an extravasation.

Cognitive Level: Analysis

Client Need: Physiological Integrity

Nursing Process: Assessment

Objective: Learning Outcome 18-1: Define the key terms used in the skills of intravenous therapy.

• The nurse is caring for a client with a medical diagnosis of increased intracranial Which 3) of the following IV fluid orders would the nurse accept without questioning?

1. Run normal saline at 125 mL/hour.
2. Run 5% dextrose in water at 80 mL/hour.
3. Run 5% dextrose in 45% NaCl at 75 mL/hour.
4. Run half-normal saline at 200 mL/hour.

Answer: C

Explanation: A)      Isotonic and hypotonic fluids should not be administered to clients with increased intracranial pressure, because they increase the risk of cerebral edema. D5 in one-half normal saline is hypertonic, and would be an acceptable IV solution for this client. Normal saline and D5W are isotonic solutions, and so would need to be questioned. Half normal saline is hypotonic, and so would not be advisable for this client.

Cognitive Level: Analysis

Client Need: Physiological Integrity

Nursing Process: Planning

1. Isotonic and hypotonic fluids should not be administered to clients with increased intracranial pressure, because they increase the risk of cerebral D5 in one-half normal saline is hypertonic, and would be an acceptable IV solution for this client. Normal saline and D5W are isotonic solutions, and so would need to be questioned. Half normal saline is hypotonic, and so would not be advisable for this client.

Cognitive Level: Analysis

Client Need: Physiological Integrity

Nursing Process: Planning

1. Isotonic and hypotonic fluids should not be administered to clients with increased intracranial pressure, because they increase the risk of cerebral D5 in one-half normal saline is hypertonic, and would be an acceptable IV solution for this client. Normal saline and D5W are isotonic solutions, and so would need to be questioned. Half normal saline is hypotonic, and so would not be advisable for this client.

Cognitive Level: Analysis

Client Need: Physiological Integrity

Nursing Process: Planning

 

1. Isotonic and hypotonic fluids should not be administered to clients with increased intracranial pressure, because they increase the risk of cerebral D5 in one-half normal saline is hypertonic, and would be an acceptable IV solution for this client. Normal saline and D5W are isotonic solutions, and so would need to be questioned. Half normal saline is hypotonic, and so would not be advisable for this client.

Cognitive Level: Analysis

Client Need: Physiological Integrity

Nursing Process: Planning

Objective: Learning Outcome 18-2: Identify common types of intravenous and infusion equipment.

• The nurse working in the Emergency Department is caring for a client who experienced 4) deep-thickness burns over 40 percent of his body and is in The nurse anticipates the physician will order:

1. A) Electrolyte B) Volume expanders.
2. C) Nutrient D) Total parenteral nutrition.

Answer: B

Explanation: A)      Initially, the client who is in shock will require volume expanders. Once vital signs are stabilized, the physician may order electrolyte solutions. Long-term, this client might require total parenteral nutrition if he is unable to maintain adequate calorie intake orally, but nutritional solutions would not be a priority concern this early in the client’s course of treatment.

Cognitive Level: Analysis

Client Need: Physiological Integrity

Nursing Process: Planning

1. Initially, the client who is in shock will require volume Once vital signs are stabilized, the physician may order electrolyte solutions. Long-term, this client might require total parenteral nutrition if he is unable to maintain adequate calorie intake orally, but nutritional solutions would not be a priority concern this early in the client’s course of treatment.

Cognitive Level: Analysis

Client Need: Physiological Integrity

Nursing Process: Planning

1. Initially, the client who is in shock will require volume Once vital signs are stabilized, the physician may order electrolyte solutions. Long-term, this client might require total parenteral nutrition if he is unable to maintain adequate calorie intake orally, but nutritional solutions would not be a priority concern this early in the client’s course of treatment.

Cognitive Level: Analysis

Client Need: Physiological Integrity

Nursing Process: Planning

1. Initially, the client who is in shock will require volume Once vital signs are stabilized, the physician may order electrolyte solutions. Long-term, this client might require total parenteral nutrition if he is unable to maintain adequate calorie intake orally, but nutritional solutions would not be a priority concern this early in the client’s course of treatment.

Cognitive Level: Analysis

Client Need: Physiological Integrity

Nursing Process: Planning

Objective: Learning Outcome 18-2: Identify common types of intravenous and infusion equipment.