Chapter 30 IV Therapy

Chapter 30 IV Therapy

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.1)Several factors will influence the selection of cannula size and insertion site for infusingintravenous solutions. Which of the following factors should be the main determinant in cannulasize and insertion site selection?1)A)Probable duration of intravenous therapyB)Principle of using the smallest gauge cannula in the smallest vein availableC)Purpose for the intravenous infusionD)Client’s level of consciousnessAnswer:CExplanation:A)Some intravenous solutions and medications are irritating to the vein walls andrequire that a larger vein be used, such as in the forearm rather than the hand.Solutions such as blood and blood products may require a larger-gauge cannula.The nurse should choose the smallest appropriate gauge cannula to use in thislarger vein to promote hemodilution and minimize vein wall damage. Theprinciple of using the smallest gauge cannula in the smallest vein available is anincorrect statement. The client’s level of consciousness and the probable duration ofintravenous therapy will influence insertion site more than cannula size, both ofwhich will ultimately be determined by the purpose for the infusion.AssessmentPhysiological Integrity-Reduction of Risk PotentialApplicationB)Some intravenous solutions and medications are irritating to the vein walls andrequire that a larger vein be used, such as in the forearm rather than the hand.Solutions such as blood and blood products may require a larger-gauge cannula.The nurse should choose the smallest appropriate gauge cannula to use in thislarger vein to promote hemodilution and minimize vein wall damage. Theprinciple of using the smallest gauge cannula in the smallest vein available is anincorrect statement. The client’s level of consciousness and the probable duration ofintravenous therapy will influence insertion site more than cannula size, both ofwhich will ultimately be determined by the purpose for the infusion.AssessmentPhysiological Integrity-Reduction of Risk PotentialApplicationC)Some intravenous solutions and medications are irritating to the vein walls andrequire that a larger vein be used, such as in the forearm rather than the hand.Solutions such as blood and blood products may require a larger-gauge cannula.The nurse should choose the smallest appropriate gauge cannula to use in thislarger vein to promote hemodilution and minimize vein wall damage. Theprinciple of using the smallest gauge cannula in the smallest vein available is anincorrect statement. The client’s level of consciousness and the probable duration ofintravenous therapy will influence insertion site more than cannula size, both ofwhich will ultimately be determined by the purpose for the infusion.AssessmentPhysiological Integrity-Reduction of Risk PotentialApplication1
D)Some intravenous solutions and medications are irritating to the vein walls andrequire that a larger vein be used, such as in the forearm rather than the hand.Solutions such as blood and blood products may require a larger-gauge cannula.The nurse should choose the smallest appropriate gauge cannula to use in thislarger vein to promote hemodilution and minimize vein wall damage. Theprinciple of using the smallest gauge cannula in the smallest vein available is anincorrect statement. The client’s level of consciousness and the probable duration ofintravenous therapy will influence insertion site more than cannula size, both ofwhich will ultimately be determined by the purpose for the infusion.AssessmentPhysiological Integrity-Reduction of Risk PotentialApplication2)A client has been receiving intravenous therapy for several days. The infusion site has beenchanged every 72 hours per facility protocol. When the nurse is assessing the client’s arms todetermine the next venipuncture site, the nurse notices a discrete, slightly raised, reddened rash onthe dorsal and ventral surfaces of the lower arms and hands. The client says the areas are itchy. Thenurse determines that a new infusion can be started and that a change should be made in theprocedure. What is the most appropriate change for the nurse to make?2)A)Avoid using povidone-iodine as part of the skin preparation.B)Apply cool, moist compresses to the itchy areas prior to doing the next venipuncture.C)Use a blood pressure cuff for a tourniquet.D)Use a hypoallergenic tape to secure the needle and tape tubing.Answer:DExplanation:A)The rash, as described by appearance and locations, is more likely to be from tapethan from the povidone-iodine used for the skin preparation. An allergic responseto the povidone-iodine is more likely to be at the needle insertion sites and circulararound them. No rash is observed at the tourniquet sites. Cool, moist compresseswill cause vasoconstriction, and make the next venipuncture more difficult. Abetter solution to the itching is to get an order for a topical antipruritic agent.ImplementationPhysiological Integrity-Reduction of Risk PotentialAnalysisB)The rash, as described by appearance and locations, is more likely to be from tapethan from the povidone-iodine used for the skin preparation. An allergic responseto the povidone-iodine is more likely to be at the needle insertion sites and circulararound them. No rash is observed at the tourniquet sites. Cool, moist compresseswill cause vasoconstriction, and make the next venipuncture more difficult. Abetter solution to the itching is to get an order for a topical antipruritic agent.ImplementationPhysiological Integrity-Reduction of Risk PotentialAnalysisC)The rash, as described by appearance and locations, is more likely to be from tapethan from the povidone-iodine used for the skin preparation. An allergic responseto the povidone-iodine is more likely to be at the needle insertion sites and circulararound them. No rash is observed at the tourniquet sites. Cool, moist compresseswill cause vasoconstriction, and make the next venipuncture more difficult. Abetter solution to the itching is to get an order for a topical antipruritic agent.ImplementationPhysiological Integrity-Reduction of Risk PotentialAnalysis2
D)The rash, as described by appearance and locations, is more likely to be from tapethan from the povidone-iodine used for the skin preparation. An allergic responseto the povidone-iodine is more likely to be at the needle insertion sites and circulararound them. No rash is observed at the tourniquet sites. Cool, moist compresseswill cause vasoconstriction, and make the next venipuncture more difficult. Abetter solution to the itching is to get an order for a topical antipruritic agent.ImplementationPhysiological Integrity-Reduction of Risk PotentialAnalysis3)All of the following clients have received one unit of packed red blood cells. All clients tolerated theprocedure well, with no reactions or complications noted. When planning the dischargeinstructions for these clients, it is most important that the nurse provide information about thesigns and symptoms of graft-versus-host delayed reaction for the client with: (Select all thatapply.)3)A)A low hemoglobin following blood loss in surgery.B)HIV disease who is taking marrow-suppressing antiviral medications.C)Anemia secondary to chemotherapy for breast cancer.D)Severe blood loss from an acute gastric bleed.E)Chronic obstructive pulmonary disease who is taking large doses of prednisone.F)Anemia secondary to anorexia nervosa.Answer:B, C, EExplanation:A)Graft-versus-host delayed reactions after blood transfusion are most often seen inclients who are immune-compromised. Clients taking corticosteroids, receivingchemotherapy for cancer, and with HIV disease are all immune-compromised.White blood cells are mixed with red blood cells in this transfusion, unless theblood has been irradiated or treated in some way to eliminate them. In this kind ofreaction, the recipient reacts to the donor lymphocytes, which sets up a responsein which the host tissue cells are attacked and destroyed.PlanningPhysiological Integrity-Reduction of Risk PotentialApplicationB)Graft-versus-host delayed reactions after blood transfusion are most often seen inclients who are immune-compromised. Clients taking corticosteroids, receivingchemotherapy for cancer, and with HIV disease are all immune-compromised.White blood cells are mixed with red blood cells in this transfusion, unless theblood has been irradiated or treated in some way to eliminate them. In this kind ofreaction, the recipient reacts to the donor lymphocytes, which sets up a responsein which the host tissue cells are attacked and destroyed.PlanningPhysiological Integrity-Reduction of Risk PotentialApplicationC)Graft-versus-host delayed reactions after blood transfusion are most often seen inclients who are immune-compromised. Clients taking corticosteroids, receivingchemotherapy for cancer, and with HIV disease are all immune-compromised.White blood cells are mixed with red blood cells in this transfusion, unless theblood has been irradiated or treated in some way to eliminate them. In this kind ofreaction, the recipient reacts to the donor lymphocytes, which sets up a responsein which the host tissue cells are attacked and destroyed.PlanningPhysiological Integrity-Reduction of Risk PotentialApplication3
D)Graft-versus-host delayed reactions after blood transfusion are most often seen inclients who are immune-compromised. Clients taking corticosteroids, receivingchemotherapy for cancer, and with HIV disease are all immune-compromised.White blood cells are mixed with red blood cells in this transfusion, unless theblood has been irradiated or treated in some way to eliminate them. In this kind ofreaction, the recipient reacts to the donor lymphocytes, which sets up a responsein which the host tissue cells are attacked and destroyed.PlanningPhysiological Integrity-Reduction of Risk PotentialApplicationE)Graft-versus-host delayed reactions after blood transfusion are most often seen inclients who are immune-compromised. Clients taking corticosteroids, receivingchemotherapy for cancer, and with HIV disease are all immune-compromised.White blood cells are mixed with red blood cells in this transfusion, unless theblood has been irradiated or treated in some way to eliminate them. In this kind ofreaction, the recipient reacts to the donor lymphocytes, which sets up a responsein which the host tissue cells are attacked and destroyed.PlanningPhysiological Integrity-Reduction of Risk PotentialApplicationF)Graft-versus-host delayed reactions after blood transfusion are most often seen inclients who are immune-compromised. Clients taking corticosteroids, receivingchemotherapy for cancer, and with HIV disease are all immune-compromised.White blood cells are mixed with red blood cells in this transfusion, unless theblood has been irradiated or treated in some way to eliminate them. In this kind ofreaction, the recipient reacts to the donor lymphocytes, which sets up a responsein which the host tissue cells are attacked and destroyed.PlanningPhysiological Integrity-Reduction of Risk PotentialApplication