Chapter 7. Nursing Care of Patients Receiving Intravenous Therapy

Chapter 7. Nursing Care of Patients Receiving Intravenous Therapy

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____     1.   The health care provider is planning to discontinue total parenteral nutrition for a patient who has been receiving it for 3 weeks after an episode of severe gastrointestinal (GI) bleeding. What patient care order should the nurse anticipate?

____     2.   The nurse is preparing to insert an intravenous (IV) catheter in a newly admitted patient. Which area should the nurse use first for this catheter?

____     3.   The IV infusion pump for a patient receiving an IV therapy begins to alarm and displays occlusion. When the silence button is pushed, the alarm quickly resumes. Which action should the nurse take first?

____     4.   Assessment of blood glucose levels is prescribed every 6 hours for a patient who is receiving parenteral nutrition (PN). The patient asks why this is necessary. Which response by the nurse is most appropriate?

____     5.   The nurse notes that a patient’s central venous access device (CVAD) infusion site gauze dressing is saturated with blood. What should the nurse do?

MULTIPLE CHOICE

1. ANS:  D
2. When PN therapy is started, the rate is increased gradually to the prescribed rate to help prevent hyperglycemia. When it ends, the rate is gradually decreased to prevent hypoglycemia. A. Clear liquids do not provide enough protein. B. Tube feedings use the GI system the same as oral feedings. C. A sodium-restricted diet with high-protein snacks is not indicated.

PTS:   1                    DIF:    Moderate

KEY:  Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application

2. ANS:  A
3. Hand veins are used first if long-term IV therapy is expected. This allows each successive venipuncture to be made proximal to the site of the previous one, which eliminates the passage of irritating fluids through a previously injured vein and discourages leakage through old puncture sites. B. The forearm can be used if hand veins are not available or if previous catheters were placed into hand veins. C. D. The upper arm and antecubital space are not ideal locations for IV catheter placement.

PTS:   1                    DIF:    Moderate

KEY:  Client Need: Physiological Integrity—Pharmacological and Parenteral Therapies | Cognitive Level: Application

3. ANS:  B
4. A kink in the tubing or closed clamp is often the reason for occlusion and can be easily remedied. C. D. Flushing tubing can dislodge a clot into systemic circulation. A. There is no reason to notify the physician.

PTS:   1                    DIF:    Moderate

KEY:  Client Need: Physiological Integrity—Pharmacological and Parenteral Therapies | Cognitive Level: Application

4. ANS:  C
5. Because of the high glucose concentration of PN, the patient is at risk for infection and blood glucose disturbances. Ongoing assessments include blood glucose levels according to institution policy. A. A physician may have prescribed the monitoring, but it is not a satisfactory answer for the patient. B. Glucose should return to normal after PN is discontinued, so the patient should not be told he has diabetes unless a diagnosis has been made. D. Rebound hypoglycemia can occur after PN is discontinued.

PTS:   1                    DIF:    Moderate

KEY:  Client Need: Physiological Integrity—Pharmacological and Parenteral Therapies | Cognitive Level: Application

5. ANS:  A
6. If saturated with blood, the gauze dressing over a CVAD infusion site should be changed. B. Reinforcing the dressing with a gauze pad is not sufficient for this access site. C. The nurse can change the dressing. D. A transparent dressing should not be placed over a soiled gauze dressing.

PTS:   1                    DIF:    Moderate

KEY:  Client Need: Physiological Integrity—Pharmacological and Parenteral Therapies | Cognitive Level: Application