Fundamentals in Nursing II (NURB 240) Exam 3 Study
Guide DRAFT Questions With Complete Solutions
How are complications of IV therapy prevented, assessed, and
treated? Correct Answers -Phlebitis (inflammation of the vein
that can cause clots) --> discontinue IV, use moist heat, and
elevate
-Infiltration (fluid leaks out of the vessel and into the tissue,
blocking blood supply due to increased pressure in the tissue) --
> stop infusion, elevate, keep pressure off, monitor perfusion,
and use warm or cool compress
-Extravasation (infiltration of a vesicant that causes direct
cell/tissue damage) --> stop infusion, elevate, keep pressure off,
monitor perfusion, use warm or cool compress, aspirate*, and
use antidote if applicable*
-Venous air embolism (emergency characterized by chest pain,
dyspnea, decreased LOC, and a sense of impending doom) -->
position on left side and in Trendelenburg and then administer
100% high-flow oxygen
How are IV lines maintained? Correct Answers -Keep tubing
off of the floor
-Label all tubing and bags with date and time
-Disconnect tubing as infrequently as possible
-Change fluid bags at least every 24 hours
,-Change IV tubing and line cap every 96 hours (exceptions -->
intermittent infusions and continuous lipid infusions, which are
changed every 24 hours; blood products, which are changed
every 4 hours; and contaminated tubing/caps, which are changed
immediately)
How are IV push medications administered? Correct Answers
1.) Follow the same procedure for all other medications with
verifying the patient (name, DOB, and allergies) and doing 3
checks for the correct medication, dose, route, time, etc.
2.) Assess the site for redness, tenderness, edema, and other
signs of inflammation/infection.
3.) Pull up the medication into the syringe, get the air bubbles
out, and make sure you have the right dose, just like with an IM
injection.
4.) Check whether or not the medication needs to be diluted with
another fluid (such as normal saline). If so, pull the correct fluid
and amount to dilute.
If the patient has continuous IV fluids running:
5.) Make sure the drug is compatible with the fluid.
6.) If not done before preparing the medication, assess that the
PIV is working properly.
, 7.) Alcohol off the y-site port for 15 seconds. Do not drop the
port after.
8.) Pause the pump and pinch off the IV tubing between the
pump and the y-site.
9.) Att
How are primary IV infusions administered? Correct Answers
1.) Verify patient identity and allergies, perform the 3
medication checks, and perform hand hygiene.
2.) Assess the IV site for redness, tenderness, edema, etc.
3.) Open the tubing packaging and close the roller clamp. Note
that nothing should ever touch the floor, including the tubing.
4.) Remove the cap from the tubing spike, pull stopper from the
IV bag, and insert the spike into the bag.
5.) Hang the bag on the pole and squeeze the drip chamber until
1/2 full.
6.) Prime the tubing.
7.) Close the roller clamp.
8.) Load the tubing into the pump.
9.) Clean the IV port with alcohol for 15 seconds.
10.) If needed, push 2-3 mLs from saline flush into the IV, and
then reclean the port with alcohol for 15 seconds. (This step is
necessary if you have not just flushed the line from an IV push
administration).
Guide DRAFT Questions With Complete Solutions
How are complications of IV therapy prevented, assessed, and
treated? Correct Answers -Phlebitis (inflammation of the vein
that can cause clots) --> discontinue IV, use moist heat, and
elevate
-Infiltration (fluid leaks out of the vessel and into the tissue,
blocking blood supply due to increased pressure in the tissue) --
> stop infusion, elevate, keep pressure off, monitor perfusion,
and use warm or cool compress
-Extravasation (infiltration of a vesicant that causes direct
cell/tissue damage) --> stop infusion, elevate, keep pressure off,
monitor perfusion, use warm or cool compress, aspirate*, and
use antidote if applicable*
-Venous air embolism (emergency characterized by chest pain,
dyspnea, decreased LOC, and a sense of impending doom) -->
position on left side and in Trendelenburg and then administer
100% high-flow oxygen
How are IV lines maintained? Correct Answers -Keep tubing
off of the floor
-Label all tubing and bags with date and time
-Disconnect tubing as infrequently as possible
-Change fluid bags at least every 24 hours
,-Change IV tubing and line cap every 96 hours (exceptions -->
intermittent infusions and continuous lipid infusions, which are
changed every 24 hours; blood products, which are changed
every 4 hours; and contaminated tubing/caps, which are changed
immediately)
How are IV push medications administered? Correct Answers
1.) Follow the same procedure for all other medications with
verifying the patient (name, DOB, and allergies) and doing 3
checks for the correct medication, dose, route, time, etc.
2.) Assess the site for redness, tenderness, edema, and other
signs of inflammation/infection.
3.) Pull up the medication into the syringe, get the air bubbles
out, and make sure you have the right dose, just like with an IM
injection.
4.) Check whether or not the medication needs to be diluted with
another fluid (such as normal saline). If so, pull the correct fluid
and amount to dilute.
If the patient has continuous IV fluids running:
5.) Make sure the drug is compatible with the fluid.
6.) If not done before preparing the medication, assess that the
PIV is working properly.
, 7.) Alcohol off the y-site port for 15 seconds. Do not drop the
port after.
8.) Pause the pump and pinch off the IV tubing between the
pump and the y-site.
9.) Att
How are primary IV infusions administered? Correct Answers
1.) Verify patient identity and allergies, perform the 3
medication checks, and perform hand hygiene.
2.) Assess the IV site for redness, tenderness, edema, etc.
3.) Open the tubing packaging and close the roller clamp. Note
that nothing should ever touch the floor, including the tubing.
4.) Remove the cap from the tubing spike, pull stopper from the
IV bag, and insert the spike into the bag.
5.) Hang the bag on the pole and squeeze the drip chamber until
1/2 full.
6.) Prime the tubing.
7.) Close the roller clamp.
8.) Load the tubing into the pump.
9.) Clean the IV port with alcohol for 15 seconds.
10.) If needed, push 2-3 mLs from saline flush into the IV, and
then reclean the port with alcohol for 15 seconds. (This step is
necessary if you have not just flushed the line from an IV push
administration).
