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WorksheetsFinal Fundamentals Quiz 1 (IV Therapy)
Total questions: 100
Worksheet time: 51mins
What is the MAIN purpose of continuous IV infusions in intravenous therapy?
To replace and/or maintain fluids and electrolytes
To administer oral medications
To give intermittent bursts of medicine
To cause the patient to excrete excess fluid volume
Which of the following is an advantage of continuous IV infusions?
A) Drug is infused over a longer period of time
B) Drug is given rapidly
C) Limited drug delivery
D) Requires frequent needle changes
Fill in the blank: One disadvantage of continuous IV infusions is the danger of infusing too much _____
fluid
water
glucose
iron
Pharmacy will usually pre-mix continuous IV infusions.
True
False
What is an example of an intermittent IV infusion?
IV piggy back or IV push
Continuous IV therapy
Intramuscular injection
Subcutaneous injection
Saline locks are used to maintain venous access without the need for continuous infusions.
True
False
When receiving orders for IV therapy, what should be included in every order?
Name of IV solution, name of the medication to be added if any, time period during which the IV is to infuse
Patient's age and weight and name of IV solution
Time of day, nurse's initials, time period during which the IV is to infuse
Type of syringe and color of tubing and name of the medication to be added if any, time period during which the IV is to infuse
Name one vascular access device needed for the initiation of IV therapy.
IV catheter
Oxygen mask
Urinary catheter
Endotracheal tube
SATA: Select the items of equipment needed for the initiation of intermittent IV therapy besides the IV catheter itself.
Tourniquets
Clean gloves
Bags of IV fluid
Tubing
Electronic infusion devices/pumps
SATA: Which veins are commonly used as sites for peripheral IV therapy?
Temporal Artery
Median Forearm Vein
Basilic Vein
Inferior Vena Cava
Accessory Cephalic Vein
Which vein is only to be used in children for IV therapy?
Foot veins
Jugular vein
Cephalic vein
Basilic vein
Which vein is only to be used in neonates for IV therapy?
Temporal veins
Cephalic vein
Basilic vein
Saphenous vein
What should be changed as needed during maintenance of IV therapy?
IV fluid containers, tubing, and dressings
Patient's diet plan
Patient's medication schedule
Room temperature settings
SATA: What should the nurse assess during maintenance of IV therapy?
Presence of complications
Changes in flow rate
Family at the bedside
Meal preferences
Pump settings
Which of the following is a reason for discontinuing peripheral IV access?
A) Upon discharge
B) Expiration of peripheral access site
D) Both A and B
C) New IV medication order that is compatible with previous IV medication administered
E) A, B and C
All types of IV therapy REQUIRE an electronic infusion device/pump.
True
False
Fill in the blank: The sterile IV administration set includes a drip chamber with specific drop size (varies) and _______.
injection spike
thermometer
sphygmomanometer
stethoscope
Which of the following is REQUIRED for fluids that need strict regulation (i.e. potassium) and for pediatric patients?
Gravity administration
Electronic infusion devices (pumps)
Manual injection
Oral administration
Pumps use pressure and DO NOT rely on gravity.
True
False
What will happen if the rate of flow is disrupted, altered, or if tubing is pinched in an electronic infusion device?
An alarm will sound.
The device will shut down immediately.
The infusion will continue at a faster rate.
Nothing will happen; the device will ignore it.
PCA (Patient Controlled Analgesia) allows for:
B) Patients to self administer pain medication
A) Patients to have a continuous 'basal' rate of medication
D) Both A and B
E) A, B, and C
C) Prevention of dosing errors
What is the safe range of infusion rates for pumps?
10-50 mL/hr
50-200 mL/hr
200-400 mL/hr
400-600 mL/hr
When performing a gravity flow infusion, where should the IV bag be hung in relation to the patient's heart?
Below the heart
At the same level as the heart
Above the heart
It does not matter
Fill in the blank: The higher the IV bag, the ______ the flow.
faster
slower
lower
same
For gravity flow, the rate is calculated ______ instead of mL/hr.
in gtt/min
in L/day
in mg/kg
in cc/sec
True or False: The rate calculated for gravity flow is as accurate as the rate for pumps.
True
False
What should you do if the infusion rate for pumps exceeds 200 mL/hr?
Ignore it
Double check the order and your calculations
Increase the rate further
Call the patient's mother
What is the FIRST step when discontinuing an intermittent IV infusion?
Remove the tubing
Turn off the pump
Change the IV site
Prime the line
When adding new IV tubing, what technique should be used?
Sterile technique
Aseptic technique
No technique required
Surgical technique
True or False: It is acceptable to let IV tubing touch the floor.
True
False
What should you always remember to do when priming fluid bags and lines?
Check for air in the line
Use cold water
Shake the bag
Add medication
IV bags MUST be labeled with which of the following?
A) Contents, rate, and client identifiers
B) Contents
C) Rate
D) Client identifiers
What may be applied to visually cue hour and volume correlations during IV therapy?
Rate tapes
Adhesive bandages
Alcohol swabs
Tourniquets
Which of the following are potential complications of intravenous therapy, and what should be done if they occur?
Phlebitis and infiltration; stop the infusion and notify the healthcare provider
Hypertension and diabetes; increase the IV flow rate
Asthma and allergies; administer more IV fluids
Dehydration and fever; apply a cold compress
Monitor client during infusion, rapid infusion of potassium can cause what?
DEATH
Rash
Constipation
Drowsiness
NEVER ADMINISTER POTASSIUM VIA IV PUSH!!!
True
False
DO NOT add potassium to an IV bag that is already infusing.
True
False
SATA: Which of the following are potential IV contamination sources of infection?
Hands of medical personnel (not washing hands)
Hub colonization (not scrubbing the hub)
Contaminated fluid
Hematogenous spread
Contaminated during insertion
Which of the following is NOT a cause of infection related to IV therapy?
Skin microflora of patient
Poor skin prep
Catheters left in place more than 72 hours
Field sticks changed every 24 hours
Which of the following is an infection complication associated with IV therapy?
Septicemia
Infiltration
Extravasation
Agranulocytosis
List two signs and symptoms (S/S) of infiltration in IV therapy.
Slowed or stopped infusion, swelling, tenderness, pallor, coolness at site
Redness and warmth at site, rapid infusion, dry skin
Elevated blood pressure, fever, headache, slowed or stopped infusion
Bradycardia, chest pain, blurred vision
What is the nursing response to infiltration during IV therapy?
Stop the infusion, restart IV in a different vein, elevate affected arm on a pillow, apply warm or cool compress
Continue the infusion and monitor for improvement, apply ice pack only
Increase the infusion rate and massage the area vigorously
Ignore the infiltration and document it at the end of the shift
Which of the following is a late sign of extravasation?
Swelling
Pallor
Blistering
Coolness
What is the first nursing response to extravasation during IV therapy?
STOP THE INFUSION STAT, administer antidote if applicable, elevate the extremity, apply a COLD compress
CRANK THE INFUSION STAT, administer antidote if applicable, elevate the extremity, apply a COLD compress
STOP THE INFUSION STAT, administer antidote if applicable, elevate the extremity, apply a WARM compress
STOP THE INFUSION STAT, administer antidote if applicable, lower the extremity, apply a WARM compress
Septicemia is the presence of a microorganism or their toxic by-products in which system?
Respiratory system
Circulatory system
Digestive system
Nervous system
Which of the following is NOT a cause of septicemia in IV therapy?
Break in aseptic technique
Contaminated fluids
Proper hand hygiene
Use of sterile equipment
Name some signs and symptoms (S/S) of septicemia.
Fever, chills, tachycardia, hypotension, confusion, elevated WBC count
Bradycardia, dry skin, low WBC count, hypertension
Weight gain, constipation, bradycardia, normal temperature
Joint pain, rash, normal blood pressure, low WBC count
What is the nursing response for circulatory overload when administering too much IV fluids or administering fluids too fast?
STOP THE INFUSION STAT, consult HCP, administer antibiotics
SLOW the IV flow rate, place the patient in high fowlers, monitor VS, administer diuretics if ordered
Place client in Trendelenburg position on the left side, administer 100% oxygen
Apply a tourniquet above the site, notify HCP and radiologist, start a new IV line
SATA: Which of the following are signs or symptoms (S/S) of circulatory overload?
Palpitations
Sharp and sudden pain at IV site
Jugular venous distention
Cough and hypotension
Crackles on lung auscultation
What is the nursing response for an air embolus?
Place client in Trendelenburg position on the left side, prepare emergency equipment for emergent procedures, administer 100% Geek Bar
Place client in Trendelenburg position on the left side, prepare emergency equipment for emergent procedures, administer 100% oxygen
Place client in High Fowlers position on the left side, prepare emergency equipment for emergent procedures, administer 100% oxygen
Place client in Trendelenburg position on the right side, prepare emergency equipment for emergent procedures, administer 100% oxygen
SATA: Which of the following is a cause of an air embolus?
Administering too much IV fluids
Reinserting a catheter used in an unsuccessful insertion
Loose connections
Removing and reinserting a stylet
Failing to prime tubing before connecting IV medications to patient
What is the nursing response for a catheter embolus?
STOP the secondary medication, but not the primary! Notify the HCP and the urologist!
Place client in Trendelenburg position!
Apply a tourniquet above the site! Notify HCP and the radiologist! Start a new IV line!
SLOW the IV flow rate! Notify the HCP and the orthopedic surgeon!
Fill in the blank: Normal blood serum osmolality is _______ mOsm/kg.
280-300
200-220
320-340
150-170
Which type of IV solution is similar to blood osmolality and remains inside the intravascular compartments?
Hypotonic
Isotonic
Hypertonic
Gin and Tonic
Fill in the blank: Isotonic solutions expand ONLY the ______, making them ideal for patients with hypovolemia or hypotension.
ECF (extracellular fluid)
ICF (intracellular fluid)
plasma proteins
red blood cells
Which of the following are examples of isotonic solutions?
D5W, ½ NS
Normal saline, LR
Volume expanders (Dextran, Albumin)
0.33% Saline
Which type of IV solution has lower osmolality than blood osmolality and causes water to move out of blood vessels into the cells and interstitial tissue?
Isotonic
Hypertonic
Hypotonic
Colloid
Fill in the blank: Hypotonic solutions are used for patients with low fluid volume/dehydration or those needing ______ replacement.
water
sodium
electrolyte
protein
Which of the following are examples of hypotonic solutions?
Normal saline, LR
D5W, ½ NS, 0.33% Saline, 0.25% Saline
Volume expanders (Dextran, Albumin)
None of the above
Which type of IV solution has osmolality greater than blood osmolality and initially raises the osmolality of the ECF?
Isotonic
Hypotonic
Hypertonic
Isosmotic
Fill in the blank: Hypertonic solutions require frequent monitoring of BP, lung sounds, and serum ______ levels.
Na+ (sodium)
Mg+ (magnesium)
Ca2+ (calcium)
Cl- (chloride)
Which of the following are examples of hypertonic solutions?
D5W, ½ NS
Normal saline, LR
Volume expanders (Dextran, Albumin)
0.33% Saline
What is the concentration of sodium chloride in a STANDARD bag of normal saline (NS)?
0.9%
0.45%
5%
10%
Normal saline (NS) is isotonic and contains no calories, free water, or other electrolytes.
True
False
Excessive administration of normal saline (NS) can result in elevated ______ and ______ levels.
Na and Cl
K and Ca
Mg and PO4
HCO3 and K
What is the concentration of sodium chloride in half normal saline (½ NS)?
0.9%
0.45%
5%
10%
D5W (5% dextrose in water) provides how many grams of glucose per 100 mL of fluid?
5 grams
1 gram
10 grams
0.5 grams
D5W is isotonic but physiologically _______.
hypotonic
hypertonic
neutral
alkaline
Which IV fluid is used to replace water losses, glucose, and to treat hypernatremia?
NS
D5W
RL
D7RL
Lactated Ringer solution (RL or LR) is more similar to plasma than NS.
True
False
Lactated Ringer solution contains which of the following electrolytes?
Na, K, Ca, lactate (metabolized to HCO3-)
Na, Cl, Mg, phosphate, lactate
Lactate, K, Ca, Mg, sulfate
Na, K, Cl, bicarbonate acetate (metabolized to HCO3-), lactate
D5NS is dextrose 5% in _________?
normal saline
water
lactated ringer's
plasma
D5 and ½ NS contains dextrose 5% in ________ saline.
half normal
normal
hypertonic
isotonic
Which of the following is true about D5 and ½ NS?
It is hypotonic
It provides 170 cal/L
It contains no dextrose
It is used only for emergencies
D10W is dextrose 10% in ________.
water
saline
plasma
milk
True or False: D10W contains electrolytes.
True
False
Any fluid higher than 10% dextrose must be infused via ________ to prevent shrinkage of RBCs.
central line
peripheral vein
subcutaneous route
intramuscular injection
Which of the following is NOT a colloid/protein solution used as a plasma expander?
Packed RBCs
Albumin
Plasma
Glucose
Dextran is a complex synthetic sugar that ________ additional fluid into the intravascular space.
pulls
pushes
removes
blocks
Hetastarch/Hespan is a synthetic colloid that works similarly to ________ to expand plasma volume.
Dextran
Albumin
Saline
Mannitol
Define the term 'central line' as associated with IV therapy.
An intravenous line inserted into a major vein, with the subclavian or internal jugular most often used.
An intravenous line inserted into a major vein, also known as a peripheral line, with the subclavian or internal jugular most often used.
An intravenous line inserted into a major vein, also known as a PICC line, with the subclavian or antecubital most often used.
An intravenous line inserted into a major vein, also known as a midline, with the antecubital or internal jugular most often used.
What is the main difference between a PICC line and a midline catheter?
PICC: multiple lumens, ends in the heart. Midline: single lumen, ends just before heart.
PICC: single lumen, ends in the arm. Midline: multiple lumens, ends in the heart.
PICC: used for short-term therapy. Midline: used for long-term therapy.
PICC: inserted in the leg. Midline: inserted in the chest.
The catheter in a central line is advanced from the insertion site into the ________.
SUPERIOR VENA CAVA
LEFT VENTRICLE
AORTA
PULMONARY ARTERY
Which of the following is NOT an advantage of central lines?
Accommodates highly irritating and hyperosmolar solutions
Easily accessible even when severely dehydrated
Does not require radiographic confirmation of placement
Useful for monitoring central venous pressure
Saline or heparin is injected into the port of a saline/heparin lock regularly to ________.
prevent clotting
increase blood pressure
reduce infection risk
enhance medication absorption
increase thrombin generation
What is required to confirm the placement of a central line?
Radiographic confirmation
Blood pressure measurement
Pulse oximetry
Physical examination
What are some other names for saline/heparin locks?
Medlock, saline lock, heplocks
IV drip lock, blood lock, plasma lock
PICC lock, midlock, central lock
"Got It" count >6.5 (-900) (absolute lock)
What should you do after infusion of medications in site?
Flush after infusion of medications in site
Remove the IV line immediately
Apply a cold compress to the site
Elevate the limb for 24 hours
What is the average heparin flush dosage?
10 units
1 units
1,000 units
5 units
The average heparin flush dosage is 10 units, and NEVER EXCEEDS ____ units!
100
10
50
70
Which of the following is a high-alert medication that comes in many dosage strengths, and could cause serious complications due to excess blood loss?
Phosphate
Heparin
Vitamin C
Saline
Warkarin
Which tubing type carries the main IV solution and is continuous?
Primary Line
Secondary Line
Peripheral Line
IV Piggyback
Which tubing type is usually connected to primary via a variety of systems and contains solutions of smaller volume medications?
Secondary Line
Primary Line
Extension Set
Blood Administration Set
Where is a peripheral line located?
Peripherally (hand, arm, leg, feet, etc)
Centrally (chest, neck)
In the abdomen
In the scalp
In the superior vena cava
IV Piggyback is also known as what?
Secondary line
Primary infusion
Bolus injection
Direct push
There is a small margin for error when giving medications via IV push.
True
False (there is a large margin)
False (there is no margin)
Which type of patient is a volume control set best suited for?
Pediatric patients
Geriatric patients
Adult patients
Dehydrated patients
Lactated Ringers (LR) provides calories.
True
False
Excessive administration of normal saline can lead to hypernatremia.
True
False
Which is the MOST important vital sign to monitor closely when a patient is suffering from circulatory overload?
BP
Temperature
SpO2%
HR
RR
