IV Therapy Final Exam Questions & Answers with 100% Success Guaranteed 2023, Exams of Nursing

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What equipment and supplies are needed for initiation of IV therapy? - Correct Answer: cannulas, tourniquets, clean gloves, site cleansing agent, IV solution, IV tubing, IV pole, extension tubing, and dressing Using what gauge, what length catheter and in the what vein will reduce the mechanical and chemical irritation to the vein wall? - Correct Answer: smallest gauge, shortest length, and largest vein What gauges do cannulas range? - Correct Answer: 14 to 26 What length do over-the needle catheters range? - Correct Answer: 3/ to 3 inches What length do butterfly style cannulas range? - Correct Answer: 3/4 to 2 inches

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What are the advantages of using extension tubing with over-the needle cannulas? - Correct Answer: loops tubing away from the insertion site preventing dislodgement and mechanical irritation if pulled, tubing can be changed away from the insertion site, and decreased cannula manipulation and risk for contamination What gauge is used for children and elderly patients? - Correct Answer: 22 to 26 gauge What gauge is used for medical patients and postoperative patients? - Correct Answer: 20 to 24 gauge What gauge is used for surgical patients and rapid blood administration? - Correct Answer: 18 gauge What gauge is used for trauma patients and those requiring large volumes of fluid rapidly? - Correct Answer: 14 to 16 gauge

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What is the purpose of the protective caps at each end of the administration set and when should they be removed? - Correct Answer: to keep both ends of the tubing sterile until immediately prior to use What parts of the IV therapy equipment must remain sterile? - Correct Answer: catheter, tubing insertion spike, and stylet A bag of intravenous solution should not hang longer than how many hours? - Correct Answer: 24 hours How often should intravenous tubing be changed? - Correct Answer: 72 to 96 hours How often should IV sites be changed? - Correct Answer: 96 hours

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How often should a gauze dressing be changed? - Correct Answer: 48 hours How often should a transparent dressing be changed? - Correct Answer: 7 days What type of administration set (tubing) should be used for nonrigid containers (bags)? - Correct Answer: nonvented What type of administration set (tubing) should be used for solutions supplied in glass containers? - Correct Answer: vented What gtt/mL is macrodrip tubing? - Correct Answer: 10 gtt/mL, 15 gtt/mL, 16 gtt/mL, and 20 gtt/mL

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What gtt/mL is microdrip tubing? - Correct Answer: 60 gtt/mL What kind of tubing set do you use to infuse a solution rapidly? - Correct Answer: macrodrip What kind of tubing set do you use to infuse a solution slowly? - Correct Answer: microdrip A physician's order for IV therapy must contain what components? - Correct Answer: date of order, type of fluid solution, volume, and length of infusion time If medication is ordered, identify what additional components to the order must be present. - Correct Answer: date, drug, dose, frequency of drug, length of infusion time, and dilution strength

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True or False: Prior to initiating IV therapy, the nurse must check the expiration date on the solution, and inspect the solution and container for particles, discoloration, cracks, leaks, or punctures. - Correct Answer: true What is time tape? What is the advantage of using time tape? Should you write directly on the solution container with a marker? Why or why not? - Correct Answer: monitors IV fluid/medication delivery. You can quickly see if the rate of IV delivery needs to be adjusted. You should not write directly on IV solution bag as it is absorbed through the IV plastic bag What is the difference between IV push (IVP) or bolus versus intermittent IV therapy? Do LPNs administer IVP medications? - Correct Answer: IVP is a medication given directly into the IV line and is pushed over a set time identified in IV Medication books, ie, Lasix 10mg over 1 min. A bolus is directly pushed into the IV line at a steady rate, ie 50% dextrose. LPNs do NOT give IVP medications

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Describe how to regulate an IV infusing by gravity. How high should the solution be positioned above the infusion site? - Correct Answer: The nurse has to first figure out how many gtt/min to deliver the specific amount of fluid or the dose of medication. Using a watch with a second hand and using a manual controller to either speed up the gtt/min or the slow the gtt/ml. IV bag should be 36 inches above insertion site What is the difference between an electronic pump and a controller? - Correct Answer: electronic pump controls IV fluid infusion by a computer and controller is controlled manually (gravity drip) by the nurse True or false: an infusion pump will stop administering an IV solution is an IV infiltrates. - Correct Answer: false

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True or false: The best time to change the tubing is when the IV solution bag is changed. - Correct Answer: true True or false: IV tubing sets will remain sterile for 72 hours even when the patient is receiving blood and fat emulsions. - Correct Answer: false True or false: IV bags should be replaced when there is 200 cc left in the bag. - Correct Answer: false True or false: The drop factor for microdrip tubing is 10gtt/mL. - Correct Answer: false True or false: An IV running too slowly has the potential to clot. - Correct Answer: true

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True or false: A sudden increase in the amount of solution infused may result in a patient's death. - Correct Answer: true True or false: IV tubing is tagged with the date and time to indicate when tubing replacement is necessary. - Correct Answer: true True or false: Failure to prime IV tubing with solution and remove air bubbles my result is a patient's death. - Correct Answer: true What is the location of the basilic vein? - Correct Answer: medial side of arm (little finger side) What are the advantages of the basilic vein? - Correct Answer: large and easy to see; 16 to 22 gauge

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What are the disadvantages of the basilic vein? - Correct Answer: rolls, difficult to stabilize location (put arm across chest, stand on opposite side of bed) What is the location of the cephalic vein? - Correct Answer: lateral aspect (thumb side) of arm What are the advantages of the cephalic vein? - Correct Answer: large, easy to access, 16 to 22 gauge; good for irritants What are the disadvantages of the cephalic vein? - Correct Answer: tip may be in bend of arm with longer catheters What is the location of the median vein? - Correct Answer: underside arm

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What are the advantages of the median vein? - Correct Answer: medium size, easy to stabilize, 20 to 24 gauge What are the disadvantages of the median vein? - Correct Answer: none What is the location of the metacarpal and dorsal veins? - Correct Answer: top of hand What are the advantages of the metacarpal and dorsal veins? - Correct Answer: good to begin IV therapy, easily visualized, 20 to 24 gauge What are the disadvantages of the metacarpal and dorsal veins? - Correct Answer: can't be used with vesicants

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Describe a vein that is suitable for venipuncture. - Correct Answer: Round, firm, elastic, engorged with blood; not hard, bumpy or flat Do you need a physician's order to start an IV in the lower extremity of an adult? Why or why not? - Correct Answer: Yes. Blood likely to pool or clot which may result in an embolism. Only a RN or primary health care provider should start an IV in a foot. List six factors which must be considered when selecting a vein. - Correct Answer: availability of the site, size of the intracath to be used, type of fluids to be infused, volume, rate and length of the infusion, degree of mobility desired, and skill of nurse initiating infusion List at least five venipuncture site contraindications. - Correct Answer: arm of a mastectomy patient, arm with an ateriovenous shunt or fistula, arm being treated for numbness, arm that has experienced trauma, and avoid legs - circulation is easily impaired, DVTs,

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How do you palpate a vein? - Correct Answer: Use index and middle fingers over anticipated site When starting a peripheral IV, which veins are used first and why? - Correct Answer: The superficial veins in the dorsum of the hand and lower forearm. Need to be as distal as possible to save potential future proximal IV sites. When should the use of hand veins be avoided? Wrist veins? - Correct Answer: When vesicant fluids or antibiotics are being infused. When it impairs ROM for the patient. Describe OSHA guidelines regarding the use of tourniquets among clients. - Correct Answer: Occupational Safety and Health Administration (OSHA) establishes enforced guidelines to assist employers in implementing safety standards for employers. Tourniquets

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are single patient use only. IV sylets are to have safety shields to reduce the possibility of needle sticks. Dispose of IV stylets in sharps container. Dispose of sharps container when ½ to ¾ full. Know your "needle stick" protocol in your hospital. How far above the intended venipuncture site should the tourniquet be applied? - Correct Answer: 4 to 6 inches above anticipated IV site A tourniquet should be left no longer than how many minutes? - Correct Answer: 2 minutes Besides the tourniquet, identify four ways to further dilate veins. - Correct Answer: Position arm in a dependent position, rub or stroke arm, cover entire arm with warm, moist towels for 5 - 10 minutes, and after applying tourniquet, have patient open and close fist

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When a tourniquet is properly applied, should you be able to palpate a distal pulse? - Correct Answer: Yes, a tourniquet should not occlude arterial flow. If there is no distal pulse, the tourniquet is on too tight and will damage the limb. What are the most common sites used on neonates? - Correct Answer: scalp and umbilical What are the most common sites used on all pediatrics? - Correct Answer: metacarpal, cephalic, basilica, and median Are gloves required during venipuncture? - Correct Answer: yes According to the CDC, when should hands be washed, or an alcohol- based hand rub be used during the venipuncture procedure? - Correct Answer: before and after palpating IV sites, before and after inserting IV catheter, and before and after accessing IV system for any purpose

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If the venipuncture site is excessively hairy what should you do? - Correct Answer: clip, do not shave Name at least two common antimicrobials used to cleanse the site before venipuncture. - Correct Answer: alcohol, alcohol - providone and chlorohexidine If both alcohol and providone- iodine are used, in what order should they be applied and why? - Correct Answer: alcohol, then providone (must be wiped off, irritating to skin), alcohol inactivates providone In adult patients, how large of surface area from the intended venipuncture site should be cleansed? - Correct Answer: 2 to 4 inches Do you use a circular or a back and forth motion to cleanse the site? Why? - Correct Answer: Cleansing should go back and forth not in a

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circle. Use increased friction to allow antimicrobial solution to penetrate to lower layer of the epidermis Is it acceptable to blot any excess solution? - Correct Answer: No, allow area to air dry If alcohol is used, how long should it be applied with friction? - Correct Answer: 30 seconds to 1 minute Describe how to immobilize the vein. How long should you maintain immobilization during venipuncture? - Correct Answer: Use thumb of nondominant hand to stretch skin downward to anchor vein. Do not apply too much pressure or you will flatten vein. Which direction should the cannula bevel face during insertion? - Correct Answer: bevel up

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What angle is the cannula inserted at? - Correct Answer: 5 to 10 degrees What is backflow or backflash? What do you do after it occurs? - Correct Answer: blood enters the hub of the IV catheter, lower cannula almost parallel to the skin, and advance slightly to ensure tip of cannula is in the lumen of the vein What are you trying to avoid piercing during venipuncture? - Correct Answer: opposite wall of vein Once the stylet has been removed, may it be reinserted to advance the catheter/check for placement? - Correct Answer: no At what point in the procedure is the tourniquet removed? - Correct Answer: Either when blood is present in the catheter hub or after the nurse has advanced the cannula but before the stylet is taken out.

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After performing venipuncture, when can you let go of the catheter? - Correct Answer: after the IV catheter is secured After the fluids are connected and started, what do you look for? - Correct Answer: redness, edema, skin, pain, any other complaints that the patient has No more than how many attempts of cannulation by any one nurse should be made in order to avoid multiple unsuccessful attempts, causing unnecessary trauma to the patients, and limiting future vascular access. - Correct Answer: 2 What does it indicate if you apply lite pressure above (or proximal) to the IV insertion site and drops cease dripping in the drip chamber? - Correct Answer: the IV cannula is in the vein

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Describe how to dress a catheter site using a transparent dressing. - Correct Answer: Insertion site clean and dry, DON'T cover tubing and cannula hub, Place transparent dressing over insertion site and up to cannula hub, don't stretch dressing, and "tuck" transparency dressing around hub to keep out microorganisms What information should be written on the dressing? - Correct Answer: date, time, IV cannula guage, your initials Should tape be placed over the IV tubing and catheter hub connection?

• Correct Answer: No, in an emergency, it becomes very difficult to remove tape/dressing off of the hub connection to be able to give emergency drugs. Should tape be placed over the IV insertion site? - Correct Answer: yes

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List the steps in disconnecting an IV site. - Correct Answer: put clean gloves on, lift tape/transparency dressing off from skin toward the insertion site (use alcohol pads if necessary), apply sterile 2x2 and remove cannula vertically out, apply pressure to the insertion site 1 - 2 minutes, elevate extremity, inspect the cannula tip, inspect the insertion site, apply bandaid or dressing depending on condition of insertion site, ask patient to restrict activity for that extremity for about 10 minutes, DOCUMENT Where do you dispose of the stylet and any blood contaminated materials? - Correct Answer: stylet - sharp's container; blood contaminated materials - in a biohazard bag and placed in biohazard container What is the organization that sets the standards of care for IV therapy? - Correct Answer: INS - Infusion Nurse Society

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List three "do's" of documentation. - Correct Answer: Document only what is observed firsthand, Use "no IV related complications", Use "observed" rather than "noted", Give details regarding complications - use infiltration and phlebitis scales, Date, time, site location, gauge, Insertion: date, time, cannula brand name, gauge, length of cannula, site location, number of attempts Document removal of IV cannula List three "don'ts" of documentation. - Correct Answer: Don't write "good blood return" Don't write "patient tolerated procedure well" Don't write "cannula tip intact"

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List the common causes for malpractice litigation for nurses. - Correct Answer: infiltration and phlebitis nerve injury extravasation of medication incorrect site wrong medication wrong medication dose Incorrect rate of fluid/medication ignoring patient's complaint of pain fractured central line catheter How often should a site check be performed? - Correct Answer: every 4 hours How often should a volume check be performed? - Correct Answer: every 1-2 hours

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How often should a IV site be changed? - Correct Answer: every 72 hours How often should a bag of IV solution be changed? - Correct Answer: every 24 hours How often should IV tubing be changed? - Correct Answer: every 24-72 hours What information must you include in your documentation when you insert an IV? - Correct Answer: date, time brand, gauge, length, of cannula anatomic location number of attempts type of solution

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flow rate name of medication (if any) adverse reaction and therapeutic action taken if it is a site change, reason for change patient education and understanding of reason for IV therapy and any precautionary measures. signature What information must you include in your documentation when you remove an IV? - Correct Answer: date and time of removal condition of site description of any drainage site care given type of dressing applied patient education and/or instructions