Equipment

Question 1

Nurses role

Answer 1

Decision making process of equipment acquisition. Knowledge of operation of equipment to ensure safe, effective delivery of infusion therapy. Financial accountability. The public holds industry, medical institutions, and professional accountable of the safe and effective delivery of health care.

Question 2

Requires air vents.

Answer 2

Glass system

Question 3

Vented tubing is used

Answer 3

closed system

Question 4

Air enters through a tube in the bottle that allows for air displacement

Answer 4

Open glass system

Question 5

Made of PVC. A closed system. Does not contain a vacuum; must be flexible and collapsible. As fluid runs out, bad closes down.

Answer 5

The plastic system

Question 6

Administration sets

Answer 6

Single line sets, include primary (standard) sets, secondary (piggyback) sets, and volume controlled sets
Primary Y sets
Administrations sets vary among manufacturers and drop factors, all have basic components

Question 7

Basic components of administration sets

Answer 7

Spike/piercing pin
Flange- helps prevent contamination
Drop orifice- determines shape and size of drop
Drip chamber- pliable clear plastic tube contains the drop orifice.
Tubing- connects to the drip chamber. Average primary tubing length is 66-100 inches, secondary tubing length 32-42 inches
Clamp- flow clamp operates on the principle of compression of the tubing wall. Types: roller, screw, slide
Injection ports- serve as an access into the tubing and are located at various points
Back check valve- allows primary solution to resume after the piggyback is complete
Hub- adaptor to connect the administration set to the IV catheter or a needless system. Also called a male Luer-lock
Final filter- removes foreign particles from the infest. May be a part of the tubing (in line filter) or an add on.
Connections- they are universal. two types: slip, Luer lock

Question 8

Piggy back set: Standard drop rate 10-20 drops/min. Connected to an injection port. Primary set is positioned lower than the secondary set.
Volume controlled set: metered-volume chamber set. Designed for intermittent administration of measured volumes of fluid. Standard hold 100-150 mL; neonatal hold 10-50 mL

Answer 8

Secondary administration sets

Question 9

Needless connectors

Answer 9

Attached to the hub of the peripheral IV catheter and CVAD, allowing the tip of a syringe or male luer end of the IV administration set to be attached. Allow for venous access without removal of the connector, thus maintaining a closed infusion system. Appropriate flushing depends on type of connector (positive pressure, negative pressure, neutral pressure- most are this). Changed according to hospital policy, and if contamination is suspected.

Question 10

Add on devices

Answer 10

Stop cocks. Extension sets. Catheter connection devices. Multi flow adapters and Y connectors. Blood sampling systems. Closed system drug transfer devices. Filters.

Question 11

Flow control devices

Answer 11

Gravity dependent flow control: roller clamp. Manual flow regulators (dial-a-flow). Pressure bags or cuffs. Mechanical pumps. Elastomeric balloon pumps. Spring based pumps.

Question 12

A female connection point of an IV cannula where the tubing or other equipment attaches

Answer 12

Hub

Question 13

Area of the IV tubing usually found under the spike where the solution drips and collects

Answer 13

Drip chamber

Question 14

Point of entry

Answer 14

Port

Question 15

Space within an artery, vein, or catheter

Answer 15

Lumen

Question 16

A tube used for infusing fluids; also called a catheter

Answer 16

Cannula

Question 17

When using a flexible plastic system, what type of administration set could you choose?

a) vented
b) nonvented
c) venter or nonvented; both work with this system

Answer 17

b) nonvented

Question 18

A disadvantage of the glass solution containers is that it:

a) is breakable and difficult to store
b) Reacts with some solutions and medications
c) May be difficult to read fluid levels
d) May develop leaks

Answer 18

a) is breakable and difficult to store

Question 19

New research supports which of the following techniques to prevent infections with needleless connectors?

a) scrubbing needleless connectors prior to access
b) use of alcohol disinfection caps
c) leaving needleless connectors in place until the IV catheter is disconnected
d) Use of negative displacement systems

Answer 19

b) use of alcohol disinfection caps

Question 20

Which of the following reduce the risk for needlestick injuries?

a) elastomeric pumps
b) Luer-locks
c) Needleless systems
d) Three-way stopcocks

Answer 20

c) Needleless systems

Question 21

The limit to operating pressure at which an alarm is triggered on an electronic infusion device is known as:

a) Air-in-line alarm
b) Parameters or timed out
c) Occlusion alarm
d) Not infusing alarm

Answer 21

c) Occlusion alarm

Question 22

The nurse identifies errors in programming an infusion pump. What should the nurse do? (SATA)

a) Report the device malfunction to the supervisor
b) Fill out appropriate hospital form
c) Notify emergency care research institute on appropriate form
d) notify the risk manager

Answer 22

a) Report the device malfunction to the supervisor
b) Fill out appropriate hospital form
d) notify the risk manager

Question 23

Peripheral IV catheters designed for intermediate-term therapies of up to 4 weeks of isotonic or near-isotonic therapy. The catheter is placed midline in the antecubital region in the basilica, cephalic, or median antecubital site and is then advanced into the larger vessels of the upper arm for greater hemodilution

Answer 23

Midline catheters

Question 24

Defined by the location of the catheter tip in a central veins (tip should reside in the lower 1/3 of the SVA, above the RA). Made of soft, radiopaque medical-grade silicone elastomers or thermoplastic polyurethane. Single or multiple lumens

Answer 24

Central venous access devices

Question 25

Percutaneously placed catheter that is usually placed via the subclavian or internal jugular vein. Considered a short-term catheter and is used primarily in the acute care setting. May be single lumen, or may have 2,3, 4 or separate lumen

Answer 25

non-tunneled CVADs

Question 26

Most common type of CVAD used in all settings. May be placed for short term needs in the acute care setting and may be used on a longer term basis for pts who require longer-term infusion therapy beyond the hospital. Usually placed in an insertion site above the antecubital fossa, via the cephalic, basilic, or median veins and threaded to its central location in the SVC. May also be placed via the internal or external jugular vein.

Answer 26

Peripherally inserted central catheters

Question 27

Surgically placed CVAD. Considered a long-term catheter for pts who require lifelong or long-term infusion therapy such as TPN or chemo. Catheter is “tunneled” in the subcutaneous tissue between and entrance and exit site. The exit site is where the catheter extrudes, usually in the lower area of the chest. The entrance site is where the catheter enters venous circulation, generally in the area of the clavicle. Over time, tissue attaches to the cuff, stabilizing and holding the catheter in place. The tunneling/cuff also serves to seal the path from the exit site to the vein, thus reducing the risk of bloodstream infection. Broviac and Hickman.

Answer 27

Subcutaneously tunneled CVADs

Question 28

A nurse is preparing to infuse an antibiotic IV piggyback. Which connection should the nurse use to secure the piggyback administration set to the primary administration set?

a. Slide clamp
b. Luer lock
c. Slip lock
d. Taping with paper tape

Answer 28

b. Luer lock

Question 29

A nurse is initiating IV therapy for a client using a Teflon over-the-needle catheter. The primary disadvantage of Teflon over-the-needle catheters for peripheral infusion is:

a. the risk for phlebitis.
b. the risk for infiltration.
c. the risk for septicemia.
d. the fact that they can be used for only 24 hours.

Answer 29

a. the risk for phlebitis.

Question 30

A committee is asked to investigate ways to reduce needlestick injuries in a hospital. Which technology best assists in the reduction of needlestick injuries?

a. Luer locks
b. Elastomeric pumps
c. Needleless systems
d. Three-way stopcocks

Answer 30

c. Needleless systems

Question 31

A nurse specialist is performing placement of a midline catheter. Midline placement refers to a:

a. peripherally inserted catheter with the tip location in the superior vena cava.
b. peripheral catheter less than or equal to 3 inches in length.
c. peripheral catheter that is between 3 and 8 inches in length with the distal tip dwelling in the basilic, cephalic, or brachial vein at or below the level of the axilla.
d. catheter surgically placed into a vessel, body cavity, or organ and attached to a reservoir that is placed under the skin.

Answer 31

c. peripheral catheter that is between 3 and 8 inches in length with the distal tip dwelling in the basilic, cephalic, or brachial vein at or below the level of the axilla.