IV Tx

Question 1

4 personnel authorized to administer IV Fluids?

Answer 1

RN, SN, Certified LVN, Affiliating Nurse Faculty

Question 2

3 purposes for IV therapy?

Answer 2

Replace past + present fluid loss; provide maintenance fluids; provide parenteral route for meds, blood, and nutrients

Question 3

Plastic overwrap for IV solution bag removed 10/30. Can this solution be saved until 11/15 ?

Answer 3

No. Open overwrap IV solution bag expire at end of shift.

Question 4

Who must be notified when IV solutions are noted to be cloudy, crystallized, colored, or coagulated?

Answer 4

Pharmacy

Question 5

Policy states that IV solutions should be changed q

Answer 5

q 72 hours

Question 6

Per policy, licensed personnel who are IV certified may only administer IV solutions mixed by whom?

Answer 6

themselves and Pharmacy

Question 7

Where does one find information regarding drug incompatibility?

Answer 7

Pharmacy, drug information, pharmacology references, micromedex

Question 8

What assessments should be made when a patient is receiving potassium in the IV solution?

Answer 8

Serum potassium level, urine ouput

Question 9

IV solution mixed by the nurse must be administered within what time frame?

Answer 9

by end of shift

Question 10

How often must continuous primary IV tubings be changed?

Answer 10

q 96 hours

Question 11

What does drop factor mean?

Answer 11

Number of drops per mL

Question 12

How can one find out the drop factor of an administration set?

Answer 12

on the IV tubing packaging

Question 13

What is the drop factor of a microdrip set?

Answer 13

60 gtt/mL

Question 14

What is the drop factor of a macrodrip set?

Answer 14

15 gtt/mL

Question 15

What is the drop factor of Alaris pump tubing?

Answer 15

20 gtt/mL

Question 16

Infant/Children < 10 kg Formula for calculating Fluid requirements

Answer 16

100 mL/kg/day

Question 17

Infant/Children 11-20 kg Formula for calculating Fluid requirements

Answer 17

1000 mL/ 1st 10 kg / day + 50 mL/ addt’l kg /day

Question 18

Infant/Children > 20 kg Formula for calculating Fluid Requirements

Answer 18

1500 mL / 1st 20 kg / day + 20 mL / addt’l kg / day

Question 19

Child wt 15 kg. How many mL for IV fluid per day?

Answer 19

1000 + (50 x 5) = 1000 + 250 = 1250 mL/day

Question 20

4 saftey factors that must be adhered to prior to IVPB medication administration.

Answer 20

check site + patency, pt allergy + med incompatibility, expiration date, warm at room temp 1 hr prior

Question 21

How often must IVPB tubings be changed?

Answer 21

q 24 hr for intermittent

Question 22

2 exceptions for changing continuous IV tubing q 24hrs

Answer 22

TPN, experimental drugs, contaminated, precipitates, drug required it, change in concentration

Question 23

T/F All RNs are approved to administer medication via IVP

Answer 23

False. Need orientation + approved per Unit Structure Standard

Question 24

T/F State Certified LVNs can administer drugs via continuous infusion.

Answer 24

False. Not even if certified.

Question 25

What must be included in a physician's order for drugs to be administered by continuous infusion?

Answer 25

Name drug, Rate infusion, Duration infusion, con't or titrating dose, titrating or discontinue parameters

Question 26

The amount of flush solution instilled in a heparin/saline LOCK

Answer 26

1-3 mL; 3 mL NS adults; 1-3 mL NS + 1-3 mL heparin (10 units/mL) Peds

Question 27

Infusion pumps must be utilized for pts who are receiving

Answer 27

all/any infusion

Question 28

Gauge size for infants, slow flow rate.

Answer 28

24 G Yellow

Question 29

Gauge size for most infusion, most ages.

Answer 29

20 G Pink or 22 G Blue

Question 30

Gauge size for blood administration.

Answer 30

18 G Green

Question 31

Gauge size for large vol, trauma or surgery pts

Answer 31

16 G Gray

Question 32

Venipucture sites

Answer 32

Cephalic + Basilic, median cephalic, median cubital, median ante-, Dorsal Venous Arch, Metacarpal, Digital Vein

Question 33

Do NOT use peripheral veins because

Answer 33

Interfere with ambulation, vascular insufficiency, Infection; exception in Peds/Neonate ok BLE + scalp

Question 34

How often must the MD reorder IV solutions with additives?

Answer 34

q 24 hrs

Question 35

Are TKO rate orders acceptable?

Answer 35

No. MD need to specify rate for "To Keep Open"

Question 36

3 factors to consider when selecting IV needle/cannula?

Answer 36

purpose, pt. population, condition of available vein, type of solution

Question 37

6 factors to consider when selecting IV sites

Answer 37

pt age, pt activity, type of solution, previous illness, surgery, or anticipated procedure; available vein; pt preference; anticipated duration of tx

Question 38

T/F Licensed nursing personnel authorized to administer IV tx start an IV in the jugular vein in an emergency?

Answer 38

False. Only MD can.

Question 39

5 techniques that may augment vein distention?

Answer 39

fist formation; dependent position; milking; gentle tapping; relaxation

Question 40

BEST solution to clean an IV insertion site

Answer 40

Antiseptic Chlorohexidine or povodine iodine to decrease skin flora

Question 41

How many times may the licensed personnel attempt to start an IV on any one pt?

Answer 41

3 times max

Question 42

2 methods that may be utilized when inserting an IV needle/cannula?

Answer 42

Direct one step + Indirect 2 step

Question 43

Gauze dressings are changed every

Answer 43

48 hours

Question 44

Transparent dressings are changed every

Answer 44

96 hours

Question 45

T/F State certified LVNs can change central line dressings

Answer 45

True. LVN that is state certified can do it.

Question 46

3 nursing responsibilities related to ensuring safety during venipuncture.

Answer 46

standard precaution, do NOT recap needle, discard contaminated supplies appropriately

Question 47

Systematic method of examining the IV system is to start from (x) and following the tubing to the (x).

Answer 47

Container to insertion site

Question 48

6 things the nurse should assess if IV infusion stops

Answer 48

bottle to low, fluid level, drip chamber, kinked tubing, infiltration, IV needle placement

Question 49

You may irrigate an IV?

Answer 49

No. Never irrigate an IV.

Question 50

IV system should be checked every (x) for adults

Answer 50

2 hours

Question 51

IV system should be checked every (x) for Peds

Answer 51

1 hr

Question 52

T/F When removing IV needle/cannula, an alcohol swab should be placed over the insertion site?

Answer 52

False. Use a dry 2x2 dry steril gauze

Question 53

Where must administration of IVPBs be documented?

Answer 53

MAR; diluent used for mixing IVPB is documented on I&O's

Question 54

Primary purpose of administering TPN is to provide (x) intraveneously

Answer 54

Nutrients

Question 55

Peripheral TPN contains (x) Dextrose concentration.

Answer 55

\< 12.% Dextrose

Question 56

Central TPN contains (x) Dextrose concentration.

Answer 56

\> 25% Dextrose

Question 57

Central TPN may be infused into a perpheral vein?

Answer 57

No. Central TPN for central vein only

Question 58

T/F Fluid, electrolytes, and glucose should be evaluated during TPN administration.

Answer 58

TRUE

Question 59

TPN Recording is q

Answer 59

q 24 hrs

Question 60

TPN administration set change is q

Answer 60

q bottle/bag and q 24 hrs

Question 61

TPN solution/bag change is q

Answer 61

q 24 hrs

Question 62

TPN content inspection is q

Answer 62

q prior to inspection and during administration

Question 63

If TPN infusion rate is behind schedule, rate should be (x) to catch up?

Answer 63

Do NOT catch up.

Question 64

Which IV solution should be hung when TPN is NOT available?

Answer 64

D5W or D10W whichever is the closest match to the prescribed TPN dextrose concentration.

Question 65

T/F Electrolyte disturbances can cause cardiac and neuromuscular abnormalities.

Answer 65

True. Monitor EKG, dysrhythmias. Hypokalemia s/s flat/inverted T waves, U wave, ST depression; Hyperkalemia s/s Peaked T wave, loss of P wave, prolonged PRI, widened QRS; neuromuscular s/s muscle weakness, paresthesia, spasms, tetany

Question 66

Potassium normal serum level.

Answer 66

3.5 - 5.1 mEq/L

Question 67

Magnesium normal serum level.

Answer 67

1.7 - 2.3 mg / dL

Question 68

Phosphorus normal serum level.

Answer 68

2.5 - 4.5 mg / dL

Question 69

K+ can be given IVP

Answer 69

Nope. Never IVP

Question 70

K+ is usually administered at 10 mEq/ hour peripherally?

Answer 70

Yes.

Question 71

K+ is best infused in a peripheral vein?

Answer 71

No. K+ is an irritant. Best to use central vein

Question 72

As an IV additive, the max dose of magnesium is

Answer 72

6 gm/24hrs

Question 73

As an IV additive, the max dose of potassium is

Answer 73

40 mEq/24hrs

Question 74

How fast can you administer potassium?

Answer 74

no faster than 20 mEq/hour via central line; no faster than 10 mEq/hr via peripheral line.

Question 75

What is the usual dose for potassium phosphate infusion in acute care units?

Answer 75

15 mmol over 8 hrs; 30 mmol over 12 hrs; max 30 mmol/24 hrs in acute care

Question 76

MD order for iV electrolyte replacement must include

Answer 76

dose, duration, parameters, weight, complete drug name

Question 77

When do you evaluate electrolyte values with IV electrolyte replacement therapy?

Answer 77

evaluate during and after therapy.

Question 78

T/F Continuous cardiac and electrolyte monitoring is required for IV electrolyte replacement?

Answer 78

True. Monitor continuously.

Question 79

Electrolytes infusion given for replacement therapy may be mixed in (x)

Answer 79

500 mL or less of compatible IV solution

Question 80

T/F Can administer potassium phosphate via same IV line, port furthest to the pt?

Answer 80

False. No. Use separate IV line with port closest to pt. when administering potassium phosphate

Question 81

T/F potassium phosphate precipitates in dextrose and saline?

Answer 81

False. Potassium phosphate precipitates in most solutions EXCEPT Dextrose and Saline.

Question 82

T/F Ok to administer potassium phosphate IVP?

Answer 82

False. Never. May cause lethal dysrhythmia and death.

Question 83

Magnesium sulfate usual dose is

Answer 83

1-4 g (1 g over 4 hours in acute care)

Question 84

Max magnesium sulfate dose is

Answer 84

6 gm/24hrs

Question 85

T/F When administering electrolytes, it is important to use infusion pumps.

Answer 85

True. Use infusion pumps for electrolyte administration.

Question 86

T/F When administering electrolytes, it is important to monitor lab values.

Answer 86

True. Monitor lab values with electrolyte administration.

Question 87

T/F Administering electrolytes, it is important to assess cardiac and neuromuscular effects.

Answer 87

True. Monitor cardiac and neuromuscular effects with electrolyte administration.