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A medical-surgical nurse is concerned about the incidence of complications related to IV therapy, including bloodstream infection. Which intervention should the nurse suggest to the management team to make the bloodstream infection?
- A. Initiate a dedicated team to insert access devices.
- B. Require additional education for all nurses.
- C. Limit the use of peripheral venous access devices.
- D. Perform quality control testing on skin preparation products.
Correct Answer: A
Rationale: A dedicated IV team reduces complications, including bloodstream infections, improving outcomes. Education is helpful but less impactful, and limiting peripheral devices or testing products is less effective.
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A nurse teaches a client who is being discharged home with a peripherally inserted central catheter (PICC). Which statement should the nurse include in this client's teaching?
- A. Avoid carrying your grandchild with the arm that has the central catheter.
- B. Be sure to place the arm with the central catheter in a sling during the day.
- C. Flush the peripherally inserted central catheter line with normal saline daily.
- D. You can use the arm with the central catheter for most activities of daily living.
Correct Answer: A
Rationale: A properly placed PICC allows considerable freedom of movement, but heavy lifting, such as carrying a grandchild, can dislodge the catheter or occlude the lumen. A sling is not necessary, and flushing is typically done with heparin, not normal saline.
A nurse assesses a client who was started on intraperitoneal therapy 5 days ago. The client reports abdominal pain and feeling warm. For which complication of this therapy should the nurse assess this client?
- A. Allergic reaction
- B. Bowel obstruction
- C. Catheter lumen occlusion
- D. Infection
Correct Answer: D
Rationale: Abdominal pain and fever suggest peritonitis, a serious infection related to intraperitoneal therapy. Allergic reactions occur earlier, and bowel obstruction or catheter occlusion present differently.
A nurse prepares to flush a peripherally inserted central catheter (PICC) line with 50 units of heparin. The pharmacy supplies a multi-dose vial of heparin with a concentration of 100 units/ml. Which of the syringe shown below should the nurse use to draw up and administer the heparin?
- A. 1-ml syringe
- B. 3-ml syringe
- C. 5-ml syringe
- D. 10-ml syringe
Correct Answer: D
Rationale: A 10-ml syringe is required for flushing PICC lines to avoid high pressure that could rupture the catheter. Smaller syringes generate higher pressure, increasing the risk of damage.
A home care nurse prepares to administer intravenous medication to a client. The nurse assesses the site and reviews the client's chart prior to administering the medication. Based on the information provided, which action should the nurse take?
- A. Notify the health care provider
- B. Administer the prescribed medication.
- C. Discontinue the PICC.
- D. Switch the medication to the oral route.
Correct Answer: B
Rationale: The PICC is intact, patent, and free from complications, indicating it is safe to administer the prescribed IV medication. No other actions are warranted based on the provided information.
A nurse assesses a client's peripheral IV site, and notices edema and tenderness above the site. Which action should the nurse take next?
- A. Apply cold compresses to the IV site.
- B. Elevate the extremity on a pillow.
- C. Flush the catheter with normal saline.
- D. Stop the infusion of intravenous fluids.
Correct Answer: D
Rationale: Edema and tenderness suggest infiltration or phlebitis, requiring immediate cessation of the infusion to prevent further tissue damage. Flushing could worsen the issue, and cold compresses or elevation are secondary actions.