Nokea
Which vein should be used first when initiating IV therapy?
- A. Jugular
- B. Basilic
- C. Brachiocephalic
- D. Axillary
Correct Answer: B
Rationale: When initiating IV therapy, the basilic vein is often used first due to its accessibility and size. The basilic vein is a common choice for venipuncture because it is located on the medial aspect of the arm and tends to be easily palpable. Additionally, the basilic vein is also less prone to complications such as nerve damage compared to other deeper veins like the jugular or brachiocephalic veins. Therefore, utilizing the basilic vein as the initial site for IV therapy is a safe and efficient choice.
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The nurse is caring for a very low birth weight (VLBW) newborn with a peripheral intravenous infusion. Which statement describes nursing considerations regarding infiltration?
- A. Infiltration occurs infrequently because VLBW newborns are inactive.
- B. Continuous infusion pumps stop automatically when infiltration occurs.
- C. Hypertonic solutions can cause severe tissue damage if infiltration occurs.
- D. Infusion site should be checked for infiltration at least once per 8-hour shift.
Correct Answer: C
Rationale: Infiltration of intravenous fluids in VLBW newborns can lead to serious complications, especially if hypertonic solutions are being administered. Hypertonic solutions have a higher osmolarity than the body's fluids, which can cause severe tissue damage if there is infiltration. It is crucial for the nurse to monitor the infusion site closely for signs of infiltration and take prompt action to prevent further harm to the newborn's delicate skin and tissues. The other options are not directly related to the risk and consequences of infiltration in VLBW newborns.
A 3-week-old neonate is brought to the emergency department because of a three-day history of intermittent vomiting. His mother reports that he has not urinated for eight hours. On physical examination, his eyes are sunken. Which of the following will MOST likely require correction before surgery is performed?
- A. Hypochloremia
- B. Hyperkalemia
- C. Hypernatremia
- D. N/A
Correct Answer: A
Rationale: Hypochloremia is often associated with dehydration and metabolic alkalosis, which may need correction before surgery.
A 78 year old male has been working on his lawn for two days, although the temperature has been above 90 degree F. he has been on thiazide diuretics for hypertension. His lab values are K 3.7 mEq/L, Na 129 mEq/L, Ca 9 mg/dl, and Cl 95 mEq/L. What would be a priority action for this man?
- A. Make sure he drinks 8 glasses of water a day.
- B. Monitor for fatigue, muscle weakness, restlessness, and flushed skin
- C. Look for signs of hyperchloremia
- D. Observe for neurologic changes
Correct Answer: B
Rationale: The 78-year-old male in this scenario is at risk for electrolyte imbalances due to prolonged exposure to high temperatures while taking thiazide diuretics, commonly prescribed for hypertension. The low potassium level (K 3.7 mEq/L) and low sodium level (Na 129 mEq/L) in his lab results are indicative of potential electrolyte disturbances, especially considering his age and medication. These electrolyte imbalances can lead to symptoms like fatigue, muscle weakness, restlessness, and flushed skin, which are signs of hyponatremia and hypokalemia.
Aling Nena, 68 years old, had a MVA and underwent surgery for hip fracture. Two days post-surgery, she suddenly complained of chest heaviness despite the absence of cardiac history. What is the nursing priority?
- A. document the onset, duration, severity, and precipitating factors
- B. may offer analgesics for chest pain
- C. administer oxygen via face mask
- D. inform the physician about the heaviness
Correct Answer: C
Rationale: In a post-operative patient, sudden chest heaviness can be a sign of various complications, such as a pulmonary embolism or cardiac issue. One of the immediate nursing interventions for a patient complaining of chest heaviness is to ensure adequate oxygenation. Administering oxygen via a face mask can help improve oxygenation and provide relief while further assessments are being done to determine the cause of the symptom. This intervention takes priority over documenting the symptom, offering analgesics, or informing the physician, as addressing the patient's oxygen needs is crucial in this situation.
For a patient with gastroesophageal reflux symptoms, the purpose of esophageal pH monitoring is to evaluate for:
- A. esophagitis from the reflux.
- B. frequency of the reflux.
- C. gastric emptying delays.
- D. possible obstructions.
Correct Answer: B
Rationale: Esophageal pH monitoring measures the frequency and duration of acid exposure in the esophagus, helping diagnose GERD.