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84 Cards in this Set
- Front
- Back
Who has the highest athourity in dictating the LPN's role in IV therapy?
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Ohio Board of Nursing
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Universal Precautions has been defined for general implementation by?
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CDC
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Who made Universal precautions fully enforceable for the first time?
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OSHEA
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CDC's definition "all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV, and other blood borne pathogens
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TRUE
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Universal precautions must be used when?
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always
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Barrier precautions include
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gloves, mask, gown,
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There are federal regulations regarding use of needleless systems by healthcare facilities.
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TRUE
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Body fluids function is to ?
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W) waste excretion, A) assist in cell metabolism, t) transfer of materials to and from cells, e) Medium for cell metabolism, R) regulates body temp.
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most adults consume how many ml of water daily?
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1500
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The simplest method of objectively evaluating fluid balance is?
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I and O
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The movement of ions from an area of greater concentration to an area of lesser concentration is called?
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diffusion
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The passage of water from an area of lower concentration of particles toward a higher concentration of particles across a semipermeable membrane is called?
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osmosis
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The body's homeostatic organs and mechanisms are?
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kidneys, lungs,glands, blood vessels
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the patient has these signs and symptoms: moist rales, increased respiratory rate, dyspnea, and 3+ edema. the appropriate mursing diagnosis is?
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fluid overload or excessive fluid intake
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Signs and symptoms of fluid volume deficit are ?
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dehydration, poor skin turgor, decreased blood pressure, decreased pulse
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Major electrolytes in the body?
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calcium, chloride, potassium, Sodium, magnesium, phosphorus, Bi Carb
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Decrease in hydrogen ion concentration is termed?
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alkalosis
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Pharmacological agents that may impair renal water and thereby lead to sodium deficit are?
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Nicotine, Diabenese morphine, barbiuates, acetaminophen, cytoxin
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blood PH above normal (greater than 7.45) indicates ?
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alkaline
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blood ph below normal (less than 7.35)
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acidic
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the main objectives in IV therapy are?
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maintenance (short term) restoration (long term) replacement (accute, surgery)
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conditions in a geriatric patient that may lead to an electrolyte imbalance?
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diarrhea, vomitting, diuretics, malnutrition
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Mechanisms that control the ph of body fluids are ?
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lungs, kidneys, chemical buffer system
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Maintenance fluids are used for the patient who is ?
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short term
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the function of glucose in parenteral therapy is to provide ?
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calories
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hypotonic fluids are used to?
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hydrate cells
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hypertonic fluids are used to?
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replace electrolytes, fluid shift into plasma
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the most commonly used multiple electrolyte fluid is?
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lactated ringer
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The main role of sodium in the body is ?
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maintains extracellular fluid volume
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if patien has poor or no urine output the should suspect?
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poor kidney function
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causes of calcium deficit include?
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diarrhea, burns, radical neck surgery
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types of infusate containers are?
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glass open, glass closed, plastic
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IV solution containers should be inspected for?
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clarity, cracks, punctures, particles, expiration date
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the size of a cannula opening is the?
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guage
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A major hazard of using teflon over the needle catheters is?
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phlebitis
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Primary sets are reffered to as?
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standard sets, availabel in maacro and microdrip form supplied as vented and non-vented.
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Hickman, groshong, leonard and broviac refer to?
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central line catheter
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intermittent IV fluids are delivered via?
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piggyback (PB)
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butterfly (scalp vein) needles are generally use for?
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elderly, infants, small veins, short term
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an 18-20 gsuge over the needle catheter (ONC) should be used for ?
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blood, surgery
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volmetric pumps require
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special tubing
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When infusing a piggyback line, the primary infusate is positioned ________ than the secondary container
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Lower
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locking devices must be monitored q four hours and kept patent with?
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saline and or heparin
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according to the INS intermittent tubing should be changed q 24 hours
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TRUE
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INS standards of practice recommended that primary continuous peripheral sets be changed?
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q 96 hours
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body surface area condition and age of the patient composition of fluid and tolerance are?
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factors that influence IV Rate
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Information required to calculate flow rate
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amount to be infused over number of hours = ml per hour
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information required to calculate drops per minute
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gtt factor x ml per hour over 60 (min in hour) = drops per min
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factors tha affect floe rate are?
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hight of cantainer , clot, canula position, clogged vent
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When preparing and instructing a patient who is to receive an IV you should address?
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solution, procedure, why your getting IV, teach for signs and symp. to report
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should you teach the patient and family how to calculate the flow rate?
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NO
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When IV placement is necessary the nurse should consider aspects such as?
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privacy, independence, mental readiness
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Some factors that can influence the size and condition of the vein include?
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Psy. out look of client,diagnosis, age, trauma, body temp
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layers of veins are?
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tunica adventitia, media and intima
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the first barrier to successful venipuncture is?
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skin
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veins differences from arteries
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thinner, more valves, not as deep
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the most uncomfortable and difficult to splint IV site is?
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anticubital
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nursing considerations in initiating an IV in elderly patient are?
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gentel and slow, direct entry, smaller gauge, no tourniquet, veins are superfical and roll
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changes in elderly that make it more difficult to perform IV therapy include?
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fat loss, water loss, thin skin, arteriosclorosis
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hand washing for___ to ___ seconds with an antimicrobial soap is recommended before equipment set up and venipuncture
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15 - 20 sec.
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in selecting the IV site choose a vein that will suupport IV therapy foar at least ___ hours.
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72 hours
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methods of distending veins include?
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warm compress, gravity, making fist, touniquet above IV site
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choice of a catheter depends upon the ?
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solution, condition of vein, purpose of solution
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the following antimicrobial solutions may be used to cleanse the cannula site
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povidone iodine
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when using or flushing a central line IV you shoul always use a ____cc
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10 cc or larger
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correct labeling of the iv set up?
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IV site, tubbing, solution
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what should be done first when discontinuing and IV infusion?
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clamp tubing
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depending upon the type and unless otherwise ordered, the dressing over a venipuncture site should be changed ?
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depends on policy, DR's orders, if comprimised
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INS guuidelines recommend administration set replacement and cannula replacement q?
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Dr's orders and according to policy
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to maintain patency of indwelling venipuncture devices, the current INS recommendation is the use of 1 ml of hepatin lock flush solution containing heparin sodium 10 or 100 unit.
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TRUE
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Hep locks must be flushed q 8 hours if not being used for medication administration. (once a shift)
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TRUE
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when regulating an IV rate, the nurse should recall that the higher the solution container the ________ the rate of flow.
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faster
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local adverse reactions that may occur from IV therapy include?
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infiltration, thrombophlebitis, venous spasm
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some systemic adverse reactions that may occur from IV therapy.
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septicemia, pulmonary edema, speed shock, air imbolism
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an IV site that is reddened edematous and warm to the touch indicates?
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phlebitis
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not using a tourniquet or applying the tourniquet just before venipuncture are two techniques for preventing?
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hematoma
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If an IV infiltrates?
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D/C IV, apply pressure, warm or cool compress (as appropriate)
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the nurse can avoid a thrombosis formation by avoiding
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injury to vein wall, multiple sticks, going through and through vein
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techniques to prevent circulatory overload include?
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monitor, know your solution, don't play catch up, maintain correct rate
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an adult peripheral IV site should be checked
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Q 2 - 4 hours
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The veins most commonly used for blood withdrawl are the?
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median cephalic and median basilic
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IV patency when infusing less than 50 ml/hr the nurse should?
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use microdrip tubing
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formula for determining the number of drops to be infused per minute
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drop factor x ml per hour over 60 (minutes in hour)
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write the formula for determining the number of drops to be infused per minute
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gtt factor x ml per hour over 60 (min per hr.) = drops per min.
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