Sherpath: Intravenous Fluid Therapy

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Question 1 of 10

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Which type of intravenous solution would be prescribed for a patient experiencing confusion secondary to swelling of brain cells?

    • IsotonicIsotonic solution would not reduce the brain swelling. Isotonic fluids do not typically cause fluid to flow across cell membranes.
    • HypotonicHypotonic solution would worsen the condition by increasing the cellular swelling and enlargement of cells within the brain.
  • Correct
    • HypertonicThis patient would need hypertonic intravenous solution so the brain cells would shrink.
    • No intravenous solutionAdministering no intravenous solution would not be appropriate. The patient needs additional sodium to draw the excess fluid out of the brain cells and reduce symptoms.

Question 2 of 10

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The patient has a dialysis catheter. The provider prescribes short-term IV antibiotics to treat an infection. Which approach would the LPN/LVN anticipate for administration of the antibiotics?

  • Correct
    • Insert a peripheral venous catheterAntibiotics can be administered through the peripheral venous catheter.
    • Insert a PICC lineA PICC line is not essential to administer antibiotics and only specially trained RNs can insert a PICC line.
    • Request an implanted portAn implanted port is not essential to administer antibiotics.
    • Use the dialysis catheterA dialysis catheter is only used for dialysis and would not be used to administer antibiotics.

Question 3 of 10

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Which goal of nursing care for the patient receiving an IV infusion does flushing the catheter or line address?

    • Preventing infectionFlushing the IV infusion does not prevent infection. Flushing the line assesses and maintains patency of the catheter and line and prevents mixing of incompatible solutions that could cause injury to veins and tissues.
  • Correct
    • Reducing injury to veins and tissuesFlushing the line assesses and maintains patency of the catheter and line and prevents mixing of incompatible solutions that could cause injury to veins and tissues.
    • Administering correct IV fluids at the correct rate and timeFlushing the catheter or line does not assist in administration of correct IV fluids at the correct time and rate.
    • Monitoring patient’s responses to IV infusionsFlushing the patient’s IV line does not assist to monitor the patient’s response to an IV infusion.

Question 4 of 10

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The patient is to receive a medication via IV piggyback, gravity infusion, and the nurse notices the medication is not flowing through the IV line. Which action would the nurse take to troubleshoot the situation? Select all that apply. One, some, or all options may be correct.

  • Correct
    • Check that the medication bag is hung higher than the other bag.The highest bag with fluid in it will flow first. The nurse must raise the desired fluid to the highest level.
  • Correct
    • Check that the clamp for the medication bag is open.Clamped tubing will not allow fluid to flow. The nurse must ensure all clamps are open.
  • Correct
    • Check the IV site for signs of infection or thrombophlebitis.Infection or thrombophlebitis of the IV site can cause sluggish fluid flow.
  • Correct
    • Check the position of the tubing.Kinked tubing can obstruct flow. The nurse must ensure no kinks are in the tubing.
  • Correct
    • Check the patient’s position.The container should be at least 36 inches above the patient’s heart. If the patient’s position has changed, the container height may need to be adjusted.
  • Correct
    • Check the IV site to ensure the cannula is correctly placed.A cannula may be pressed against a vessel, obstructing the flow. Retaping may be helpful.

Question 5 of 10

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The patient has an implanted port and the nurse notes a fever, chills, and increased white blood cell (WBC) count. Which action would the nurse take to manage the new symptoms?

    • Remove the implanted port.The nurse cannot remove the implanted port. This is done by the provider.
    • Elevate the head of the bed.Elevating the head of the bed is not indicated. Raising the head of the bed does not affect the patient’s symptoms.
    • Decrease the infusion rate.Decreasing the infusion rate is not indicated. Decreasing the infusion rate does not affect the patient’s symptoms.
  • Correct
    • Inform the provider of symptoms.The provider needs to be aware of the new symptoms so a treatment plan can be developed. The treatment plan may include lab testing for sepsis/infection.

Question 6 of 10

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The nurse notes the transparent dressing over a central line is loose on the edges and has blood around the insertion site. Which action would the nurse take to address the goal of preventing infection?

    • Reinforce the dressing with a new gauze dressing.Reinforcing the dressing does not address the soiled and compromised integrity of the current dressing. The integrity of the dressing must be addressed.
    • Determine when the dressing was last changed.It is not pertinent to determine when the dressing was last changed. Knowing the date of the last dressing change does not address the current integrity of the dressing.
  • Correct
    • Change the dressing per facility protocol.The dressing is no longer intact and is soiled, changing the dressing is indicated to prevent infection and maintain the site.
    • Flush the line with saline solution.Flushing the line is not indicated and does not address infection prevention or the lack of integrity of the dressing.

Question 7 of 10

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Which expected patient outcome would the nurse identify as appropriate for the problem statement “fluid volume overload”?

    • Blood gasses are within normal limitsThe outcome of blood gasses returning to normal does not apply to fluid volume overload.
  • Correct
    • Edema will decrease from 3+ to 1+Decreased edema is an appropriate outcome for fluid volume overload. A decrease in edemas suggests excess fluid has been excreted.
    • Intake will be greater than outputIntake greater than output is not an appropriate outcome for fluid volume overload. The nurse would expect to see output greater than input until the fluid volume balance is restored.
    • The patient’s weight will increaseIncreased patient weight is not an appropriate outcome for fluid volume overload. Increased weight suggests the fluid volume has increased rather than decreased.

Question 8 of 10

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Which instruction would the nurse give to an assistive personnel who is assisting with the care of a patient with fluid volume deficit?

  • Correct
    • Ask the patient which liquids they prefer.Patients need to take in additional liquid, knowing their preferences will encourage intake.
    • Report any edematous areas with redness.The patient with a fluid volume deficit will not typically demonstrate edema; this is not pertinent.
    • Keep the patient’s head of bed elevated.The patient with fluid volume deficit does not usually experience respiratory effects; this is not pertinent.
    • Offer hard candy or chewing gum.Offering hard candy or gum is appropriate for the patient with fluid volume overload on a fluid restriction, rather than the patient experiencing fluid volume deficit.

Question 9 of 10

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The nurse notes that the patient with fluid volume overload has a balanced intake and output and their weight has returned to baseline, but other patient outcomes have not been met. Which action would the nurse take based on this evaluation?

  • Correct
    • Document achievement of the outcomes and revise the plan of care.The nurse would document how the patient has met the outcomes and revise the plan of care based on current assessment of patient needs.
    • Continue monitoring the outcomes on the plan of care.Once achieved, the outcomes are discontinued from the plan of care as part of the revisions.
    • Revise the outcomes to demonstrate further patient improvement.The outcomes demonstrate achievement of outcomes, no further improvement would be expected.
    • Ask the assistive personnel to verify the patient has met the outcomes.Assistive personnel do not participate in care planning so their evaluation is not appropriate.

Question 10 of 10

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The older adult home care patient is taking digitalis which assessment would the nurse monitor daily? Select all that apply. One, some, or all options may be correct.

  • Correct
    • Heart rateMonitoring the patient’s heart rate is essential to monitoring for digitalis toxicity. Digitalis toxicity may lead to dangerously low heart rates.
  • Correct
    • Presence of nauseaMonitoring the presence of nausea is essential to monitoring for digitalis toxicity. Digitalis toxicity is often accompanied by nausea.
  • Correct
    • Character and frequency of stoolsMonitoring the patient’s stool patterns to check for diarrhea is essential to monitoring for digitalis toxicity. Potassium is lost in diarrhea, contributing to the risk of digitalis toxicity.
    • ConfusionConfusion is not specific to digitalis toxicity.
    • Respiratory rateThe patient’s respiratory rate is not specific to digitalis toxicity.