Nursing 214 midterm Questions With Complete Solutions
2 hypervolemia examples Correct Answers Both patient had a
major surgery- joint replacement surgery
Healthy adult = as develop hypervolumia have lower leg edema,
fingers feeling like sausages, heart rate and bp within normal
range, patient received 5 L of fluid in and put out 2L therefore
netgain of 3L. When assess no SOB, dyspnea, no cognitive
changes. Inspite of all this, the patient is tolerating fluid. When
tolerating, hormones are causing retain of fluid after surgery. If
tolerating, hormones will come back down to normal therefore
monitor patient closely to make sure they don't go into stress.
Same surgery, elderly and comorbidities (heart/resp diseaseS).
Also has edema, received 5L in and pout ot 2L therefore took on
3L fluid. Notice neck veins, heart rate and BP elevated from
normal baseline, and dypnea, SOB, need extra O2, hear crackles
in lungs. This person is not tolerating fluid. Because they are
going into distress and having trouble tolerating. Interventions
will need to be taken.
Accidental removal of IV catheter Correct Answers Usually
with peripheral IVs- tape loose or gets caught on something
Treat just like catheter remove on purpose apply pressure and if
continues to bleeding elevate limb- put dressing on
Prevention: make sure IV is well secured
Additional diagnostic tests Correct Answers Liver function:
AST, ALT, ALP, GGT
Pacemaker: will need to get pacemaker checked prior to surgery
Cardiac function: Stress test, echocardiogram, etc.
Testing for sleep apnea
,Air embolism Correct Answers Air gets into venous system
and travels through circulatory system
No problem with little air bubbles
If we get larger air bubbles- problems because lung in veins and
air travels to heart- enters through vena cava and goes through to
lungs it can create an air lock and fluid can't go through. Blocks
blood being oxygenated by lungs and if large enough it can lead
to death
If we get large air bubble we will need medical help (doctor)-
we will turn person onto left side so air is trapped up in upper
side of heart and lift up foot of bed because the air will have to
travel downwards to get into lungs- doctor can do intervention
by putting in catheter to get the air bubble out. Very rare with
peripheral more common with central.
Can be called by medical misadventure- the wrong thing getting
connected to IV tubing
Allergic reaction or anaphylaxis Correct Answers Allergic
reaction can be because:
equipment- like ports, tubing, latex, medication/IV solution
Can develop rash or hives ( sometimes seen on persons back)
Sometimes signs don't appear until a few days later
Anaphylaxis- allergic reaction moves towards shock- need to
worry about airways, and persons being able to breath, and
circulation - report to dr. =
Minor reaction - antihistamine (benedryl), or more serious =
epinephrine
,can result in loss of consciousness, hives, swelling of tongue,
inability to swallow, rapid swelling of throat tissues
Angiocatheters Correct Answers Come in a variety of sizes and
are distinguishable by their coloring. They are over the needle as
safety precaution. Made of special material to soften
invasiveness to cause less irritation.
Yellow= pediatrics
blue (22) and pink (20) are the most common for adults
black and orange inserted by a physician and usually don't see
green= for blood
Are students allowed to give ID injections? Correct Answers
** under direct supervision
BSN scope of practice regarding IV access Correct Answers -
Most peripheral stuff able to do under supervision until deemed
competant, hemodialysis: set up, strip down, and cleaning
machine - administering oral meds -- perform predialysis
assessment -- monitor BG and document care
-NO for anything to do with hemodialysis, ABGs,
continuous/intermittent irrigation or chest tubes with
medications or solutions
-central line always under supervision like dressing changes,
flushing and aspirating blood to verify patency, drawing blood
sampling, assessing implantation device-- phelbotomy
Can a LPN supervise a student's dressing change? Correct
Answers LPNs may supervise students, if the teacher involves
the LPN in the regulatory supervision process
, Catheter embolism Correct Answers Piece of catheter could
travel through venous system and travel to the lungs- very rare
with peripheral more common with Central
Implanted port and central line going into superior vena cava
and stops right above right atrium of heart.
Right side shows fragmented piece
If it breaks off try and grab it and if that doesn't work apply a
tourniquet because you need a medical intervention to go in and
fish it out.
Catheter occlusion Correct Answers Common
Mechanical failure = 19% of all IV failure
Occluded: something gone up into catheter and blocked - often
blood backing up forming clot and occluding it - prevent by
appropriate flushing routine- every 24 hours unless continuous-
also flush if blood gets into tubing
Can be caused by precipitate or other solutions can occlude -
total parenteral nutrtion is more likely to form precipitate
Sometimes 2 solutions that are not compatible with each other -
prevent by looking up IV drugs to see compatibility and flush
really well between solutions that are not compatible
If peripheral and can't flush we remove it- try and flush very
gently and if you don't feel like anything is going through d/c
saline flush and remove catheter
Central venous access system. Where does it go and who is it
oftenly used in? Correct Answers The IV tip (end of IV
catheter) usually threaded up to superior vena cava.
2 hypervolemia examples Correct Answers Both patient had a
major surgery- joint replacement surgery
Healthy adult = as develop hypervolumia have lower leg edema,
fingers feeling like sausages, heart rate and bp within normal
range, patient received 5 L of fluid in and put out 2L therefore
netgain of 3L. When assess no SOB, dyspnea, no cognitive
changes. Inspite of all this, the patient is tolerating fluid. When
tolerating, hormones are causing retain of fluid after surgery. If
tolerating, hormones will come back down to normal therefore
monitor patient closely to make sure they don't go into stress.
Same surgery, elderly and comorbidities (heart/resp diseaseS).
Also has edema, received 5L in and pout ot 2L therefore took on
3L fluid. Notice neck veins, heart rate and BP elevated from
normal baseline, and dypnea, SOB, need extra O2, hear crackles
in lungs. This person is not tolerating fluid. Because they are
going into distress and having trouble tolerating. Interventions
will need to be taken.
Accidental removal of IV catheter Correct Answers Usually
with peripheral IVs- tape loose or gets caught on something
Treat just like catheter remove on purpose apply pressure and if
continues to bleeding elevate limb- put dressing on
Prevention: make sure IV is well secured
Additional diagnostic tests Correct Answers Liver function:
AST, ALT, ALP, GGT
Pacemaker: will need to get pacemaker checked prior to surgery
Cardiac function: Stress test, echocardiogram, etc.
Testing for sleep apnea
,Air embolism Correct Answers Air gets into venous system
and travels through circulatory system
No problem with little air bubbles
If we get larger air bubbles- problems because lung in veins and
air travels to heart- enters through vena cava and goes through to
lungs it can create an air lock and fluid can't go through. Blocks
blood being oxygenated by lungs and if large enough it can lead
to death
If we get large air bubble we will need medical help (doctor)-
we will turn person onto left side so air is trapped up in upper
side of heart and lift up foot of bed because the air will have to
travel downwards to get into lungs- doctor can do intervention
by putting in catheter to get the air bubble out. Very rare with
peripheral more common with central.
Can be called by medical misadventure- the wrong thing getting
connected to IV tubing
Allergic reaction or anaphylaxis Correct Answers Allergic
reaction can be because:
equipment- like ports, tubing, latex, medication/IV solution
Can develop rash or hives ( sometimes seen on persons back)
Sometimes signs don't appear until a few days later
Anaphylaxis- allergic reaction moves towards shock- need to
worry about airways, and persons being able to breath, and
circulation - report to dr. =
Minor reaction - antihistamine (benedryl), or more serious =
epinephrine
,can result in loss of consciousness, hives, swelling of tongue,
inability to swallow, rapid swelling of throat tissues
Angiocatheters Correct Answers Come in a variety of sizes and
are distinguishable by their coloring. They are over the needle as
safety precaution. Made of special material to soften
invasiveness to cause less irritation.
Yellow= pediatrics
blue (22) and pink (20) are the most common for adults
black and orange inserted by a physician and usually don't see
green= for blood
Are students allowed to give ID injections? Correct Answers
** under direct supervision
BSN scope of practice regarding IV access Correct Answers -
Most peripheral stuff able to do under supervision until deemed
competant, hemodialysis: set up, strip down, and cleaning
machine - administering oral meds -- perform predialysis
assessment -- monitor BG and document care
-NO for anything to do with hemodialysis, ABGs,
continuous/intermittent irrigation or chest tubes with
medications or solutions
-central line always under supervision like dressing changes,
flushing and aspirating blood to verify patency, drawing blood
sampling, assessing implantation device-- phelbotomy
Can a LPN supervise a student's dressing change? Correct
Answers LPNs may supervise students, if the teacher involves
the LPN in the regulatory supervision process
, Catheter embolism Correct Answers Piece of catheter could
travel through venous system and travel to the lungs- very rare
with peripheral more common with Central
Implanted port and central line going into superior vena cava
and stops right above right atrium of heart.
Right side shows fragmented piece
If it breaks off try and grab it and if that doesn't work apply a
tourniquet because you need a medical intervention to go in and
fish it out.
Catheter occlusion Correct Answers Common
Mechanical failure = 19% of all IV failure
Occluded: something gone up into catheter and blocked - often
blood backing up forming clot and occluding it - prevent by
appropriate flushing routine- every 24 hours unless continuous-
also flush if blood gets into tubing
Can be caused by precipitate or other solutions can occlude -
total parenteral nutrtion is more likely to form precipitate
Sometimes 2 solutions that are not compatible with each other -
prevent by looking up IV drugs to see compatibility and flush
really well between solutions that are not compatible
If peripheral and can't flush we remove it- try and flush very
gently and if you don't feel like anything is going through d/c
saline flush and remove catheter
Central venous access system. Where does it go and who is it
oftenly used in? Correct Answers The IV tip (end of IV
catheter) usually threaded up to superior vena cava.
