A nurse is caring for a client following insertion of a subclavian nontunneled percutaneous central venous catheter (CVC). The provider writes a prescription to initiate an IV infusion of Ringer's lactate at 150 mL per hr. Prior to starting the infusion, which of the following actions should the nurse take?

Apply oxygen at 3 L/min per nasal cannula.

Review the chest x-ray report.

Flush the catheter with sterile water.

Obtain a peripheral blood glucose level.

Answer and Explanation

The Correct Answer is B

A. Apply oxygen at 3 L/min per nasal cannula: While oxygenation is important, there is no

indication in the scenario that the client requires oxygen supplementation at this time. Checking oxygen saturation would be more relevant if there were respiratory concerns.

B. Review the chest x-ray report: This is the most appropriate action before initiating the IV

infusion to ensure proper placement of the central venous catheter and absence of complications such as pneumothorax or malposition.

C. Flush the catheter with sterile water: Flushing the catheter with sterile water is not necessary before starting the infusion, especially without confirming proper catheter placement through chest x-ray.

D. Obtain a peripheral blood glucose level: While monitoring blood glucose levels may be

important in certain clinical situations, it is not directly relevant to initiating an IV infusion of Ringer's lactate via a central venous catheter.

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Correct Answer is C

Explanation

A. Varicella-zoster (chickenpox) requires airborne precautions due to its transmission via respiratory droplets or aerosols.

B. Vancomycin-resistant enterococcus (VRE) is typically transmitted through direct contact with contaminated surfaces or equipment and does not require droplet precautions.

C. Pertussis (whooping cough) is transmitted via respiratory droplets and requires droplet precautions to prevent transmission to others.

D. Rotavirus is primarily transmitted through the fecal-oral route and requires contact precautions, not droplet precautions.

A. Determine the client's pain level. B. Irrigate the wound with 0.9% sodium chloride irrigation. C. Apply skin preparation to wound edges. D. Don sterile gloves.

Correct Answer is A

Explanation

A. Assessing the client's pain level is the first step to ensure appropriate pain management during the procedure.

B. Irrigating the wound comes after assessing the client's pain level and preparing the wound for the dressing change.

C. Applying skin preparation to wound edges is part of the preparation process but should come after assessing the client's pain level.

D. Donning sterile gloves is necessary for the procedure but should come after assessing the client's pain level.

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