A nurse is caring for a client who had IV fluids initiated at 0330. The IV fluids are infusing at 120 mL/hr. The nurse should record how many mL of IV fluids on the intake record at 0600?
The Correct Answer is ["300"]
To calculate the volume of IV fluids infused from 0330 to 0600, you would determine the number of hours that have passed.
From 0330 to 0600 is 2.5 hours. Since the IV is infusing at 120 mL/hr, you would multiply the infusion rate by the number of hours. So, 120 mL/hr * 2.5 hours = 300 mL.
Therefore, the nurse should record 300 mL of IV fluids on the intake record at 0600.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Applying a warm compress can help dilate the blood vessels, potentially improving circulation around the IV site. This can sometimes alleviate discomfort caused by irritation or infiltration. However, if there is significant pain or swelling, warm compresses may not be sufficient.
B. Applying firm pressure on the syringe plunger during the flush is not recommended. Excessive force could potentially cause damage to the vein or exacerbate pain and discomfort. It's important to flush gently to maintain patency and avoid causing further irritation or complications.
C. If the client reports pain above the IV saline lock and there are signs of infiltration (such as swelling, coolness, or blanching of the skin around the site), removing the IV saline lock may be necessary. Infiltration occurs when IV fluid leaks into the surrounding tissue instead of flowing into the vein, which can lead to discomfort and complications.
D. Injecting the solution more slowly during the flush can help minimize discomfort and reduce the risk of causing further damage. Slower infusion allows for better tolerance by the vein and surrounding tissues, decreasing the likelihood of pain or infiltration.
Correct Answer is A
Explanation
A. Troponin is a protein found in cardiac muscle cells. When there is damage to the heart muscle, such as during a myocardial infarction (heart attack), troponin is released into the bloodstream. Therefore, elevated troponin levels in the blood indicate myocardial injury or damage.
B. Troponin is not an enzyme; it is a protein. While there are enzymes such as creatine kinase (CK) and lactate dehydrogenase (LDH) that can indicate damage to various tissues including heart and skeletal muscles, troponin specifically indicates cardiac muscle damage.
C. Troponin is not involved in oxygen transport. Hemoglobin, found in red blood cells, is the protein responsible for oxygen transport in the body.
D. Troponin is not a lipid; it is a protein. Lipids include substances like cholesterol and triglycerides. Troponin levels do not reflect the risk for coronary artery disease; rather, they indicate acute damage to the heart muscle.
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