A nurse is caring for a client who is receiving a continuous infusion through a peripheral IV device. The nurse notes the catheter site is cool, swollen, blanched, and painful to touch. Which of the following actions should the nurse take?
Aspirate fluid from the IV cannula.
Place the affected extremity below the level of the client's heart.
Slow the IV infusion.
Place a pressure dressing over the IV site.
The Correct Answer is C
Choice A reason: Aspirating fluid from the IV cannula is not recommended as it does not address the issue of infiltration or extravasation.
Choice B reason: Placing the affected extremity below the level of the client's heart could worsen the swelling and is
not recommended.
Choice C reason: Slowing the IV infusion is a correct immediate action to minimize further infiltration and should be done while further assessment and interventions are planned.
Choice D reason: Placing a pressure dressing over the IV site is not recommended as it may exacerbate the infiltration
and increase discomfort.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is c. "You will have a stoma placed in your right lower abdomen."
Choice A reason: The stoma should appear red and moist, similar to the inside of the mouth, not purple.
Choice B reason: The stoma does not have nerve endings, so it should not be painful.
Choice C reason: An ileostomy is typically placed in the right lower abdomen.
Choice D reason: Stool passing through an ileostomy is usually liquid to pasty, not solid.
Correct Answer is B
Explanation
Choice A reason: Aluminum-containing antacids are more likely to cause constipation rather than diarrhea.
Choice B reason: Magnesium-containing antacids can cause diarrhea because magnesium can act as an osmotic laxative, drawing water into the intestines and increasing peristalsis.
Choice C reason: While antibiotics can disrupt the gut flora and potentially cause diarrhea, they are not the best
answer when compared to magnesium-containing antacids specifically known for this side effect.
Choice D reason: Anticholinergics/antispasmodics typically reduce gastrointestinal motility, which would more likely lead to constipation instead of diarrhea.
Choice E reason: Opioid narcotics are known to cause constipation due to reduced gut motility, not diarrhea
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.