A nurse is caring for a client who requires a re-insertion of a short peripheral venous catheter. In which of the following locations should the nurse place the catheter?

A vein that feels hard to the touch

A vein in the client's dominant arm

A vein on the client's wrist

A vein proximal to the previous site

Answer and Explanation

The Correct Answer is D

A. A vein that feels hard to the touch: A hard vein may indicate sclerosis, thrombosis, or inflammation, making it unsuitable for catheter insertion. Using such a vein increases the risk of infiltration, pain, and unsuccessful insertion.

B. A vein in the client's dominant arm: While not absolutely contraindicated, avoiding the dominant arm when possible helps preserve function and comfort for the client, especially if complications occur.

C. A vein on the client's wrist: Veins on the wrist are generally smaller and more superficial, which can increase the risk of infiltration or discomfort. They are usually considered a last-resort option.

D. A vein proximal to the previous site: Selecting a vein proximal (closer to the body) to the previous insertion site allows for the use of healthy tissue, reduces the risk of complications at the prior site, and provides adequate venous access for the new catheter.

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Correct Answer is D

Explanation

A. Medication reconciliation report: A medication reconciliation report is used to compare the client’s current medications with new prescriptions to prevent errors during transitions of care. It is not used to document incidents or near misses.

B. Root cause analysis form: A root cause analysis is a detailed process performed after a serious adverse event to determine underlying system issues. It is not the initial documentation tool for a single medication error or near-miss.

C. Plan of care: The plan of care outlines nursing interventions and goals for the client’s treatment. It is not used to record or report medication-related incidents.

D. Occurrence report: An occurrence (incident) report is the appropriate document for recording medication errors or near misses, such as discovering an allergy before administration. It provides information for quality improvement and risk management without becoming part of the client’s medical record.

A. Rapid rise in temperature B. Hypertension C. Tachycardia D. Severe headache

Correct Answer is D

Explanation

A. Rapid rise in temperature: A sudden increase in body temperature is not associated with epidural anesthesia. This symptom is more characteristic of malignant hyperthermia, which occurs with certain general anesthetics, not regional anesthesia.

B. Hypertension: Epidural anesthesia typically causes vasodilation and hypotension rather than hypertension. Monitoring for a drop in blood pressure is more appropriate following this procedure.

C. Tachycardia: While mild tachycardia may occur as a compensatory response to hypotension, it is not a primary adverse effect of epidural anesthesia and usually resolves with fluid or position changes.

D. Severe headache: A severe headache can occur if cerebrospinal fluid leaks due to accidental dural puncture during epidural insertion. This post-dural puncture headache is a known adverse effect requiring monitoring and may necessitate interventions such as a blood patch.

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A nurse is caring for a client who requires a re-insertion of a short peripheral venous catheter. In which of the following locations should the nurse place the catheter?

Nursing Test Bank

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