A nurse is inserting a short peripheral IV catheter for a client who requires IV fluids.
Which of the following actions should the nurse take?

Initiate IV access on the palmar side of the client's wrist.

Insert a larger gauge IV catheter to prevent phlebitis.

Choose the client's dominant arm for IV access whenever possible.

Select a site proximal to previous venipuncture sites.

Answer and Explanation

The Correct Answer is D

Choice A rationale:

Initiating IV access on the palmar side of the client's wrist is not recommended. This area has many delicate structures and is prone to complications such as nerve damage. Choosing a safer, larger vein proximal to the wrist is a better practice.

Choice B rationale:

Inserting a larger gauge IV catheter is not necessary unless the client's condition or prescribed therapy specifically requires it. Using an unnecessarily large catheter can cause discomfort and increase the risk of complications, such as phlebitis.

Choice C rationale:

Choosing the client's dominant arm for IV access whenever possible is not a universally appropriate guideline. The choice of the arm should depend on the condition of the veins and the individual patient's circumstances. The nurse should assess both arms and choose the one with the most suitable and accessible veins.

Choice D rationale:

Selecting a site proximal to previous venipuncture sites is the correct action. Repeated venipuncture in the same area can cause phlebitis and compromise the integrity of the veins. Selecting a new site proximal to previous punctures helps to preserve vein health and reduce the risk of complications.

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Correct Answer is A

Explanation

A. Correct. Difficulty performing ADLs such as dressing, grooming, bathing, or feeding may indicate that the client has impaired motor function, sensory perception, or cognitive ability due to the stroke, which can affect their independence and quality of life. Occupational therapy can help the client regain or adapt their skills and abilities for daily living.
B. Incorrect. Inability to swallow clear liquids may indicate that the client has dysphagia or impaired swallowing function due to the stroke, which can increase their risk of aspiration and malnutrition. Speech therapy can help the client improve their swallowing function and provide recommendations for safe oral intake.
C. Incorrect. Elevated blood glucose levels may indicate that the client has diabetes mellitus or impaired glucose metabolism due to the stroke, which can affect their healing and recovery process and increase their risk of complications such as infection or hyperglycemia/hypoglycemia episodes. Diabetes education and management can help the client control their blood glucose levels and prevent adverse outcomes.
D. Incorrect. Unsteady gait when ambulating may indicate that the client has impaired balance, coordination, or muscle strength due to the stroke, which can affect their mobility and safety and increase their risk of falls or injuries. Physical therapy can help the client improve their gait and mobility and provide assistive devices if needed.

A. Random plasma glucose 176 mg/dL. B. Triglycerides 182 mg/dL. C. HbA1c 6.8%. D. Fasting blood glucose 120 mg/dL.

Correct Answer is C

Explanation

Choice A rationale:

A random plasma glucose level of 176 mg/dL indicates high blood sugar at the time of the test. Random glucose levels are not ideal for assessing glycemic control as they can vary based on recent food intake and stressors.

Choice B rationale:

Triglyceride levels are not used to assess glycemic control. They measure the amount of triglycerides in the bloodstream and are related to lipid metabolism, not glucose control.

Choice C rationale:

HbA1c (glycated hemoglobin) is a long-term measure of blood glucose control. An HbA1c level of 6.8% indicates acceptable glycemic control in a person with diabetes. The normal range for HbA1c is typically less than 6.5%. This test reflects the average blood sugar level over the past 2-3 months, giving a better understanding of overall glucose control.

Choice D rationale:

Fasting blood glucose of 120 mg/dL is slightly elevated. While fasting blood glucose levels below 100 mg/dL are generally considered normal, levels between 100-125 mg/dL are considered prediabetic, and levels above 126 mg/dL on two separate occasions indicate diabetes. The result provided falls within the prediabetic range but does not indicate optimal glycemic control.

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A nurse is inserting a short peripheral IV catheter for a client who requires IV fluids.
Which of the following actions should the nurse take?