A nurse is inserting an IV catheter for an older client in preparation for an outpatient procedure. Which of the following veins should the nurse select?

Radial vein in the wrist

Median vein in the forearm

Dorsal metacarpal vein

Ante-cubital vein

Answer and Explanation

The Correct Answer is B

Answer: B

Rationale:

A. Radial vein in the wrist: The radial vein is not commonly used for IV catheter insertion due to its location and size. The wrist veins can be smaller and more difficult to cannulate compared to veins in the forearm or antecubital area.

B. Median vein in the forearm: The median vein in the forearm is a preferred site for IV catheter insertion in older adults. It is generally more accessible and less prone to complications than veins in the hand or wrist, making it a suitable choice for stable, longer-term access.

C. Dorsal metacarpal vein: While the dorsal metacarpal veins on the hand can be used for IV insertion, they are typically smaller and more difficult to access than veins in the forearm. Additionally, veins in the hand can be more prone to irritation and complications.

D. Ante-cubital vein: The antecubital vein (such as the median cubital vein) is a good site for IV insertion due to its size and accessibility, especially for larger gauge catheters or when longer-term access is needed. However, it is often preferred for more acute situations rather than routine outpatient procedures.

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Free Nursing Study Resources

Correct Answer is C

Explanation

A. At the beginning: Examining the tympanic membrane at the beginning of the physical examination may not be ideal because it disrupts the flow of the assessment. It's more logical to start with general observations and proceed to more specific areas of assessment.
B. Before auscultating the chest and abdomen: While examining the tympanic membrane before auscultating the chest and abdomen may seem reasonable, it's not the optimal sequence. The nurse should focus on assessing major body systems before proceeding to more specific areas, such as the ears.
C. At the end: This is the correct approach. After completing the assessment of major body systems, such as the cardiovascular, respiratory, and abdominal systems, the nurse can then proceed to examine the ears, including the tympanic membrane. This sequence ensures a systematic and organized assessment.
D. Before examining the head and neck: While examining the tympanic membrane before the head and neck may seem logical due to proximity, it's more practical to conduct a comprehensive head-to-toe assessment first before focusing on specific areas like the ears.

A. Polyuria B. Hypotension C. Weakened gag reflex D. Hyperthermia E. Absence of bowel sounds

Correct Answer is ["B","C","E"]

Explanation

A. Polyuria: Polyuria, or excessive urination, is not typically associated with cervical spinal cord injury. In fact, urinary retention or neurogenic bladder is more commonly observed due to disruption of bladder control. Clients with cervical spinal cord injury often experience bladder dysfunction, which can lead to urinary retention rather than polyuria.
B. Hypotension: Hypotension is a common complication of cervical spinal cord injury, particularly in cases involving injury above the level of T6. Damage to the sympathetic nervous system can result in neurogenic shock, characterized by vasodilation and bradycardia, leading to hypotension. Monitoring for signs of hypotension, such as decreased blood pressure and altered mental status, is essential for early intervention and prevention of complications.
C. Weakened gag reflex: Cervical spinal cord injury can impair the gag reflex due to disruption of the glossopharyngeal nerve (CN IX) and vagus nerve (CN X) function. This impairment can lead to difficulty swallowing, aspiration risk, and increased susceptibility to respiratory complications such as aspiration pneumonia. Therefore, monitoring the gag reflex and assessing for signs of dysphagia are crucial in clients with cervical spinal cord injury to prevent respiratory compromise and aspiration-related complications.
D. Hyperthermia: Hyperthermia is less commonly associated with cervical spinal cord injury. However, in some cases, autonomic dysreflexia—a potentially life-threatening condition—can occur, leading to increased body temperature among other symptoms. This is more common in injuries above the T6 level.
E. Absence of bowel sounds: Neurogenic bowel dysfunction, including the absence of bowel sounds, is a common complication of cervical spinal cord injury. Disruption of autonomic nervous system function can lead to decreased peristalsis and absent bowel sounds.

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