A nurse is monitoring a client's IV site.
The nurse should report which of the following findings as manifestations of phlebitis? (Select all that apply.).

Blistering around the insertion site.

Streak formation along the vein.

Erythema at the insertion site.

Warmth at insertion site.

Answer and Explanation

Correct Answer : B,C,D

Choice A rationale:

Blistering around the insertion site is not a common sign of phlebitis. It could indicate a more severe complication like extravasation or infiltration.

Choice B rationale:

Streak formation along the vein is a classic sign of phlebitis. It indicates inflammation and possible infection.

Choice C rationale:

Erythema at the insertion site is another common sign of phlebitis. It indicates inflammation.

Choice D rationale:

Warmth at the insertion site is also a common sign of phlebitis. It is caused by increased blood flow to the area due to inflammation. So, the correct answers are B, C, and D.

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Correct Answer is C

Explanation

The correct answer is choice C. Apply gentle pressure with a finger to the tragus of the ear.

Choice A rationale:

Chilling the medication prior to administration is not recommended. Cold ear drops can cause dizziness or discomfort when instilled into the ear. It is generally advised to warm the drops to body temperature by holding the bottle in your hands for a few minutes before administration.

Choice B rationale:

Holding the dropper against the ear canal while instilling the medication is incorrect. The dropper should be held above the ear canal to avoid contamination and injury. Touching the dropper to the ear canal can introduce bacteria and cause infection.

Choice C rationale:

Applying gentle pressure with a finger to the tragus of the ear helps to facilitate the flow of the medication into the ear canal. This action helps to ensure that the medication reaches the affected area effectively.

Choice D rationale:

Straightening the external auditory canal by pulling it down and back is incorrect for adults. For adults, the correct method is to pull the ear up and back to straighten the ear canal. Pulling it down and back is the method used for children.

A. Developing a respiratory infection. B. Taking too much prescribed medication. C. Insufficient sleep. D. Insufficient exercise.

Correct Answer is A

Explanation

Choice A rationale:

Developing a respiratory infection can indeed trigger a myasthenic crisis. Any form of stress on the body, including infections, can exacerbate symptoms.

Choice B rationale:

Taking too much prescribed medication is not typically a cause of myasthenic crisis. However, medication changes should always be managed carefully.

Choice Crationale:

Insufficient sleep can contribute to overall stress and fatigue, potentially exacerbating symptoms, but it is not a primary cause of myasthenic crisis.

Choice Drationale:

Insufficient exercise is not a known trigger for myasthenic crisis. While regular exercise can help manage symptoms, lack of exercise is not a direct cause.

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A nurse is monitoring a client's IV site.The nurse should report which of the following findings as manifestations of phlebitis? (Select all that apply.).

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A nurse is monitoring a client's IV site.
The nurse should report which of the following findings as manifestations of phlebitis? (Select all that apply.).