A nurse is preparing to remove an IV catheter from the arm of a client who has phlebitis at a peripheral IV site.
Which of the following actions should the nurse plan to take?

Apply a pressure dressing at the IV site.

Place a warm, moist compress on the site.

Express drainage from the IV site and send it to be cultured.

Insert a new IV catheter distal to the discontinued IV site.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Applying a pressure dressing at the IV site might be necessary after removing the catheter, but it does not address the inflammation and discomfort caused by phlebitis. Warm, moist compresses are more appropriate for this situation.

Choice B rationale:

Placing a warm, moist compress on the site is the correct action for phlebitis. Heat helps improve blood circulation, reduce inflammation, and provide relief from pain and discomfort. This choice addresses the client's condition effectively.

Choice C rationale:

Expressing drainage from the IV site and sending it for culture is not necessary in this context. Phlebitis is primarily an inflammatory condition, and drainage culture is not a standard practice for phlebitis.

Choice D rationale:

Inserting a new IV catheter distal to the discontinued IV site is not the immediate action to take for phlebitis. First, the nurse should address the inflammation and pain with warm compresses. If a new IV site is needed, it can be considered after managing the client's symptoms.

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Correct Answer is C

Explanation

Step 1: Convert the dopamine hydrochloride dose from mcg to mg. We know that 1 mg = 1000 mcg. So, 4 mcg = 0.004 mg.

Step 2: Calculate the total amount of dopamine hydrochloride the client needs per minute. We know that the client weighs 80 kg and the dose is 0.004 mg/kg/min. So, 0.004 mg/kg/min × 80 kg = 0.32 mg/min.

Step 3: Convert the total amount of dopamine hydrochloride the client needs per minute to an hourly rate. We know that 1 hour = 60 minutes. So, 0.32 mg/min × 60 min/hr = 19.2 mg/hr.

Step 4: Calculate the volume of the solution that contains 19.2 mg of dopamine hydrochloride. We know that the solution contains 800 mg in 250 mL. So, (19.2 mg ÷ 800 mg) × 250 mL = 6 mL.

Therefore, the nurse should set the IV infusion to deliver 6 mL/hr (rounded to the nearest whole number).

A. Place the client's soiled bed linens in a biohazard bag outside the client's room. B. Wear an isolation gown when caring for the client. C. Keep visitors at least 6 feet (1.8 m) away from the client. D. Discard the radioactive source in the client's trash can.

Correct Answer is C

Explanation

Answer is c. Keep visitors at least 6 feet (1.8 m) away from the client.

a. Place the client's soiled bed linens in a biohazard bag outside the client's room: While it is essential to follow standard precautions for handling potentially contaminated linens, soiled bed linens from a client undergoing brachytherapy do not require special handling in a biohazard bag unless contaminated with blood or bodily fluids. Brachytherapy involves the internal placement of radioactive sources near or within the tumor site, but the risk of contamination from bodily fluids is minimal. Therefore, soiled linens can be managed according to standard facility protocols for handling linens.

b. Wear an isolation gown when caring for the client: This option is incorrect because wearing an isolation gown is not necessary for radiation safety during brachytherapy. Radiation exposure is primarily managed through the use of lead aprons, gloves, and other shielding devices when directly handling radioactive sources or being in close proximity to the client during treatment sessions. Isolation gowns are typically used to prevent the spread of infection and are not specifically designed to shield against radiation exposure.

c. Keep visitors at least 6 feet (1.8 m) away from the client: Correct. This action minimizes radiation exposure to visitors, as brachytherapy involves the internal placement of radioactive material near or within the tumor site. Maintaining a distance of at least 6 feet (1.8 meters) from the client helps reduce the risk of radiation exposure to visitors while allowing them to provide support and companionship to the client. Visitors should also be informed about radiation safety precautions and instructed to limit their time spent near the client during treatment.

d. Discard the radioactive source in the client's trash can: This option is incorrect because radioactive sources used in brachytherapy must be handled and disposed of by trained personnel following established radiation safety protocols. Disposing of radioactive material in a client's regular trash can poses significant risks of exposure to others and is not permitted. Proper disposal procedures for radioactive sources involve packaging them in approved containers and returning them to the facility's radiation safety department for appropriate disposal or recycling.

In summary, the correct answer is c because keeping visitors at least 6 feet (1.8 meters) away from the client helps minimize their radiation exposure during brachytherapy, which involves the internal placement of radioactive material near or within the tumor site. This action aligns with radiation safety principles and helps protect both the client and visitors from unnecessary radiation exposure.

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A nurse is preparing to remove an IV catheter from the arm of a client who has phlebitis at a peripheral IV site.Which of the following actions should the nurse plan to take?

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A nurse is preparing to remove an IV catheter from the arm of a client who has phlebitis at a peripheral IV site.
Which of the following actions should the nurse plan to take?