During new employee orientation, a nurse is explaining how to prevent IV infections. Which of the following statements by an orientee indicates understanding of the preventive strategies?
"As long as I am working with the same client, I can use the same IV catheter for my second insertion attempt."
“I will replace any IV catheter when I suspect contamination during insertion."
“I will leave the IV catheter in place after the client completes the course of IV antibiotics."
“If my client needs to use the rest room, it would be safer to disconnect their IV infusion as long as I clean the injection port thoroughly with an antiseptic swab."
The Correct Answer is B
A. Using the same IV catheter for a second insertion attempt is not advisable. Once an IV catheter has been inserted, it should not be reused or reinserted in the same or a different site. If the initial insertion fails or if the catheter needs to be repositioned, a new sterile catheter should be used.
B. If there is any suspicion of contamination during the insertion of an IV catheter, it is important to replace the catheter to prevent infection. This is crucial for maintaining sterility and reducing the risk of introducing pathogens into the patient’s bloodstream.
C. The IV catheter should be removed once the course of IV antibiotics or any other IV therapy is completed, unless there is a specific medical reason to keep it in place. Leaving the catheter in place unnecessarily increases the risk of infection and other complications.
D. Disconnecting the IV infusion for a client to use the restroom is not typically recommended as a standard practice. Disconnecting can introduce risks of infection and requires thorough cleaning and handling. Instead, a safer practice is to secure the IV line and allow the client to use the restroom while keeping the infusion running, or use a specialized catheter with a secure, closed system.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["100"]
Explanation
To calculate the rate at which the IV pump should be set to deliver the medication, you would use the formula:
(Total Volume in mL / Time in hours) = mL/hr.
The total volume of the IV bag is 50 mL and the time frame is 0.5 hours (since 30 minutes is half an hour). So, the calculation would be 50 mL / 0.5 hours = 100 mL/hr.
Therefore, the nurse should set the IV pump to deliver 100 mL/hr to administer 500 mg of ampicillin over 30 minutes.
Correct Answer is B
Explanation
A. While administering 0.9% sodium chloride is an important step to maintain venous access and to help dilute any blood that might still be in the tubing, it is not the first action to take if a transfusion reaction is suspected. This step should occur after the transfusion is stopped and the patient’s safety is ensured.
B. The immediate priority when a transfusion reaction is suspected is to stop the transfusion immediately. This action helps to prevent further exposure to the potentially harmful blood product and mitigates the risk of worsening the reaction. Stopping the transfusion also allows for prompt medical assessment and intervention.
C. Returning the unit of blood to the blood bank is important for investigation and to determine the cause of the reaction, but it should be done after stopping the transfusion and ensuring the client’s safety. The blood bank may require the returned unit to confirm any issues with the blood product.
D. Obtaining a blood sample from the client is crucial for diagnostic purposes and to identify the cause of the reaction, but this should be done after the transfusion has been stopped. The sample may help in diagnosing the type of reaction or in managing it, but it does not address the immediate safety concerns.
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