The nurse is monitoring a patient who has a central venous catheter in place for signs of complications. Which of the following are potential complications of central venous catheters? (Select all that apply.)

Pneumothorax.

Air embolism.

Catheter-related bloodstream infection.

Catheter occlusion.

Hematoma formation.

Answer and Explanation

Correct Answer : A,B,C,D

Choice A reason: Pneumothorax: This is a condition where air accumulates in the pleural space, causing the lung to collapse. It can occur during insertion of a central venous catheter if the needle or catheter punctures the lung or the pleura.

Choice B reason:. Air embolism. This is a condition where air bubbles enter the bloodstream and obstruct blood flow. It can occur during insertion, removal or maintenance of a central venous catheter if air enters the catheter or the vein.

Choice C reason:. Catheter-related bloodstream infection. This is an infection that occurs when microorganisms colonize the catheter or the insertion site and enter the bloodstream. It can cause fever, chills, sepsis and other serious complications. It can be prevented by using strict aseptic technique and following infection control guidelines.

Choice D reason:. Catheter occlusion. This is a condition where the catheter lumen becomes blocked by blood clots, fibrin sheaths, precipitates or kinks. It can impair the infusion or withdrawal of fluids and medications. It can be prevented by flushing the catheter regularly with saline or heparin solutions.

Choice E reason: Hematoma formation. This is a condition where blood accumulates under the skin or in the tissues around the insertion site. It can occur due to bleeding from the punctured vein or artery, or from trauma to the site. It can cause pain, swelling, bruising and infection.

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Correct Answer is D

Explanation

Choice A reason:

Serum sodium is not directly related to the acid-base balance of the body. Sodium bicarbonate therapy does not affect the serum sodium level significantly. Therefore, monitoring serum sodium is not an effective way to evaluate the effectiveness of the therapy.

Choice B reason:

Serum potassium is inversely related to the serum pH. As the pH increases, the potassium level decreases, and vice versa. Sodium bicarbonate therapy raises the pH and lowers the potassium level. Therefore, monitoring serum potassium is important to prevent hypokalemia, but it does not directly reflect the acid-base balance of the body.

Choice C reason:

Serum chloride is inversely related to the serum bicarbonate level. As the bicarbonate level increases, the chloride level decreases, and vice versa. Sodium bicarbonate therapy increases the bicarbonate level and decreases the chloride level. Therefore, monitoring serum chloride is important to prevent hypochloremia, but it does not directly reflect the acid-base balance of the body.

Choice D reason:

Serum bicarbonate is directly related to the acid-base balance of the body. The normal range of serum bicarbonate is 22 to 26 mEq/L. In metabolic acidosis, the bicarbonate level is low, and in metabolic alkalosis, it is high. Sodium bicarbonate therapy aims to increase the bicarbonate level and correct metabolic acidosis. Therefore, monitoring serum bicarbonate is the most effective way to evaluate the effectiveness of the therapy.

A. Administer magnesium sulfate IV. B. Monitor the client's blood pressure and heart rate. C. Encourage the client to increase intake of green leafy vegetables. D. Prepare to administer calcium gluconate IV. E. Assess the client for Chvostek's sign and Trousseau's sign.

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

Explanation

Choice A reason:

Administer magnesium sulfate IV. This is correct because magnesium sulfate is the treatment of choice for severe hypomagnesemia. It can rapidly increase the blood level of magnesium and correct the symptoms of deficiency.

Choice B reason:

Monitor the client's blood pressure and heart rate. This is incorrect because monitoring vital signs is not a specific intervention for hypomagnesemia. However, it is important to monitor the client for signs of hypotension and bradycardia, which can occur as adverse effects of magnesium sulfate therapy.

Choice C reason:

Encourage the client to increase intake of green leafy vegetables. This is correct because green leafy vegetables are rich sources of dietary magnesium. Increasing the intake of magnesium-rich foods can help prevent or treat mild hypomagnesemia.

Choice D reason:

Prepare to administer calcium gluconate IV. This is incorrect because calcium gluconate is not indicated for hypomagnesemia. Calcium gluconate is used to treat hypocalcemia, which can occur as a complication of hypomagnesemia. However, calcium gluconate should not be given until the magnesium level is corrected, as low magnesium can impair the response to calcium.

Choice E reason:

Assess the client for Chvostek's sign and Trousseau's sign. This is correct because Chvostek's sign and Trousseau's sign are clinical tests for neuromuscular irritability, which can occur in hypomagnesemia. Chvostek's sign is elicited by tapping the facial nerve in front of the ear and observing for facial twitching. Trousseau's sign is elicited by inflating a blood pressure cuff above the systolic pressure for 3 minutes and observing for carpal spasm.

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The nurse is monitoring a patient who has a central venous catheter in place for signs of complications. Which of the following are potential complications of central venous catheters? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Explanation

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