The nurse is preparing to start a transfusion of packed red blood cells for a client with a hemoglobin of 5.4 g/dL. (normal Female: 11.7-15.5 g/dL; Male: 14-17.3 g/dL). Which IV site should the nurse use?
20-gauge catheter in the right wrist infusing IV antibiotics
18-gauge catheter infusing 20 mEq Potassium Chloride IV
22-gauge catheter in the left forearm infusing 0.9% Normal Saline
20-gauge catheter in the right forearm infusing 0.9% Normal Saline
The Correct Answer is D
A. The 20-gauge catheter in the right wrist is not ideal for blood transfusions, as wrist veins are smaller and may be less optimal for high-flow transfusions.
B. An 18-gauge catheter is appropriate for blood transfusions, but the catheter is currently in use for potassium chloride, which would need to be discontinued. The best choice is a separate site.
C. A 22-gauge catheter is not large enough for blood transfusion; it may cause hemolysis or slow the transfusion rate.
D. The 20-gauge catheter in the right forearm is an appropriate size for a blood transfusion and is currently infusing normal saline, which does not interfere with the blood transfusion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. These are not typical symptoms of atrial flutter. They may be seen in other conditions like hypertensive crisis or systemic problems, but not as a primary manifestation of atrial flutter.
B. These are classic signs of diabetes or hyperglycemia, not atrial flutter.
C. These are common symptoms of atrial flutter, which results in an irregular heart rhythm and may cause increased heart rate, leading to palpitations and shortness of breath.
D. A systolic murmur is more associated with valve problems, and anxiety could be a result of various issues but is not a typical finding directly caused by atrial flutter.
Correct Answer is B
Explanation
A. Sodium is crucial for maintaining normal cellular function, especially for nerve impulses and muscle contractions. However, sodium imbalances typically affect the general function of the heart, and sodium abnormalities are not commonly associated with torsades de pointes, which is a type of polymorphic ventricular tachycardia.
B. Magnesium plays a critical role in the electrical stability of the heart and helps regulate potassium and calcium channels, which are involved in the cardiac action potential. Hypomagnesemia (low magnesium) is a well-known risk factor for torsades de pointes, a specific type of polymorphic ventricular tachycardia that is associated with QT interval prolongation. In this case, the magnesium level is 2.5 mg/dL, which is above the normal range (1.6-2.2 mg/dL), suggesting hypermagnesemia.
C. Calcium is vital for proper muscle function, including the heart muscle, and is essential for electrical conduction. Hypocalcemia (low calcium) can lead to QT interval prolongation, which in turn increases the risk for arrhythmias such as torsades de pointes. However, in this case, the calcium level is 8.0 mg/dL, which is only slightly below the normal range (8.2-10.2 mg/dL), making calcium a less likely primary contributor to torsades de pointes in this situation.
D. Potassium plays a crucial role in regulating the resting membrane potential and action potentials in cardiac cells. Hypokalemia (low potassium) can lead to QT prolongation and increase the risk of arrhythmias, including torsades de pointes. However, in this case, the potassium level is 2.8 mEq/L, which is low (normal range: 3.5-5.3 mEq/L), and hypokalemia is more commonly associated with arrhythmias such as torsades de pointes than hyperkalemia (high potassium).
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