Which of the following complications can occur if a clotted cannula is flushed too aggressively?

The patient can experience speed shock

A clot can be forced into the circulation causing serious complications.

A painful arterial spasm can occur

The catheter can become dislodged and fall out.

Answer and Explanation

The Correct Answer is B

A. The patient can experience speed shock: Speed shock is a rapid infusion of a substance (like a medication or fluid) into the bloodstream, usually occurring when the infusion rate is too fast. This is not typically caused by flushing a clotted cannula.

B. A clot can be forced into the circulation causing serious complications: Flushing a clotted cannula too aggressively can dislodge a clot, causing it to travel into the bloodstream. This can lead to serious complications like embolism or stroke, especially if the clot is large or travels to a vital organ.

C. A painful arterial spasm can occur: While arterial spasms can occur, they are more often related to arterial catheterization or manipulation rather than flushing a venous cannula.

D. The catheter can become dislodged and fall out: While this could potentially happen, it is less of a concern compared to the risk of pushing a clot into circulation, which is a more immediate danger.

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Correct Answer is B

Explanation

A. Increased salivation: Increased salivation is not typically associated with hypernatremia.

B. Decreased level of consciousness: Hypernatremia can cause cellular dehydration, which can lead to neurological symptoms such as confusion, irritability, and decreased level of consciousness.

C. Hypertension: Although hypernatremia can cause fluid retention and contribute to increased blood pressure, the primary concern is neurological changes due to the effect of sodium on cell function.

D. Cool, clammy skin: Cool, clammy skin is more often seen with hypovolemic shock or other conditions like sepsis or hypothermia, not hypernatremia.

A. Turn off the IV solution and gently flush the line with 3 mL of saline flush solution. B. Decrease the rate to 10 mL/hr and flush the line with 1 mL of heparin solution. C. Notify the physician D. Check for kinking of the tubing or a closed clamp.

Correct Answer is D

Explanation

A. Turn off the IV solution and gently flush the line with 3 mL of saline flush solution: This may be necessary later if the occlusion is not resolved by troubleshooting, but the first action should be to check the tubing and clamp for any obstructions.

B. Decrease the rate to 10 mL/hr and flush the line with 1 mL of heparin solution: This is not appropriate as an initial action. Heparin flushes are generally used for maintaining patency in central lines and are not indicated for occlusions caused by tubing issues.

C. Notify the physician: While important if the issue persists, this is not the first action. The nurse should attempt to resolve the problem independently first.

D. Check for kinking of the tubing or a closed clamp: This is the first action the nurse should take. Most occlusions are due to kinking in the tubing or a closed clamp, and resolving this issue may immediately restore the flow.

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Which of the following complications can occur if a clotted cannula is flushed too aggressively?

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