I.V. Therapeutics Evidence Based Practice for Infusion Therapy 6th Edition by Lynn Dianne Phillips, Lisa Gorski – Test Bank

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Chapter 5: Infusion Equipment

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. A nurse is preparing to administer a preoperative antibiotic I.V. piggyback. Which connection should be used to secure a piggyback administration set to the primary administration set?

a. Slide clamp
b. Luer lock
c. Slip lock
d. Taping with paper tape

____ 2. The product evaluation committee at a local hospital has decided to purchase a needleless I.V. system to be used throughout the organization. For which reason did the team most likely make this decision?

a. To protect the I.V. line’s integrity
b. To decrease tubing changes
c. To enable quicker blood draws
d. To decrease the risk for needlestick injuries

____ 3. A nurse is inspecting a container of infusate before client administration. To ensure integrity of a flexible plastic infusate solution container, the nurse should check for:

a. solution clarity, expiration date, and air vents.
b. solution clarity, expiration date, and punctures.
c. punctures, cracks, presence of ports, and clarity.
d. punctures, expiration date, and presence of ports.

____ 4. The nurse wants to maintain the integrity of a peripheral venous catheter. According to Infusion Nurses Society Standards of Practice (2011), peripheral intermittent locking devices must be kept patent following each catheter use with:

a. heparin.
b. medication.
c. 0.9% bacteriostatic sodium chloride.
d. combination of sodium chloride followed by heparin flush.

____ 5. A nurse is preparing an I.V. infusion using a Y-type infusate administration set. The nurse is most likely using this administration set to administer:

a. total parenteral nutrition.
b. fat emulsion.
c. primary I.V. solution.
d. packed red cells.

____ 6. A nurse is preparing to administer I.V. cyclosporine. To prevent leaching of diethylhexyl phthalate (DEHP) by this medication, the nurse should ensure that:

a. the pharmacy provides the cyclosporine in a polyvinyl chloride (PVC) bag.
b. cyclosporine is compatible with the client’s other medications.
c. the cyclosporine is administered through non-PVC I.V. tubing.
d. cyclosporine is administered by a physician.

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

____ 1. A critical-care nurse is using a 0.22-μm filter for the delivery of infusion therapy. According to the Infusion Nurses Society Standards of Practice (2011), for nonlipid-containing solutions that require filtration, a 0.2-μm filter should be

a. air eliminating.
b. particulate retentive.
c. fat emboli reducing.
d. bacterial retentive.

____ 2. A client with osteomyelitis is admitted to the acute-care hospital to begin infusion therapy. The client needs infusion therapy for 3 weeks and has poor venous access. The I.V. team registered nurses are competent to insert peripherally inserted central catheters, as well as midline catheters. Which should be taken into consideration when selecting the most appropriate venous access device? SELECT ALL THAT APPLY.

a. The pH and osmolarity of prescribed therapy
b. The interventional radiology support
c. The time it takes to insert the venous access device
d. The patient’s understanding and caregiver support for managing catheter upon discharge

Chapter 5: Infusion Equipment

Answer Section

MULTIPLE CHOICE

1.ANS:B

The male Luer lock has threads that secure and lock the connectors. Taping connectors is not acceptable practice. The slide clamp does not secure connectors but regulates the rate. A slip lock is a type of male adapter that slips into the female end of the equipment; however, there is no mechanism to secure the two pieces of equipment.

PTS: 1 KEY: Cognitive Level: Application

2.ANS:D

It is now required that needleless systems be used whenever the risk for needlestick injury can occur from I.V. piggyback, push, or withdrawal of medication from a vial.

PTS: 1 KEY: Cognitive Level: Application

3.ANS:B

.

Plastic infusion containers need to be checked for punctures to the plastic material, expiration date of the infusate, and integrity of the solution.

Reference: Phillips, L. D., & Gorski, L. (2014). Parenteral solutions. In Manual of I.V. therapeutics: Evidence-based infusion therapy (6th ed.). Philadelphia, PA: F.A. Davis.

PTS: 1 KEY: Cognitive Level: Application

4.ANS:C

Short peripheral catheters should be locked with preservative-free 0.9% sodium chloride (USP) following each catheter use in adults and children.

Reference: Infusion Nurses Society. (2011). Infusion Nursing Standards of Practice. Journal of Infusion Nursing, 34(1S), S60.

PTS: 1 KEY: Cognitive Level: Application

5.ANS:D

Y infusate sets are used for administration of blood to facilitate the priming infusate (0.9% sodium chloride) and the blood bag.

Reference: Phillips, L. D., & Gorski, L. (2014). Parenteral solutions. In Manual of I.V. therapeutics: Evidence-based infusion therapy (6th ed.). Philadelphia, PA: F.A. Davis.

PTS: 1 KEY: Cognitive Level: Application

6.ANS:C

To prevent leaching, the nurse should ensure that the cyclosporine is provided in a non-PVC bag and administered through non-PVC tubing. DEHP is a plasticizer that is used to add softness and pliability to PVC material. Some drug formulations that contains surfactants, such as cyclosporine, leach this plasticizer out of the plastic matrix and into the solution. This can cause DEHP-induced toxicity.

Reference: Phillips, L. D., & Gorski, L. (2014). Parenteral solutions. In Manual of I.V. therapeutics: Evidence-based infusion therapy (6th ed.). Philadelphia, PA: F.A. Davis.

PTS: 1 KEY: Cognitive Level: Application

MULTIPLE RESPONSE

1.ANS:A, B, D

A 0.2-μm filter is considered a bacterial/particulate retentive air-eliminating filter and is recommended. Lipid filters are 1.2 μm.

Reference: Infusion Nurses Society. (2011). Infusion Nursing Standards of Practice. Journal of Infusion Nursing, 34(1S), S33.

PTS: 1 KEY: Cognitive Level: Application

2.ANS:A, B, D

If the pH of the solutions is above 9 or below 5, or if the osmolarity is above 600 mOsm, then a PICC is needed to deliver the infusion to larger veins of the superior vena cava. The PICC must be read and verified by x-ray before use. The client will be discharged before 3 weeks; therefore, discharge planning must begin upon admission with choice of venous access device.

Reference: Phillips, L. D., & Gorski, L. (2014). Parenteral solutions. In Manual of I.V. therapeutics: Evidence-based infusion therapy (6th ed.). Philadelphia, PA: F.A. Davis.

PTS: 1 KEY: Cognitive Level: Application

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