the physician has ordered a peripheral iv to be inserted before the patient goes for computed tomography what should the nurse do when selecting a sit

ATI RN

ATI Fluid Electrolyte and Acid-Base Regulation

1. The physician has ordered a peripheral IV to be inserted before the patient goes for computed tomography. What should the nurse do when selecting a site on the hand or arm for insertion of an IV catheter?

A. Choose a hairless site if available.
B. Consider potential effects on the patients mobility when selecting a site.
C. Have the patient briefly hold his arm over his head before insertion
D. Leave the tourniquet on for at least 3 minutes.

Correct answer: B

Rationale:

2. A nurse in the neurologic ICU has orders to infuse a hypertonic solution into a patient with increased intracranial pressure. This solution will increase the number of dissolved particles in the patient's blood, creating pressure for fluids in the tissues to shift into the capillaries and increase the blood volume. This process is best described as which of the following?

A. Hydrostatic pressure
B. Osmosis and osmolality
C. Diffusion
D. Active transport

Correct answer: B

Rationale: The correct answer is B: Osmosis and osmolality. Osmosis is the movement of fluid from a region of low solute concentration to a region of high solute concentration across a semipermeable membrane. In this case, the hypertonic solution increases the number of dissolved particles in the blood, causing fluids to shift into the capillaries due to the osmotic pressure gradient. Osmolality refers to the concentration of solutes in a solution. Hydrostatic pressure refers to changes in water or volume related to water pressure, not the movement of fluids due to solute concentration differences. Diffusion is the movement of solutes from an area of greater concentration to lesser concentration; in an intact vascular system, solutes are unable to move freely, so diffusion does not play a significant role in this scenario. Active transport involves the movement of molecules against the concentration gradient with the use of energy, typically at the cellular level, and is not related to the vascular volume changes described in the question.

3. When selecting a site on the hand or arm for insertion of an IV catheter, the nurse should:

A. Choose a proximal site.
B. Choose a distal site.
C. Have the patient hold their arm in a dependent position.
D. Leave the tourniquet on for no longer than 2 minutes.

Correct answer: B

Rationale: When selecting a site for insertion of an IV catheter, the nurse should choose a distal site, not a proximal site. Opting for a distal site ensures that upper veins remain available for future cannulations. Instructing the patient to hold their arm in a dependent position can enhance blood flow, aiding in the procedure. It is crucial never to leave a tourniquet on for more than 2 minutes as prolonged restriction can lead to complications. Choice A is incorrect because a proximal site is not preferred for IV insertion. Choice C is incorrect as having the patient hold their arm over their head is not necessary and may impede proper blood flow. Choice D is incorrect as leaving the tourniquet on for at least 5 minutes is excessive and can be harmful.

4. A nurse preparing to start an IV on a newly admitted patient teaches the patient about the procedure and begins to prepare the site. The nurse should always start by:

A. Leaving one hand ungloved to assess the site
B. Preparing the skin with an iodine solution
C. Asking the patient if they are allergic to latex or iodine
D. Removing excessive hair at the selected site

Correct answer: C

Rationale: Before preparing the skin, the nurse should ask the patient if they are allergic to latex or iodine, which are commonly used in IV therapy setup. This is crucial to prevent potential allergic reactions at the IV site or even life-threatening anaphylaxis. Leaving one hand ungloved (choice A) is not a recommended practice as both hands should be gloved for infection control. While preparing the skin with an iodine solution (choice B) is a step in the process, ensuring the patient's safety by checking for allergies comes first. Removing excessive hair at the selected site (choice D) is not necessary and can lead to skin irritation.

5. Which positive ion is most prevalent in intracellular fluid?

A. Calcium
B. Potassium
C. Sodium
D. Magnesium

Correct answer: B

Rationale: The correct answer is Potassium (K+). Potassium is the predominant cation found within cells, making it the most prevalent positive ion in intracellular fluid. Calcium, sodium, and magnesium are also essential ions in the body, but they are not as abundant in intracellular fluid. Calcium is vital for bone health and muscle function, sodium helps in maintaining fluid balance and nerve function, and magnesium is involved in numerous biochemical reactions.