When caring for a child with an intravenous infusion, the nurse ...

[luminitza]

When caring for a child with an intravenous infusion, the nurse should:
 
  a. use a macrodropper to facilitate reaching the prescribed flow rate.
  b. avoid restraining the child to prevent undue emotional stress.
  c. change the insertion site every 24 hours.
  d. observe the insertion site frequently for signs of infiltration.

Question 2

A 2-year-old child comes to the emergency department with dehydration and hypovolemic shock. Which best explains why an intraosseous infusion is started?
 
  a. It is less painful for small children.
  b. Rapid venous access is not possible.
  c. Antibiotics must be started immediately.
  d. Long-term central venous access is not possible.

[DHRUVSHAH]

Answer to Question 1

ANS: D
The nursing responsibility for IV therapy is to calculate the amount to be infused in a given length of time; set the infusion rate; and monitor the apparatus frequently (at least every 1 to 2 hours) to make certain that the desired rate is maintained, the integrity of the system remains intact, the site remains intact (free of redness, edema, infiltration, or irritation), and the infusion does not stop. A minidropper (60 drops/ml) is the recommended IV tubing in pediatrics. The IV site should be protected. This may require soft restraints on the child. Insertion sites do not need to be changed every 24 hours unless a problem is found with the site. This exposes the child to significant trauma.

Answer to Question 2

ANS: B
In situations in which rapid establishment of systemic access is vital and venous access is hampered, such as peripheral circulatory collapse and hypovolemic shock, intraosseous infusion provides a rapid, safe, lifesaving alternative. The procedure is painful, and local anesthetics and systemic analgesics are given. Antibiotics could be given when vascular access is obtained. Long-term central venous access is time-consuming, and intraosseous infusion is used in an emergency situation.