When selecting a site to start an IV infusion in an adult, the ...

[@Brianna17]

When selecting a site to start an IV infusion in an adult, the nurse should select a site
 
  a. in the lower extremities when possible
  b. on the effected side of a patient who has a mastectomy
  c. adjacent to a functioning arteriovenous fistula
  d. on the distal end of a vein in the arm

Question 2

The client is receiving sodium bicarbonate intravenously (IV) for correction of acidosis secondary to diabetic coma. The nurse assesses cyanosis, slow respirations, and irregular pulse. What is the nurse's priority action?
 
  1. Continue the infusion; the client is still in acidosis.
   2. Increase the rate of the infusion and continue to assess the client for symptoms of acidosis.
   3. Stop the infusion and notify the physician; the client is in alkalosis.
   4. Decrease the rate of the infusion and continue to assess the client for symptoms of alkalosis.

[poopface]

Answer to Question 1

D
Lower-extremity veins are used for IV therapy only when so ordered by a health care practitioner. A vein should be selected at its most distal end to maintain the integrity of the vein. Intravenous therapy is contraindicated in the affected arm of a postmastectomy patient or any arm with a functioning arteriovenous fistula.

Answer to Question 2

3. Stop the infusion and notify the physician; the client is in alkalosis.

Rationale:
The client receiving sodium bicarbonate is prone to alkalosis; monitor for cyanosis, slow respirations, and irregular pulse. The client's symptoms indicate alkalosis so infusion must be stopped and the physician notified. The client is not in acidosis; symptoms of acidosis include lethargy, confusion, CNS depression leading to coma, and a deep, rapid respiration rate that indicates an attempt by the lungs to rid the body of excess acid. The client is not in acidosis, so the infusion must be stopped, not increased or decreased.

[@Brianna17]

Excellent

[ktidd]

TYSM