An 82-year-old patient returns to the floor after being gone for ...

[Davideckstein7]

An 82-year-old patient returns to the floor after being gone for 1 hour for an x-ray examination. On return, the nurse notes that 700 mL of fluid have infused during the last hour and the patient is short of breath.
 
  What is the nurse's best action? a. Check the intravenous (IV) site and document the findings.
  b. Slow the IV rate and notify the prescriber immediately.
  c. Discontinue the IV therapy and notify the prescriber immediately.
  d. Notify the prescriber and ask whether the IV therapy should be discontinued.

Question 2

A patient is prescribed 25 mg by intravenous (IV) push of a drug that is a known chemical irritant. The drug vial contains 100 mg/mL of the drug.
 
  To reduce the risk for chemical trauma when administering this drug, what is the nurse's best action? a. Immediately after injecting the drug by IV push, apply firm pressure over the site for 1 minute.
  b. Dilute the drug with 9.75 mL of an appropriate solution before administration.
  c. Apply a cold compress to the IV site for 10 minutes before administering the drug.
  d. Apply a cold compress to the IV site for 10 minutes after administering the drug.

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Answer to Question 1

B
A volume of 700 mL in an hour is a large amount, even for a much younger patient. The fact that this 82-year-old is now short of breath is an indicator of fluid overload. The nurse slows the IV rate but does not discontinue it. It may be needed to administer IV drugs to treat the fluid over-load. The prescriber must be notified immediately of the patient's change in status and this IV volume error.

Answer to Question 2

B
Diluting a drug that is chemically irritating can reduce the chemical trauma it produces in veins. It is necessary to check first with the pharmacist to determine which specific fluid can be used to dilute the drug.

[Davideckstein7]

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