While examining a patient's peripheral intravenous (IV) site, the ...

[notis]

While examining a patient's peripheral intravenous (IV) site, the nurse observes a red streak along the length of the vein. On palpation, the vein feels hard and cordlike. What is the nurse's best action?
 
  a. Check for a blood return and notify the prescriber.
  b. Discontinue the infusion and remove the IV needle.
  c. Apply ice packs to the vein and continue the infusion.
  d. Change the IV fluid to normal saline and redress the site.

Question 2

A 70-year-old patient who has been taking digoxin (Lanoxin) for 4 years has all of the following laboratory blood tests. For which test value does the nurse notify the prescriber immediately?
 
  a. Sodium (Na) 132 mEq/L
  b. Potassium (K) 2.1 mEq/L
  c. Blood urea nitrogen (BUN) 9 mg/dL
  d. International normalized ratio (INR) 1.5

[srodz]

Answer to Question 1

B
Phlebitis is an inflammation of the vein. Its presence in a vein being used for IV therapy may be caused by mechanical forces associated with the IV device or by chemical factors related to the composition and osmolarity of the drug solution. The key manifestation is that the symptoms are directly associated with the vein. The vein with phlebitis should not receive any additional fluids and the IV therapy is discontinued. If IV therapy needs to continue, it is restarted in a different vein.

Answer to Question 2

B
Although all of these values are abnormal, only the potassium level is dangerously out of the normal range (it is low, indicating hypokalemia; normal is 3.5 to 5 mEq/L). Abnormal potassium levels change the effectiveness of digoxin. In the case of hypokalemia, the sensitivity of the car-diac muscle membrane is increased to the effects of digoxin. This means that the risk for toxicity is greatly increased. The prescriber will probably order a digoxin level and lower the dosage of the drug.

[notis]

TYSM

[bblaney]

Excellent