A 90-year-old woman is admitted to an acute care facility with ...

[HudsonKB16]

A 90-year-old woman is admitted to an acute care facility with the diagnosis of pneumonia. She has a past medical history of diabetes mellitus, hypertension, and right-sided mastectomy.
 
  When starting an IV for infusion of antibiotic therapy, the nurse will
  a. insert the IV catheter into the left hand.
  b. use a lower extremity vein for insertion.
  c. choose the left radial artery for insertion.
  d. attempt insertion into the left antecubital space vein.

Question 2

The nurse is about to administer a prescribed medication IV push into a patient's Hickman catheter. When providing this medication, the nurse will first
 
  a. administer the prescribed drug.
  b. flush with saline.
  c. flush with heparin.
  d. prepare a pump.

[dpost18]

Answer to Question 1

ANS: D
IV insertion should not be initiated in an arm with compromised lymphatic or venous flow such as a mastectomy. The left antecubital space vein would be a good choice for this patient given her age and medical history. In the older adult, using the veins in the hand area may be a poor choice because of the fragility of the skin and veins in this area. When possible, the veins of the lower extremities should be avoided for IV insertion because of the danger of developing thrombi and emboli. IV therapy should never be started in an artery.

Answer to Question 2

ANS: B
Drugs given by IV push or bolus through a Hickman catheter generally follow the SASH guideline: saline flush first; administer the prescribed drug; saline flush following the drug; heparin flush line. A pump is not used when a drug is administered by push technique.

[HudsonKB16]

Excellent

[Jossy]

TYSM