A nurse is inserting an IV catheter for an older client in preparation for an outpatient procedure. Which of the following veins should the nurse select?

Radial vein in the wrist

Median vein in the forearm

Dorsal metacarpal vein

Ante-cubital vein

Answer and Explanation

The Correct Answer is B

Answer: B

Rationale:

A. Radial vein in the wrist: The radial vein is not commonly used for IV catheter insertion due to its location and size. The wrist veins can be smaller and more difficult to cannulate compared to veins in the forearm or antecubital area.

B. Median vein in the forearm: The median vein in the forearm is a preferred site for IV catheter insertion in older adults. It is generally more accessible and less prone to complications than veins in the hand or wrist, making it a suitable choice for stable, longer-term access.

C. Dorsal metacarpal vein: While the dorsal metacarpal veins on the hand can be used for IV insertion, they are typically smaller and more difficult to access than veins in the forearm. Additionally, veins in the hand can be more prone to irritation and complications.

D. Ante-cubital vein: The antecubital vein (such as the median cubital vein) is a good site for IV insertion due to its size and accessibility, especially for larger gauge catheters or when longer-term access is needed. However, it is often preferred for more acute situations rather than routine outpatient procedures.

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Correct Answer is A

Explanation

A. Measure the circumference of both upper arms: This is the priority action. Swelling above the PICC insertion site could indicate infiltration or another complication. Measuring the circumference of both upper arms allows the nurse to assess the extent of swelling and monitor for any changes over time, providing valuable information for further intervention and evaluation.
B. Notify the provider who inserted the PICC line: This is an important action, but it may not be the first step. Before notifying the provider, the nurse should gather objective data by assessing the client's condition, such as measuring arm circumference, to provide a comprehensive report to the provider.
C. Remove the PICC line: This is not the first action to take. Removing the PICC line should only be considered after thorough assessment and under the direction of a healthcare provider, especially if there are signs of complications such as swelling.
D. Apply a cold pack to the client's upper arm: While applying a cold pack may help reduce swelling in some cases, it is not the priority action in this situation. The nurse should first assess the extent of swelling and gather additional data before implementing interventions such as cold therapy.

A. Apply 4 to 5 ml of liquid soap to the hands B. Hold the hands higher than the elbows C. Rub hands and arms to dry D. Adjust the water temperature to feel hot

Correct Answer is A

Explanation

A. Apply 4 to 5 ml of liquid soap to the hands: This is the correct action. Applying an adequate amount of soap ensures effective cleaning of the hands. The recommended amount is typically 3 to 5 ml or enough to cover the entire surface of the hands.
B. Hold the hands higher than the elbows: This is incorrect. When performing hand hygiene, the hands should be held lower than the elbows to prevent water from running down the arms and contaminating previously cleaned areas.
C. Rub hands and arms to dry: This is incorrect. After washing the hands, they should be dried using a clean paper towel or air dryer. Rubbing hands and arms to dry is not recommended as it can lead to friction and potential skin irritation.
D. Adjust the water temperature to feel hot: This is incorrect. The water temperature should be warm, not hot, to prevent skin damage or discomfort. Hot water can strip the skin of its natural oils and lead to dryness or irritation.

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A nurse is inserting an IV catheter for an older client in preparation for an outpatient procedure. Which of the following veins should the nurse select?

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Correct Answer is A

Explanation

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