A nurse is planning care for a client who has a central venous access device for intermittent infusions.

Which of the following actions should the nurse include in the plan of care?

Use an aseptic technique when changing the dressing.

Cleanse the site with povidone-iodine.

Flush the catheter using a 10-mL syringe.

Change the dressing every 24 hours.

Answer and Explanation

The Correct Answer is A

The aseptic technique is important to prevent infection when changing the dressing of a central venous access device.
Choice B is not correct because povidone-iodine is not always the recommended cleansing agent for central venous access devices.
Choice C is not correct because a 10-mL syringe may generate too much pressure and damage the catheter.
Choice D is not correct because the dressing does not always need to be changed every 24 hours; the frequency of dressing changes depends on the type of dressing and the condition of the site.

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Correct Answer is C

Explanation

Step 1: 100 mL ÷ 30 min

Step 2: (100 mL ÷ 30 min) × 60 min/hr

Step 3: 3.33 mL/min × 60 min/hr

Answer: 200 mL/hr

A. Remove the indwelling urinary catheter. B. Decrease traction on the catheter. C. Administer ibuprofen 400 mg for pain relief. D. Flush the catheter manually with 0.9% sodium chloride.

Correct Answer is D

Explanation

“Flush the catheter manually with 0.9% sodium chloride.” The client is receiving continuous bladder irrigation following a transurethral resection of the prostate and reports bladder spasms and decreased urinary output.
These symptoms may indicate that the catheter is blocked with blood clots.
Flushing the catheter manually with 0.9% sodium chloride can help to remove any blood clots and restore urinary output.
Choice A is not the correct answer because removing the indwelling urinary catheter would not address the underlying issue of blood clots blocking the catheter.
Choice B is not the correct answer because decreasing traction on the catheter would not address the underlying issue of blood clots blocking the catheter.
Choice C is not the correct answer because while ibuprofen may provide some pain relief, it would not address the underlying issue of blood clots blocking the catheter.

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A nurse is planning care for a client who has a central venous access device for intermittent infusions. Which of the following actions should the nurse include in the plan of care?

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer piperacillin 3.375 g by intermittent IV bolus every 6 hr. Available in piperacillin 3.375 g in dextrose 5% in water (DsW) 100 mL to infuse over 30 min. The nurse should set the IV pump to deliver how many mL/hr?

Correct Answer is C

Explanation

A nurse is caring for a client who is receiving continuous bladder irrigation following a transurethral resection of the prostate. The client reports bladder spasms and the nurse observes decreased urinary output. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

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A nurse is planning care for a client who has a central venous access device for intermittent infusions.

Which of the following actions should the nurse include in the plan of care?