A nurse is planning care for a client who is receiving intermittent IV fluids via a peripherally inserted central catheter (PICC). Which of the following information should the nurse include in the client's plan of care?

Use a 3 mL syringe to flush the PICC following infusions.

Assess the PICC infusion system systematically.

Change the needleless connector device on the IV tubing after each infusion.

Provide daily dressing changes to the PICC insertion site.

Answer and Explanation

The Correct Answer is B

Rationale:
A. Use a 3 mL syringe to flush the PICC following infusions: A syringe smaller than 10 mL creates excessive pressure, which can damage the catheter. A 10 mL syringe or larger should always be used to flush a PICC to maintain catheter integrity.

B. Assess the PICC infusion system systematically: Systematic assessment of the PICC line, including the site, tubing, and connections, is essential for detecting complications such as infiltration, infection, or occlusion. This promotes safe and effective use of the catheter.

C. Change the needleless connector device on the IV tubing after each infusion: The needleless connector device does not need to be changed after each infusion. It is typically changed every 7 days or if contamination, leakage, or other issues are noted.

D. Provide daily dressing changes to the PICC insertion site: PICC dressings should be changed every 7 days if using a transparent dressing, or sooner if the dressing becomes damp, loose, or visibly soiled. Daily dressing changes increase infection risk unnecessarily.

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Correct Answer is B

Explanation

Rationale:
A. "I will have to move out of my family's home until I am no longer contagious.": It is not necessary for the client to move out of the home, but precautions such as proper ventilation, wearing a mask, and isolating in a separate room can reduce the risk of transmission to household members during the contagious period.

B. "I will place my used tissues in a plastic bag.": Disposing of used tissues in a sealed plastic bag helps contain respiratory secretions and prevent the spread of Mycobacterium tuberculosis. This is an appropriate infection control practice that demonstrates understanding of proper hygiene.

C. "I will cover my mouth with my hands when I have to cough.": Covering the mouth is essential, but using the hands increases the risk of spreading bacteria through contact with surfaces. The client should be instructed to use a tissue or the inside of the elbow to minimize contamination.

D. "I will not go in public areas until I am cured.": Total avoidance of public areas is not necessary, but the client should avoid crowded places and public transport during the initial phase of treatment, typically the first few weeks, when they are still contagious.

A. Troponin I level B. ECG result C. Heart palpitations D. Heart rate E. Blood pressure

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"B"},"D":{"answers":"A,B"},"E":{"answers":"B"}}

Explanation

Rationale:

Troponin I level: An elevated troponin I level indicates myocardial cell injury and is a key diagnostic marker for MI. Even a value at the upper limit of normal (0.03 ng/mL) warrants concern, especially with accompanying symptoms.
ECG result – sinus tachycardia: Sinus tachycardia is nonspecific but may occur in both MI and angina due to pain, anxiety, or sympathetic stimulation. However, more definitive MI-related changes like ST elevation or Q waves would provide clearer diagnostic value.
Heart rate: A heart rate of 116/min is elevated and may represent the body’s response to pain, hypoxia, or stress. This can be seen in both angina and MI, though persistent or worsening tachycardia in MI may indicate hemodynamic instability.
Heart palpitations: Palpitations are common during episodes of angina and are often due to increased sympathetic tone or transient arrhythmias. They are usually mild and resolve with rest or nitroglycerin in stable angina.
Blood pressure: A blood pressure of 158/92 mm Hg indicates hypertension, a known trigger and risk factor for angina. Elevated BP increases myocardial oxygen demand, potentially precipitating chest pain in those with coronary artery disease.

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A nurse is planning care for a client who is receiving intermittent IV fluids via a peripherally inserted central catheter (PICC). Which of the following information should the nurse include in the client's plan of care?

Nursing Test Bank

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Correct Answer is B

Explanation

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Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"B"},"D":{"answers":"A,B"},"E":{"answers":"B"}}

Explanation

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