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","C","D"]

Explanation

Rationale:
A. Ferrous sulfate: Ferrous sulfate is an iron supplement and does not directly interact with warfarin's anticoagulant effect. While some mild interactions are possible, it is not generally contraindicated unless specifically advised due to individual clinical conditions.

B. Aspirin: Aspirin has antiplatelet effects and can increase the risk of bleeding when taken with warfarin. The combination enhances anticoagulation and significantly raises the chance of gastrointestinal or systemic bleeding.

C. Naproxen: Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that can interfere with platelet function and irritate the gastrointestinal lining, increasing the risk of bleeding when combined with warfarin.

D. Echinacea: Echinacea may interfere with liver enzyme activity and affect the metabolism of warfarin, potentially altering its effectiveness. Herbal supplements can cause unpredictable interactions and should generally be avoided while on warfarin.

E. Dextromethorphan: Dextromethorphan is a common cough suppressant and does not have significant interactions with warfarin. It is generally considered safe for occasional use in clients taking anticoagulants.

A. Place the affected leg in external rotation. B. Encourage the client to use the incentive spirometer every shift. C. Instruct the client to lean forward when rising from a chair. D. Maintain abduction of the affected extremity.

Correct Answer is D

Explanation

Rationale:
A. Place the affected leg in external rotation: External rotation of the leg can increase the risk of hip dislocation following a total hip arthroplasty. The leg should be maintained in a neutral or slightly abducted position to protect the joint.

B. Encourage the client to use the incentive spirometer every shift: Incentive spirometry should be used every 1 to 2 hours while awake to prevent postoperative complications like atelectasis. Using it only once per shift is not sufficient.

C. Instruct the client to lean forward when rising from a chair: Leaning forward while rising increases hip flexion beyond 90 degrees, which places stress on the hip joint and raises the risk of dislocation. Clients should keep their hips higher than their knees and use armrests for support.

D. Maintain abduction of the affected extremity: Keeping the leg in abduction helps prevent dislocation of the prosthetic joint by maintaining proper alignment. This can be achieved using an abduction pillow or wedge between the legs.

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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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