A nurse is planning care for a client who requires insertion of a peripherally inserted central catheter (PICC) line. Which of the following actions should the nurse plan to take?

Use a 3 ml syringe when flushing the PICC line.

Flush the PICC line with 0.9% sodium chloride after medication administration.

Expect the PICC line to be inserted into a lower extremity vein.

Monitor for a pneumothorax following insertion of the PICC line.

Answer and Explanation

The Correct Answer is B

A) Use a 3 ml syringe when flushing the PICC line:
Using a 3 ml syringe for flushing is not recommended. Smaller syringes generate higher pressure, which can damage the catheter. Instead, a 10 ml syringe is typically used to flush PICC lines to ensure safe pressure levels.
B) Flush the PICC line with 0.9% sodium chloride after medication administration:
Flushing the PICC line with 0.9% sodium chloride after medication administration is standard practice. It helps clear the line of any residual medication, preventing drug interactions and ensuring the line remains patent.
C) Expect the PICC line to be inserted into a lower extremity vein:
PICC lines are typically inserted into veins in the upper extremities, such as the basilic, brachial, or cephalic veins, rather than lower extremity veins. This positioning reduces the risk of complications and allows for better access and care.
D) Monitor for a pneumothorax following insertion of the PICC line:
Monitoring for a pneumothorax is not typically necessary following PICC line insertion. Pneumothorax is a potential complication of central venous catheter placements involving the subclavian or jugular veins, not the peripheral veins used for PICC lines. Instead, complications like infection, thrombosis, and catheter occlusion are more relevant concerns.

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Correct Answer is B

Explanation

A) Oral glucose tolerance test results:
The oral glucose tolerance test (OGTT) measures how well the body processes glucose over a short period, typically 2 hours. It is used primarily for diagnosing diabetes rather than monitoring long-term glycemic control. It provides a snapshot of glucose metabolism but does not reflect long-term glucose levels.

B) Glycosylated hemoglobin level:
The glycosylated hemoglobin (HbA1c) level is the most effective measure for long-term glycemic control. It reflects average blood glucose levels over the past 2 to 3 months by showing the percentage of hemoglobin that has glucose attached. Monitoring HbA1c helps assess how well diabetes management strategies are working over time.

C) Fasting blood glucose level:
Fasting blood glucose levels provide a measure of glucose concentration after an overnight fast, giving an indication of glucose control at a specific time. However, it does not provide a comprehensive view of long-term glycemic control and can be influenced by daily fluctuations.

D) Postprandial blood glucose level:
Postprandial blood glucose levels measure glucose concentrations after a meal and are useful for assessing how well the body handles glucose from food. Like fasting blood glucose levels, it is more indicative of short-term glucose control rather than long-term trends.

A. "I should wear goggles when irrigating a wound." B. "I should wear a gown to remove linens from a client's bed." C. "Sterile gloves are required when administering an IM injection." D. "I should use both hands to recap a needle.

Correct Answer is A

Explanation

A. "I should wear goggles when irrigating a wound.":
Wearing goggles during procedures like wound irrigation is appropriate as it protects the eyes from potential splashes or sprays of bodily fluids, which can pose an infection risk. This statement reflects an understanding of proper personal protective equipment (PPE) use for preventing exposure to potentially infectious materials.

B. "I should wear a gown to remove linens from a client's bed.":
Wearing a gown is typically indicated when there is a risk of contact with blood, body fluids, or contaminated items, rather than for removing linens. For routine linen changes, gloves are usually sufficient, unless the linens are visibly soiled or there is a risk of significant contamination.

C. "Sterile gloves are required when administering an IM injection.":
Sterile gloves are not required for administering intramuscular (IM) injections. Clean, non-sterile gloves are generally sufficient for this procedure. Sterile gloves are reserved for sterile procedures, such as those involving sterile fields or invasive procedures requiring strict asepsis.

D. "I should use both hands to recap a needle.":
Recapping needles using both hands is not recommended due to the increased risk of needle-stick injuries. The safest practice is to use a one-handed "scoop" technique or, preferably, to use safety-engineered devices designed to prevent needle-stick injuries.

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A nurse is planning care for a client who requires insertion of a peripherally inserted central catheter (PICC) line. Which of the following actions should the nurse plan to take?

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