A nurse is preparing to administer a hazardous IV medication to a client. Which of the following actions should the nurse take?

Wear gloves when handling the medication.

Administer the medication in a negative pressure room.

Administer the medication while wearing protective footwear.

Wear an N95 respiratory mask when administering the medication.

Answer and Explanation

The Correct Answer is A

A) Wear gloves when handling the medication: This is the correct action to take when preparing to administer a hazardous IV medication. Wearing gloves helps protect the nurse from direct contact with the medication, reducing the risk of exposure to potentially harmful substances.

B) Administer the medication in a negative pressure room: While some hazardous medications may require administration in a negative pressure room to prevent the spread of airborne contaminants, this is not a standard precaution for administering IV medications. Negative pressure rooms are typically used for airborne infection isolation rather than for medication administration.

C) Administer the medication while wearing protective footwear: While wearing appropriate footwear is important for general safety in healthcare settings, it is not specifically required for administering hazardous IV medications. Protective footwear may be necessary in certain situations, such as when handling biohazardous materials or when there is a risk of spills, but it is not directly related to IV medication administration.

D) Wear an N95 respiratory mask when administering the medication: While respiratory protection may be necessary when handling certain hazardous substances, such as those that produce airborne particles or aerosols, it is not typically required for administering IV medications. N95 masks are primarily used for respiratory protection in situations where there is a risk of inhaling airborne contaminants, such as infectious agents or hazardous chemicals.

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Correct Answer is B

Explanation

A) Instruct the ’lient that their central line dressing must be changed every 24 hr: While it's essential to maintain proper hygiene a’d care for a central line to prevent infection, changing the dressing every 24 hours may not be necessary. The frequency of dressing changes depends on institutional policies and the client's condition. Providing accurate informat’on about dressing changes based on specific guidelines is important for the client's safety and the prevention of central l’ne-related infections.

B) Instruct the client to weigh themselves daily and record their weight: This is the correct instruction. Monitoring daily weight allows for the assessment of fluid status and the effectiveness of TPN therapy. Weight gain or loss can indicate fluid retention or depletion, respectively, which may necessitate adjustments to the TPN prescription. Recording daily weights provides valuable data for healthcare providers to evaluate the client's response to TPN and make appropriate m’difications to the treatment plan.

C) Instruct the client that one container of TPN may infuse for up to 72 hr: The duration of TPN administration varies depending on factors such as the client's nutritional needs, medical condition, ’nd the stability of the TPN solution. While some TPN solutions may be stable for up to 24-48 hours, infusing for 72 hours could increase the risk of contamination and compromise the integrity of the solution, leading to adverse effects. Providing accurate information about the duration of TPN infusion based on the specific prescription ensures the client's safety and the efficacy of therapy.

D’ Instruct the client to speed up the rate of their TPN infusion if it falls behind schedule: Altering the rate of TPN infusion without healthcare provider guidance can lead to complications such as hyperglycemia, electrolyte imbalances, or fluid overload. TPN infusion rates are carefully prescribed based on the client's nutritional needs and metabolic status’ If the infusion falls behind schedule, it's essential for the client to contact th’ir healthcare provider for guidance on adjusting the infusion rate or managing any potential issues.

A. Distended neck veins B. Elevated hematocrit level C. Shortness of breath D. Weight gain

Correct Answer is B

Explanation

Distended neck veins: Distended neck veins are typically associated with fluid volume excess rather than deficit. In heart failure, venous congestion can cause jugular venous distention, indicating fluid volume overload rather than deficit. Therefore, this finding would not suggest fluid volume deficit in a client with heart failure receiving furosemide.
B) Elevated hematocrit level: Fluid volume deficit, also known as dehydration or hypovolemia, is characterized by a loss of both water and electrolytes from the body, leading to a relative increase in the concentration of red blood cells and other blood components. This increase in concentration results in an elevated hematocrit level, which is a common laboratory finding in clients with fluid volume deficit. Furosemide, a loop diuretic, is commonly used to manage fluid overload in clients with heart failure by promoting diuresis and reducing excess fluid retention. However, excessive diuresis with furosemide can lead to fluid volume deficit if not adequately monitored and managed.

C) Shortness of breath: Shortness of breath is a common symptom of heart failure, particularly when fluid accumulates in the lungs (pulmonary edema) due to fluid volume overload. While shortness of breath may be present in both fluid volume deficit and excess, it is more commonly associated with fluid volume overload in clients with heart failure.

D) Weight gain: Weight gain is indicative of fluid volume excess rather than deficit. In heart failure, weight gain often occurs due to fluid retention, reflecting an increase in total body water and extracellular fluid volume. Monitoring weight is essential in managing heart failure and assessing fluid status, but weight gain would not suggest fluid volume deficit in a client receiving furosemide for heart failure management.

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