The nurse is preparing a continuous intravenous (IV) infusion at the medication cart. As the nurse goes to insert the spike end of the IV tubing into the IV bag, the tubing drops and the spike end hits the top of the medication cart. The nurse should take which action?

Choice A reason: A drop factor of 10 gtts/mL is typical for macrodrip tubing, used for rapid fluid administration in adults. It delivers larger drops, requiring fewer drops per milliliter, unsuitable for microdrop tubing, which is designed for precise, smaller-volume infusions, such as in pediatrics or critical care settings.
Choice B reason: A drop factor of 15 gtts/mL is also associated with macrodrip tubing, used for standard IV infusions in adults. It delivers larger drops than microdrop tubing, making it inappropriate for situations requiring precise control of small fluid volumes, such as in neonatal or critical care scenarios.
Choice C reason: Microdrop tubing has a drop factor of 60 gtts/mL, delivering smaller drops for precise fluid administration. This is critical in pediatrics or when administering small volumes of medication, ensuring accurate dosing and minimizing fluid overload risks in sensitive populations.
Choice D reason: A drop factor of 20 gtts/mL is used in some macrodrip sets, not microdrop tubing. It is designed for general adult infusions, delivering larger drops than microdrop tubing, which is unsuitable for precise, low-volume fluid administration required in specialized settings like pediatrics.

Choice A reason: Checking contraindications (e.g., mastectomy, lymphedema, or fistula) prevents complications like infection or swelling. Using an inappropriate extremity risks impaired lymphatic or vascular function, compromising patient safety during IV therapy.
Choice B reason: Starting distally and moving proximally is standard to preserve proximal veins for future use. Starting proximally may limit future access sites, increasing the risk of complications if distal veins are compromised.
Choice C reason: A vein with minimal curvature reduces the risk of catheter kinking or vessel trauma. Straight veins allow smoother catheter advancement, ensuring stable IV access and minimizing infiltration or dislodgement risks.
Choice D reason: Choosing the dominant arm is not standard, as it may limit patient mobility. The non-dominant arm is preferred unless contraindicated, to enhance comfort and reduce disruption during daily activities.
Choice E reason: Avoiding areas of flexion (e.g., elbow) prevents catheter dislodgement or kinking due to movement. Stable sites like the forearm ensure reliable IV access, reducing infiltration and improving therapy effectiveness.