Physiological Integrity

The healthcare provider has prescribed an intermittent intravenous (IV) infusion of potassium chloride for a client experiencing severe hypokalemia. Which of the following safety measures must the registered nurse implement? Select all that apply.

A nurse is preparing to administer a prescribed intravenous (IV) push medication through a client's existing continuous IV fluid infusion. Which action should the nurse take first to ensure client safety?

A nurse is reviewing the medication administration record for a client admitted with a severe lower respiratory tract infection. The client is scheduled to receive a newly prescribed dose of intravenous (IV) ceftriaxone. During the pre-administration assessment, the nurse notes that the client has a documented allergy to amoxicillin, with the reaction listed as anaphylactic shock. Which of the following actions is the priority for the nurse?

A nurse is caring for a client who is actively experiencing status epilepticus. The healthcare provider prescribes phenytoin IV push. The client has an existing continuous peripheral IV infusion of 5% dextrose in water (D5W) infusing at 100 mL/hr. Which action should the nurse take?

A nurse is caring for a client in septic shock who is receiving a continuous intravenous (IV) infusion of norepinephrine through a dedicated single-lumen peripherally inserted central catheter (PICC). The client's current blood pressure is 86/48 mmHg. The healthcare provider prescribes pantoprazole 40 mg IV push daily. Which action should the nurse take first?

A nurse is preparing to administer 2 mg of intravenous morphine sulfate to a client experiencing acute postoperative pain. The medication is supplied in a glass ampule containing 4 mg/mL. Arrange the following steps for preparing this medication from the ampule in the correct chronological order.

A nurse is teaching a client who has a casted right tibia fracture and is strictly non-weight-bearing on the right leg how to ascend stairs using axillary crutches. Arrange the following instructions in the exact chronological order the nurse should teach the client to perform them.

A client with diabetes mellitus is prescribed a morning dose of 10 units of regular insulin and 20 units of NPH insulin. The nurse will mix both insulins in a single syringe. In what order should the nurse perform the following actions? Arrange the steps in the correct chronological sequence from first to last.

A client is admitted to the intensive care unit recovering from a severe gastrointestinal hemorrhage. The client has a double-lumen peripherally inserted central catheter (PICC). Lumen one is dedicated to a continuous infusion of total parenteral nutrition (TPN). Lumen two is infusing a continuous IV drip of pantoprazole. The client suddenly reports severe dizziness. The cardiac monitor displays sinus bradycardia at 32 beats/min, and the client's blood pressure drops to 76/40 mmHg. The healthcare provider orders atropine 1 mg IV push STAT. The client does not have a patent peripheral IV line. Which of the following is the most appropriate nursing action to administer the medication?

An adult client on the medical-surgical unit is 15 minutes into a packed red blood cell (PRBC) transfusion. The client suddenly reports severe lower back pain, shortness of breath, and chills. The client's temperature has spiked to 38.9°C (102.0°F). Arrange the following nursing interventions in the correct chronological sequence to manage this acute event.

A nurse is caring for a postoperative client who is currently receiving a continuous transfusion of packed red blood cells through a 20-gauge peripheral intravenous (IV) catheter. The client reports sudden, severe incisional pain rated 9 on a 0-to-10 pain scale. The healthcare provider has prescribed as-needed intravenous push hydromorphone for severe pain. Which action should the nurse take next?

A nurse is caring for a client with a pulmonary embolism who requires a continuous IV infusion of heparin. The client's weight is $176\text{ lbs}$. The healthcare provider prescribes heparin at a rate of $18\text{ units/kg/hr}$. The available medication is heparin sodium $25,000\text{ units}$ in $250\text{ mL}$ of $0.9\%$ sodium chloride. What rate should the nurse program into the infusion pump in $\text{mL/hr}$? Record your answer using one decimal place.

A nurse is caring for a client who is prescribed a continuous intravenous (IV) infusion of $1,000$ mL of $0.9\%$ sodium chloride to infuse over $8$ hours. The nurse should set the IV infusion pump to deliver how many mL/hr? (Record answer as a whole number. Do not use a trailing zero.)

An intensive care nurse is preparing to initiate a continuous intravenous infusion of milrinone for a client experiencing cardiogenic shock.

The client's admission weight is $80$ kg. The prescribed dose is $0.5$ mcg/kg/min. The pharmacy has provided a premixed bag containing $20$ mg of milrinone in $100$ mL of $5\%$ dextrose in water ($D_5W$).

Calculate the required infusion pump setting in mL/hr. (Record your answer as a whole number).

An oncology client arrives at the outpatient infusion clinic to receive an intravenous antibiotic. The client has an implanted central venous access device (port) that is currently de-accessed. Place the nursing actions for accessing and preparing the port in the correct chronological sequence.

A client with advanced cancer has a single-lumen peripherally inserted central catheter (PICC). A primary infusion of 0.9% sodium chloride is running at 50 mL/hr, and a continuous infusion of hydromorphone for severe, intractable pain is connected via a Y-site to the primary line. The nurse needs to administer a scheduled dose of intravenous vancomycin over 90 minutes. A drug reference indicates that vancomycin is physically incompatible with hydromorphone. Which of the following is the most appropriate nursing action?

A pediatric client is prescribed ibuprofen $200$ mg by mouth for a fever. The pharmacy dispenses an ibuprofen oral suspension labeled $100$ mg/$5$ mL. How many milliliters will the nurse administer to the client for this single dose?

A nurse is preparing to administer a scheduled dose of intravenous phenytoin to a client with a seizure disorder. The client has a single peripheral intravenous line with a continuous infusion of 5% dextrose in water (D5W) infusing at 75 mL/hr. Based on the safe administration guidelines for this medication, which action should the nurse take?

A client admitted with cardiogenic shock requires hemodynamic support. The healthcare provider prescribes a continuous intravenous infusion of dobutamine at $2.7$ mcg/kg/min. The client's most recent weight is $209$ lbs. The pharmacy dispenses a premixed IV bag containing dobutamine $500$ mg in $250$ mL of $5\%$ dextrose in water. Calculate the appropriate infusion pump rate in mL/hr. (Round the final answer to the nearest tenth.)

A nurse is caring for a client with acute decompensated heart failure and atrial fibrillation. The client has a double-lumen central venous catheter (CVC) with the following continuous infusions:

* Lumen 1: Dobutamine at $10 \text{ mcg/kg/min}$
* Lumen 2: Heparin at $1,200 \text{ units/hr}$

The client develops sudden, severe dyspnea and crackles bilaterally. The provider prescribes furosemide $40 \text{ mg}$ IV push STAT. The client does not have peripheral intravenous access. Which action by the nurse is the most appropriate method to administer the furosemide?