The nurse assesses erythema, warmth, and burning pain along the patient's IV site. Which complication is this patient most likely experiencing?
a. Air embolism
b. Extravasation
c. Phlebitis
d. Pulmonary edema
ANS: C
Erythema, warmth, and tenderness along the course of the vein and swelling are signs of phlebitis. Air embolism occurs as a result of an air bubble entering the vascular system, and shortness of breath, chest pain, and hypotension are indicative of this complication. Extravasation is the leakage of an irritant and is accompanied by redness, warmth or coolness, swelling, and a dull ache to severe pain at the venipuncture site. Pulmonary edema is caused by fluid infusing too rapidly; dyspnea, cough, anxiety, rales, and possible cardiac dysrhythmias are indicative of pulmonary edema.
You might also like to view...
Which nursing advocate worked to encourage respect for cultural diversity and was America's first African American professional nurse?
a. Lavinia Dock c. Adelaide Nutting b. Mary Mahoney d. Linda Richards
The client is having a nonstress test the next day. Which instruction should the nurse give to the client?
1. "Be sure to come in with a full bladder." 2. "Remember not to eat anything before the test." 3. "You will feel some contractions during the test." 4. "The test should last no longer than 30 minutes."
An experienced delegator is mentoring a newly appointed nurse in the hospital. The new nurse states, "I am hesitant to delegate tasks to unlicensed assistive personnel (UAP) because I am afraid they will not be done correctly." Which response by the exper
A) Tell her not to delegate any tasks unless she is completely confident. B) Tell her to clearly identify the task and expectations and then to monitor the delegate's progress. C) Tell her that delegation often results in a decrease in job satisfaction. D) Tell her that her job responsibility requires that she do everything herself.
Which of the following would be considered to be a system barrier to the birth of prenatal care?
a. Adolescent pregnant client b. Inability to schedule an appointment with the health care provider because of a busy medical practice c. Pregnant client has no health insurance d. Having to sign in for the initial appointment and complete health history records