1. Describe the central line bundle and why it is used. (2 points)… 1. Describe the cent

1. Describe the central line bundle and why it is used. (2 points)… 1. Describe the central line bundle and why it is used.  (2 points)  2. As a new graduate, you are doing a complex dressing change on a patient with a chest wound. Your patient has a Hickman catheter and they are receiving antibiotics through that line.  As you are using your scissors during the chest wound dressing change you accidentally puncture one of the central lines with your scissors. (3 points)What is the priority? What is your initial action?How could have this been avoided? 3. Document a central line dressing change using the DAR format.  You may make up the details.  (2 points) 4. Sally, age 25, is admitted to the hospital with severe diarrhea and poor intake.  Her weight is 120 pounds currently (usually 132 pounds).  Other important assessment data include: BUN 40, Cr 1.3, K 3.2, Na 133, poor skin turgor, urine output 15 ml/hr, urine specific gravity 1.030, BP 120/82 supine, 92/68 standing, pulse 110 weak, regular.  (5 points)What percentage of body weight did she lose?   What concerns you about her lab values?  What nursing diagnoses are appropriate for her?   What IV fluids do you anticipate the MD to order?  What nursing interventions need to be implemented?    5. A nurse walks into a patient’s room and finds the IV solution container dry.  The bag of 1000ml of 5% dextrose and 0.9% sodium chloride had been hung 30 minutes earlier.  (2 points)What should the nurse do?  What concerns do you have about this situation?   6. Some hypertonic solutions are contraindicated in clients with cardiac and renal failure.  Why? (1 point)  7. Mr. Grinell is a 78 year-old admitted with renal insufficiency.  He has an order for NS 1 L every 12 hours.  (2 points)What size needle do you choose to insert?  What concern do you have about the IV fluid orders?     8. Obtain PCA orders from the instructor and practice setting the PCA pump with the instructor.  Answer the following questions.  (3 points)A client receiving a narcotic by PCA route has the following VS: BP 80/42, pulse 48, temp 97.0, resp 8, sats 82% on oxygen at 2 LPM.  Explain what is happening with this client.  What are the immediate actions required by the nurse?  The MD orders Naloxone (Narcan) 0.2 mg IV STAT.  Naloxone is available as 0.4 mg/ml.  How much will the nurse administer?  At what rate will the nurse push the med? By what other routes (other than IV) can Naloxone be given?  What is the desired response after Naloxone administration? What are some of the undesirable effects of Naloxone administration?    9. Over a 10-hour period, a pediatric client was inadvertently given 500 ml 5% Sodium Chloride instead of 5% Dextrose in Water.  The client developed convulsions and coma.  (3 points)Compare the tonicity of the 2 solutions mentioned in the scenario.  What are the legal aspects of this case?  What safeguards can be used for pediatric clients?    10. A client has a unit of RBCs infusing now with 150 ml left in bag, which was started prior to your shift.  When assessing the infusion, you notice a hole at the top of the bag. (4 points)What should you do?  What legal factors are of concern in this case?  What are the risks to the client?  What assessments should have been done prior to administering the blood?   11. A 40-year-old client is admitted with abdominal pain.  Currently he is 6 feet tall, 130 pounds and has lost 45 pounds over 3 months.  He is weak, pale, and has dry mucous membranes.  His abdomen is distended and firm.  He is diagnosed with pancreatitis and has orders for remaining NPO with TPN & lipids to be administered.  (2 points)What nursing care is involved with this client?  What are the nursing considerations for administering TPN?What potential complications is this client at risk for related to TPN?    12. Mrs. Johnson is a 60-year-old female who is one your unit following a total knee arthroplasty.  She has a history of allergy to penicillin.  Following surgery, there is an order for Ancef 2 g IVPB every 8 hours for 24 hours.  Her initial post-op vitals were: BP 136/84, pulse 88, respirations 12, and temp 98.8.  Thirty minutes after the Ancef was started, the client reports that she is “itchy all over” and has some shortness of breath.  You note facial edema and audible wheezes.  The client’s skin is red with large, swollen blotches over her chest, back and arms.  Her current vitals are: BP 118/78, pulse 108, and respirations 24.  Please use Iggy text.  (5 points)What specifically is the client experiencing?  What actions should you do next? What medications do you anticipate will be ordered?  What other symptoms may be present in this type of situation?  What complications could occur?    13. Mr. Westley is admitted with anemia due to chemotherapy treatments.  He weighs 200 pounds. He is to receive 2 units of whole blood today.  The doctor has ordered a type and cross match which has been completed and the lab notifies you that the blood is ready for the client.  The client is Type B positive.  Pre-transfusion vitals are: BP 116/76, respiratory rate 18, pulse 100, and temp 98.6.  The transfusion is started using Type A positive blood.  Within 25 minutes of starting the transfusion, the client complains of chest pain, is diaphoretic, and very anxious.  Vital signs are now: BP 94/58, pulse 136, temp 98.2 and respiratory rate 28.  Please use Iggy text.  (7 points)What specifically is the client experiencing?  Why is it occurring?What should you do initially?  What medications do you anticipate will be ordered for this client?  If the doctor orders Dopamine infusion of 5 mcg/Kg/min and Dopamine is available as 400 mg/250 ml, at how many ml per hr. will you set the pump?  Round to nearest whole number.  What would be the purpose for the Dopamine?  What complications can occur in this situation?  How can this be prevented?    14. Describe at least 10 nursing considerations for administration of blood products.  (4 points) Health Science Science Nursing NUR 2115 Share QuestionEmailCopy link Comments (0)

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